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i <br /> � <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Departmeni <br /> I � <br /> i Date Received Phone Contast for Parmittint�� � <br /> Tc--i-rrrr .... _ _ rr' ���r."r Tr-r.rrr-rr <br /> f ':�.:. +� <br /> � Owner's Name /l� /a/V Owner Pbone Number G7 �! � � ' <br /> � /111�}'�'��- G�j�+i�tu- Owner Phone Num6er � � <br /> � owner's Address <br /> I Fee Simple Titlaholdar Name �--i_�-- � Ownet Phone Number �._-^ � <br /> I <br /> Fee Simple TiUeholder Address <br /> I JOS AD6ftESS d LOT q � <br /> SUBDtViSf6tJ � � PARCEI.tA# <br /> i (OBTAME�PROM P.ROPERTY TAX NOT�CE) � ' <br /> WORK PROP45ED e NEW CONs7R� ADD/ALT � SIGN Q Q DEMqLISH - <br /> INSTALL REPAlF2 <br /> PROPOSED USE Q SFR Q COMM �J OTHER <br /> TYPE OFCONS7RUCTIQN Q BLOCK Q FRAME 0 STEEL Q <br /> DESGRIPTION OF WORK G �/(�N J G f��C�i�(J • <br /> BUI�diNG SIZE S4 FOOTAGE HEiCaN3 �� <br /> TI�ITTPiTTI'TrPI'.'1"1"�9'TI"1"1"1'.'7'�T�1:�Tr�"rTrP1"'ITr'1'.'1"'1TT9�PT�1"7�ITI�TTPTP`I"f� <br /> QBUILDING �� VAL.UATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL �� AMP SERVICE � PRqGRESS ENERGY Q W.R.E.C. <br /> QPLUMBiNG �� � � �1/!`7 ({ <br /> /�ir �E' 1 <br /> �MECHANlCA� $ ����J� VAGUATtON OF MECFtANICAL INSTALtAT10N <br /> OGAS Q ROOFING Q SPECIAL7Y � OTMER � ^� <br /> FINISHED FLOOR ELEVA7IORSS �� FLOOD ZONE AREA QYES NO ��l 1✓ <br /> -i-1-6-1-4-i.•L-�i-4-4.' '.-rrr.�.�•�.�r-.-.�'-1-.�4�f-�i-1-1-i-'�-.��F.i-4i-FI-�1-i.�F-.`-'r4.+-:-��E�.'w'-S-i-`r,'.-'��-:-.T,� <br /> BUILDER � � COMpANY � <br /> SIGNATURE REGISTERED Y�FEE CURiiE� Y/N � <br /> Address License# � � <br /> ELECTRICtAN � � COMFANY � <br /> SIGNATUAE REGISTERED Y I N FEE CURREh Y I N <br /> � Address License# � � <br /> PLUMBER � � COMPANY � <br /> SIGNATURE RECaIS7ERED Y/ N FEE CURRE� ' Y/N <br /> Address License# � � <br /> MECNANlCAI. �� � G6MPANY �_ �_, �Cl! _�L�C}� �`'y • <br /> SIGNATl3f2E REGIBTEREO L Y/ N PEE CURRE� Y!N <br /> I Address Q OO�C.�l,G(/���.r �3J��� License#f �,�i��l i�Y j� � <br /> ' OTHER COMPANY <br /> I SIGNATURE REGISTEREO Y( N FEE CURREA Y/N � <br /> � Address License# � � <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTiAt. Atfach(2)Ptot Pians;(2)sais of Building Pians;{t)set af Energy Forms;R-O-W Permit for new construction, <br /> tvtinimum ten{10}working days after submittat date. Required onsiie,Construction Ptans,Stormwater P{ans w!Silt Fence instalied, ' <br /> � I SaNtary Facililies 8 1 dumpster,Site Work Permil for subdivisionslla�ge projecls <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safery Page;(1j set of Energy Farms.R-O-W Permit for naw construction. <br /> � � Minimum ten(10)working deys after sebm�ttai date. Requlred�nsite,Construotion Plans.Stormwater Ptans wl Silt Fence installed, <br /> �i Sanitary Facililies 8 1 dumpster Sita Work Permit for alI new projects.AII cammerciai requirements must meet compilance <br /> � SIGN PERMIT Atlach(2)sels of Engineered Plans. <br /> E I ""PRQPER7Y SURVEY required for all NEW construction. <br /> -1-S-:-r�-�..::�6-e-E-:�-}-`r-'.-i3-'�'.-:-',�-S-;-r6-.�-......rr..-f-I--i-i-i-i�-I-�i-' .-. ...-.-.�-. `rC . t�• '�:-• '.-��:-� <br /> Directions: <br /> Fill oul application complelely <br /> � Owner&ConMactor sign back of application,notarizad <br /> tf ovar$2500,a Notica of Gommencemant is raqu3red. {AtC upgrades ove�$7566} <br /> I " Agent(for the conVactor)or Power of Attorney(for lhe owner)would be someone with notarized ietter from owner authorizing same <br /> I QVBR l'NE COUNTER PERMIi'TING (copy of cantract required} � <br /> Reroofs if shingies Sewers Service Upgrades PJG Fences{�IaUSurveytFaotage} <br /> Ipriyeways-Not over Counler if on public roadways..needs RpW I <br /> I ~ -- ' <br />