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873-780-0020 City af Zephyrhills Permit Application Fax 813-780.oaz� <br /> Building Qepartrrsent <br /> yT� <br /> Date Received Phane•Contact for PermlttFn _ .,.,`L'�31 t,�� . - �b�� - <br /> Owner'�Plame � L l.T c,,1 U� �1 tV Owi►er.Ptibne Nunsbec ��.�,.-- Lf'�� � ���� <br /> Owner's Address ��b �,. 1` OwnarPh�one Numher�~ �— � <br /> � � <br /> Fee Simple Titleholder Nama �� �� Owner Phone Number I <br /> Fee Simple Titleholder Address a <br /> JOB ADDRESS `� � (7��' S� LOT#' �� <br /> SUBDIViS10N �— � PARCEL tD# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED �NEW CONSTR ADDIALT � S1GN Q [� pEMOI.ISH <br /> INSTALL 8 REPAIR <br /> PROP05ED USE Q SFR � COMM �] QTtiE}2 <br /> TYPE OF CONSTRUC710N Q BLOCK ' [] FRAME � STEEL C] ! <br /> DESCRIPTiON OF WORK , �, Z, ,r P f p%z�'" �i} Cj��7"'J `S �-e/" �`..� . C , � . i <br /> BUIl.C11NG SIZE <br /> � � SGt FOOTAGE C� HEIGHT ��� ���.�T� �r�'.S�P�/, I <br /> QSt11�DING � � �.�-�...,._. � <br /> VALUATION i'JF TOTAL COIVSI'R1ICTION <br /> `�EI.ECTRiCAI. $ �,� � AMP SEt2VICE Q PROGRESS ENERGY Q V1t.R.E.C. <br /> 7' OG'7, DD <br /> �P1UMBiNG � � �f � t�� <br /> f � <br /> QMECNANICAL $ VALUATEON OF MEGHANICAl.INSTAI.LATJON <br /> �� �� <br /> QGAS Q ROOFING Q SPECIALTY C� OTHER <br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZQNE AREA QYES NO <br /> BUICDER COMPANY <br /> SIGNATURE REGI$7ERED Y/ N PEE CURRE� Y/N <br /> Address License# � � <br /> ELECTRICIAN �� /�� COIVIPANY {'2 S��N e e � , � ' � ��• <br /> 31GNATURE G'(/!e''� REGISTERED Y/ N FEE CURRE� Y/N <br /> � <br /> , Addrsss � i M ��j� Z. � S o1 a -11 - License# �C ,���o`"7�Z Z � <br /> PLUMBER COMPANY <br /> SIGNATURE ;REGISTERED Y/ N FEE CURRE� Y/N <br /> ���� License# � � <br /> ( MECttANICAL COINtPANY <br /> SIGNATURE REGISTERED Y:/ N FEE CURREP Y/�N <br /> Address License# � �� <br /> QTtiER COMPANY � <br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y-/�N <br /> Address � License# �^ � <br /> RES1dEN11At. Attach(2}Rlot•Plans;(2}se#s.of Bui#ding'Plans;{1)se#of Energy�Fo�ns;R-O�W PeTfnit for new.constnicfton, . <br /> Minimum.ken(10),working;daysafter."submittal date. Required onsite,Const'ruc8an Plans;�Stormwater Plans w/Silt Fence installed, _ _ <br /> Sanitary Facilities.&�1.:dumpster,5ite Woric;Rermlt for subdiyi"slansAarge projects � <br /> �CONIMERCiA1. Attach{3)comple,te sefs of Suitiiin'g'Plans plus a��ife Sa#ety Page;{1}set of Energy Forms.R-O-W Parmit#or new const�ucction. <br /> Minimum ten(10)working days after submittal date. Requi�ed onsite,ConstrucUan Plans,Stortnwater Plans w/�ilt Fence installed, <br /> Sanitary Faoilit(es&1 dumpster.Site Work Permit for all.ne`vu proJects.All commercial requirements must meet compUance <br /> SIGN PERMIT Attadi'{2}sets of Erigineered P�ans.:.. �� • <br /> ••"•PROPERTY SURVEY reguired for all NEW constnaction. <br /> Dlrectlons: � <br /> Fill out applicatlon completely. <br /> Owner&Contraetor sign bacic of appitcarion,notarizet! <br /> If ovar 52508,a Notice of Commencement is required. (A!C upgrades ovar�T54A} , <br /> `" Agent(for the contractor)or Power of Attomey(for the avmer)wauld be someone with notarized letter from owner autharizing same <br /> DVER TFCE COUNTER PERMITTiFtG {Front af Appiicatian Only) <br /> Reroofs if shingles Sewers Service Upgrades-A/C �Fences(PIoUSurvey/Foatage) <br /> Drtveways-Not over Counter if an pubhc roadways..needs ROW <br />