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— <br /> : o <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-7$0-0021 <br /> Building Department <br /> Date Received .,,.-�_ .�. ._ _ __ __ phone Gontacf for Permittln f,3 �i� .�3��t " <br /> T1-R-1-I-Tf' <br /> Owner'sName t'�'C: -1GL !S� ''�-�(-C r"' C r� OwnerPhoneNumber ��- 29� '.37�J�' <br /> Owner's Address (.�7% ���"+'�N�����`- � "`'S� g�3,D Owner Phone Number � _ � <br /> � $� r} � � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> FeQ Simple Titleholder Address <br /> JOB ADDRESS �Sa �o� !�i!t C.u�s -�h i Il •...t_ 33 s`Ya- �oT� f la l� <br /> SUBDIVISlON �`l +�,� �Trt UR.+�S PARGEL 1D# �Y`•� G' � t- a�,�v -' ��✓�l� " �'fl(o � <br /> (OBTAIN�p FROM PROPERTY TAX NOTICE) <br /> WORK PROFOSED , NEW CON5TR ADD/ALT � SEGN Q Q DEMQLIS!-i <br /> e 1NSTALI. 8 REPAIR <br /> PI20POSED USE � SFR Q COMM �� Q7HER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCl�tPTtON 4F WORK jit!? �+ �'�� l'Q T! �t� C 13 h</�' Q(/�'a� �SC%S t <br /> BUILDIl+IG SlZE � � SG2 FOOTAGE 7�oZ � l HElGHT �,�� <br /> �f�il'�!T'R'7T1—r'"r1TTlTATl�t's�AT1�1Tl�='1rIT1"rlT1'��1�1"rl�l'TiT1�lT1�1"�"[Ti"rT1"11TrTe�iT2"tTt" <br /> QBUILDING $ � p�b� ��� VALUATIOII OF TO'fA�CONSTRUCTION <br /> b <br /> 'QELECTRICAL r6 � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> L <br /> QPLUMBING � � � ��� <br /> t�, <br /> ���t <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIQN � � � .� <br /> QGAS Q ROOFING Q SPEC�ALTY � QTHER � C <br /> � ( � �� <br /> FINIBHED FLOOE2 ELEVATi0I+1S FI.00D ZONE AftEA QYES !VO �� 1 <br /> -hi-f--1-W-1-6-H-1-1-H-1-W-1-1--1-f-f-1- 1--1-1-�H-H-1-1--I-hl--1-I-H-f-Ma--1�-�-1-H-1-H-H-f-f--h1--1�--h <br /> BUILDER ������ �-COMPANY �//t cS �� t LC H� /Iyf [!� <br /> SIGNATURE �� 0���+�''l/�"IiJ �� REGISTERED Y/ N FEE CURREN Y/N <br /> Address Gl��.s�� �`� Grk � �� �a 3.5� �-- License# ��V(v t� t 7 1 � <br /> E4ECTR(CIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURF2EN Y/N <br /> Address License# �^ � <br /> PL.UMBER � � COMPANY <br /> SIGNATURE � I REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# �_ � <br /> MEGHANICAL � � GO1tttPAt�1Y <br /> SIGNATURE � � REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# �� �� <br /> OTHER - � CQMPA4tY <br /> StGNATURE REGISTERED Y 1 N FEE CURREN Y I N <br /> Address License� �T �� <br /> IIIIIIIIMIII1111111111111 '111111I11M111111111MM1111111111M1111111111 <br /> FtESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit far new construction, � <br /> Niinimum ten{10}working days after submittaE date. Requ�red ansife,Gonstructton PIans,S#ormwafer Ptans wl Silt Fence insfalied, <br /> 3anitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERClAL Attach(3)complete sefs of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> �+linimum ten{'I O}working days after submiftai date. Required onsite,Gonstruction PIans,Sformwater PIans wl Silt Fence instalied, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> *"**PROf'ERTY SURVEY required for aH NEW aonstruction. <br /> -1-i-1--1-M�I.a-W•1-1-1-L-i..f�l�i�-�-{-i-1-i-f-{-i•-1-1-1-4�f�L-1..1-A..I.•f-W�i-1--L-i-{..f..f-i-f-E..f-i-t-M..{-I--1-I••i-•1-1..1-a-i-J-fe.l..f�l-. <br /> Directions: , <br /> Fi1i out appilcation complefely. <br /> Owner&Contractor sign back of application,notarized ' <br /> , If over$2500,a NotiCe of Commencement is required. (AIC upgrades over$7500) <br /> °* Agen#(far the confractar}or Power of Atfomey(for fhe owner)would be someone with natarized letter from owner aufhorizing same <br /> OVER THE COUN7'ER PERMITTINC (Front af Application Only) <br /> Reroafs if shingtes Sewers Servics Upgrades A!G Fences{PlotiSurveylFoatage} <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />