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i . <br /> aTs-7� o-oazo . City of Zephyrhills Permit Applicatian Fax-8'l3-780-0021 <br /> � Building Department <br /> 1 <br /> i +'� . <br /> Date Received Phone Contact for Permitting — <br /> �Owner's Name �� �� �� Owner Phone Number <br /> Owner's Addr�ss c�f��/ y/�a��4 �/��+' Owner Phone Number �� � <br /> fee Simpte Tif eholder Name � � Owner Phone Number �— � <br /> Fee Simple TiUiefiolder Address <br /> i <br /> �asaoa��s; ���if� 7'/Z�GG-1�{' ��'�. �.a�r� C� <br /> sueQlv�s�aN �"G�,'�1� 1,�y�s���- 1 �aRc��1�� �S��- --t1 d�`,/`�l��llldl�--/3� <br /> ' (OBTAINED FROM PRdPERTY TAX NOTICE) <br /> WORK Pf24P��SED e , NEW CONSTR 8 ADDIA�T � SiGN Q Q DENIQLISN <br /> I �NSTALL REPAIR <br /> PRORQSED USE Q SFR Q COMM � OTFiER <br /> TYPE OF CO STRUCTION Q BLOCK - Q FRAME � STEEL Q <br /> dESCRtPTlO OF WORK KL` � �� �� � ,�//,/�I� j�Odi�.�"L �iY/��'"L� <br /> BUIE�diNG S[I E � � SQ FQO'TAGE HEICHT ��, � <br /> �BUII.DtNG $ " <br /> �S� VAi.UATIORt�OF`i'C}TA�CONSTRUCTI4N <br /> DEi.EI TRICAL $ AMP SERVICE Q 3'RQGRESS ENERGY 1N.R.E.C. <br /> � <br /> OPLUMBING $ <br /> ���{ <br /> �ME�HANICAL $ VAI.UATtON QF NI�GHANICAL lNSTALIATION �� � <br /> � ��� <br /> QGA� /��,/� ROOFING Q SPECIALTY � QTHER <br /> FINISHED FL�OR ELEVATIONS FLOQD ZONE AREA QYES NO <br /> BUII�DER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— —� <br /> EtECTRtCt COMPAF�Y <br /> SIGNATURE „ ,,, ' REGISTERED Y/ N FEE GURRE� Y/N <br /> Address License# �_ ' � <br /> PLl1MBER Ct?MPAFIY <br /> SIGPIATURE 'RBGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �� � <br /> MECHANICA[. COiVlAANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Aiidress� License# �_ �� <br /> OTHER' ' �.: COi�IPAAIY �j"�IYlN J(y!//�l� <br /> 1 <br /> SIGIVATURE. _ REGISTEREd Y/ N FEE CURRE� Y/N <br /> Address J��/I�- ��„J d��?1.�t�l� License# ���I�p�'L` � <br /> RESiDENTlAL` Attach{2}.Plot Ptans;(2}sets af'Building'Ptans;{1}set of Energy Forms;R-O-W Permit for new cons#ruction, <br /> ,i Minimum:ten•(10}working,days after submittal•date. Required onsite,Construction Plans,Starrnwater Plans w/Silt Fence installed, <br /> i Sanitary-Facilities 81,dumpster•;Site Work Permit for subdivisions/large projec#s <br /> COMMERClAd. Attach(2}cori�ple#e sets of Bu]Iding Plans plus a Life Safety Page;{9}set of Energy Forms.R-0.W Permlt for new canstrucfian: -- <br /> Minimum ten(10j working days after submittal date. Required onsite,Construction Plans,Starmwater Plans w/Silt Fence installed, <br /> i Sanitary Facilities&1 dumpster.Site Work Permit fo�all new projeats.All commerciat requirements must meet compfiance <br /> SIGPI PERMI I iRttach(2}sets of.Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> Dt�ections; � <br /> Fill out a plicaUon completely, <br /> Owner&Cantrackor sign back of application,notarized <br /> lf aver$t 500,a Natiae oi Commenceenent is required. {A!C upgrades over$T500) <br /> " Agent(fqrthe contractor�or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE C�OUNTER PERMiTTlNG (copy of contract required) <br /> Reroofs if shir�gles Sewers Service Upgrades AJC Fences(Plot/Survey/Footage) <br /> Drivewai s-t3ot over Caunter if an pubtic roadways..needs ROW <br /> I - <br /> i ' , <br /> I .- <br /> � <br />