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; s�3'78°-°°2° Cifjr of Zephyrhills Permit Application Fax-8'!3- - <br /> . ' Building Department 1�•a��� <br /> �`Qate Received . <br /> Phane Contact for Permitting - <br /> �r's Name Owner Phone Number � _ �,5 � <br /> ._. .....� <br /> Owner's Address k ba • `' }'(.Sfic� j G.�.S Owner Phone Number <br /> Fee Simpie Titlehalder Narr�e Owner Phone Number �� � <br /> Fee Simpte Titlehalder Address � <br /> JOB ADDRESS y.�'t1� ' � 2�.'�} .S LOT# E_..L_.._� <br /> SUBDIVISiON ��(t1��J,A,1Za �%!�f�,g� PARGEL tD# � � t� - (;�()�4• j� t�� <br /> .�7. -J ^ . <br /> (qBTAINEp FROM PROPERTY TAX NOTICE) <br /> WORK PROPQSED e NEW GONSTR � ADDlRLT � StGN � MOVE � QEMQLiSH <br /> tNSTALL REPAIR <br /> PROPOSED USE Q SFR 0 CQMM Q 07HER C-Q <br /> TYPE OF CONSTRUCTION Q BLCICK Q FRAME � STEEL Q'` OTMER <br /> DESCRIPTION OF WORK � e 3S �. 3� �� J , ! <br /> BU3LDlNG SiZE ��� SQ FOCiTAGE � HEIGHT ��_� <br /> �� BUILDtNG � VALUATI4N OF TOTAE.GOhlSTRUCTiON <br /> ��,�..1.�5�`I_._� <br /> � ELEGTRICAL � � RMP SERVICE � PftO�RESS ENERGY Q W.R.E.C. <br /> � <br /> �� PLUMQING �$ �� <br /> � <br /> 0 MECHANlGAL �$ � VALUATlON d�NiECHAi�1CA�lNSTALLATION <br /> � <br /> � GAS Q� ROOFING � SPEGIALTY � O7HER _ <br /> FINISHED FLOOR ELEVATIONS � FLt70D ZONE AREA QYES QNO I <br /> � � <br /> NW� <br /> 8Utl.DER COMPANY �i 1�� Ui�G� �(�t��'l.1c�,t-.��.�- �31 c � <br /> {�,_ <br /> SIGNATURE ,.�- REGISTERED / N FEE CURR�NT T�N � I <br /> Address j�'JR�� (,,,�� �) �Q � �) ,�j 3 License# �(.(,, �3�„'jv;�'Z �� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGIS7ERED Y/ N ; FEE CURRENT Y/N <br /> Address License# � � <br /> PLUMBER ' COMPANY <br /> SIGNATURE REGISTERED Y! N � FEECURRENT Y!N <br /> Address License# �� � <br /> "�ECHANICAL COMPANY <br /> 3NATURE REGlSTERED Y� N FEE CURftENT Y!N <br /> Address _ License# �T I <br /> QTHER � COMPANY <br /> SiGi�iaTURc S:EGlS','CR�Y Y/ I`! FEE GURR�NT Y/N <br /> Address - `L'icense# � � <br /> a <br /> �'i2ESIDENTIAL Attach(2)-Plot-Plans;(2)sets of Building Plans;(1)set of kneryy Forms I <br /> Minimum ten(16)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&�1 d"umpsier � `" <br /> COMMERCtAL Attach{3}sefs af Building Pians;(1}set af Energy Forrns. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construc#ion Plans,Sanitary Facilities&1 dumpster <br /> Ail commerciaf requirements must meet compliance. ` <br /> SiGN PERMIT Attach(2}sets of Engineered Plans. <br /> ' ****PROPERTY SURVEY required for all NEW construc#ion. ' <br /> �:3 <br /> rections: <br /> Fill aut application completely. <br /> Owner&Gontractor sign back of application,notarized <br /> If aver$2500,a Natice of Commencement is raqufred. (AIC upgrades over$5000) <br /> " Agent{for the contractor}or Power af Attorney(for the owner}would be someone with na#acized letter from owner authorizing same � <br /> QVER THE COUNTER PERMITTING (Front of Application Only) ' <br /> Rerqofs Sewers Service Upgrades AtG Fences{PloUSurvey/Faotage} <br /> Driveways-Not over CouMer if on public raadways..needs ROW - <br />