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s�saso-oozo City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Buiiding Department <br /> Date Recelv�d Phone Contact far Permtttin - � <br /> Owner's Mame � �� �� Owner Phone Nuniber <br /> Owners Address �(... � Q� Owner Phone Number � �� <br /> Fee Simple Titleholder Name �`J�5� ` � .� Owner Phane Number ��' � <br /> r <br /> Fee Simple Tltleholder Address �b ~ c� c�r -�� �L � <br /> JOBrADdRESS '....��' I�I (Z �1 v�� � �L 3.�-a 5 LOT# C� <br /> SUSpIViStON �� � PARCEL ID# I �- - � <br /> (OBTAINED FROM PROPERTY TAX NOTICE)� <br /> WORK PROP�SED NEW CONSTR ADD/At.T � SiGN [� Q pEMOt,ISii <br /> INSTALI. 8 REPAIR <br /> PR4PQSED.UBE � SFR �, COMM 0 pTNER <br /> TYPE OF CONSTRUGTION � BLOCK " [� FRAME [ ^] STEEL Q <br /> DESCRIP7'�ON OF WORK � �C.. j � �IG{, (�m� <br /> BUIIDtNG SIZE � � $Q fOOTAGE�� HEIGHT _____� <br /> ������1��'' � �d Q�� �� VALUATION OF TOTAL CONSTRUCTiON <br /> f <br /> QELECTftIGA� � � AMP SERVICE Q PROGRESS ENEFlGY Q W.R.E.C. <br /> QPl.UMBlNG �_� �_�[ <br /> -'`�"1 ` <br /> QMECHANICAI $ VALUAT[4N OF MECHANICAE INSTA�lAT10N }��� <br /> QGAS Q RQQFING. Q 3PECiAl.TY �� OTFiER <br /> FIfVISHED FLOOR ELEVATIQNS �-----r� FLOOD ZONE AREA QYE�u NO <br /> BUILDER ,� ����(� COMPAl�}lf c..�� ��; o,_ n ' n . <br /> SIGNA7URE � REGISTERED / N FEE CURRE� Y N <br /> Address � c }�- �L 3`Jla(o�' License# (,'(�C_.l 51 '-E �?,�'2... � <br /> E1.ECTltEC1AP! COMPANY <br /> SIGNATURE '' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# �� � <br /> PLUMB�R �111 COMPANY <br /> SIGNATURE __` REGISTERED Y/ N FEE CURRE� Y/N <br /> �d�s$ License# � � <br /> MECHANICAI. COMPAI�IY <br /> SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address �License# �— � � <br /> OTHER�- - - - -- - _ _ _ , ._ CQMPANY i � —� — �._—_.� <br /> SIGNATl7RE y� REGISTERED � Y/ N' FEE CURFtE� Y/N <br /> Address License# �� � - <br /> RESlDENTIAL. Attach(2}Fiat Plans;(2}sets af$tiilding'Plans;{1)set af Energy�Eorms;R-O-1N Permit iar new canstruction, <br /> Minimum ten(10)working days after subrrilttal date. Required onstte,CanstrucUon Plans;Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facil(des&1.dumpster 51te Work Permit for su6divisionsAarge proJects <br /> CQMMERCIAL. Attach{3}complete sets of Buitdirig'Ptans plus a Life Safety Page;(i)set of Energ}r For►ns.R Q-W Permit for new canstruction. <br /> Mlnienum ten(10)working days after submittat date. Required onsite,ConstrucUon Pians,Stormwater Plans w/Silt Fence installed, <br /> Santtary Facilities&1 dumpster.Site Work Permit for aU new projects.Al!commerclal requirements must meet compllance ;1 <br /> SlGN PERMIT Attach{2}sets of Englneered-Plans., <br /> ••*`PROPERTY SURVEY required for all NEW constructlon. <br /> DErectlons: <br /> FIII out applicadon completely. , <br /> Owner&Contra�tor sign back of applicatlon,notarized <br /> If aver y28Q0,a NoElae of Cammenasment is requEred. (AlC upgrades over S7SOQ) <br /> " Agent•(for the cantractor)or Power of Attomey(for the owner)would be someane with notarized letter from owner authorizing same <br /> DVER THE CQUNTER PERMiiTiNG (Front af Appitca#ion Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fe�ces(PIoUSurvey/Footage) <br /> Drivewa -No �s `�:: a, • .. ; _-`'. ' �:-�U�;;..:_'.:. s�.j,:��, "<,. _ <br /> ys tove�Countefi€an�public,roadways..aeedsROW _ _�;,,,a; ,. <br /> , ; .� n .� , .. . . =- ' f7 <<„�: � :., . . , . ':,c,i.;: • <br /> ,t;', �j' � �. � �. � , �i -- ",�.....:.,..'il' _, �_ � <br /> i -_ r � , � � , t': ' ' � f t'}i. .� �Y�Jv�� <br /> / <br />