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( � I <br /> * �� <br /> i � aia-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ( ' Bui(tlkng Department { <br /> � <br /> ;i � <br /> IDatQ Received ^ � phono Contact for Permttting �rT�'TT'C" _ I <br /> Owner's Namc, ���FQQ�r p�� ... r-��-r _ . --rt-rrr p Q / [�� <br /> �' /� GQ�`i�S Owner phone Number �13"0�O '�/�$T ' <br /> � ,t <br /> {7wners Address ��� +'(+�A i„ ��n �� Owner Phone Number �'- <br /> i ' <br /> ij FeQ Simple Titleholder Name f_^ � Owner Phone Number f'---_ � <br /> I <br /> Fee Simple Titleholder Address <br /> I <br /> � �oB aooR�ss �33t� u �n �on `�� �oT# �� � <br /> � <br /> � SUBDlVISlON S+�UCf d�i S PARCEL.ED� �J��¢"��^O(�L}-�t�DO"{� {1 � <br /> II iOBTAINE4 fROM PROPERTY TAX NOTtCE} � <br /> � WORK PROPOSED e NEw CON57R 8 ADD/ALT � SIGN Q Q DEMpLISH <br /> INSTALL REPAIR <br /> PROPOSE4 USE 0 SFR � COMM [� OTHER � <br /> I TYPE OF CONSTRUCTION �' BLOCK Q FRAME � STEEI. � i <br /> � DESCR�PTIONOFWORK ���'��A- �`"�'�Y++`�!� i�ipb�i� j7'�J�Jo(. p� j �(�� �j � <br /> BR11I�DlNG SIZE �- � SG2 FOQTACiE C� NEIt',HT �.__� � <br /> - r-�-r-r-rrrr-rm�-�-rrr- mm <br /> a <br /> �BUILDING �r���'6 O1 ✓..._.' VALUATION OF T07AL CONS7RUCTION � <br /> �ELECTRICAL �� AMP SERVICE � pROGRESS ENERGY Q W.R.E.C. <br /> I <br /> ( �PGUMBING �� <br /> �MECHANICAI. �-� VALUATION OF MECHANICALlNSTALLATION . ' <br /> �� <br /> � OGAS 0 ROOFING Q SPECIALTY �� p7HER <br /> iFINiSHED F1.00R El.EVATIONS �� �LdQO ZONE AREA �YES NO <br /> -I-i-4i-F1-i-i-'T' S-i-C-�'-S-'.-7-i�3-S�F�-i-i-5-'r-i�'-7�'-'�'-Fd-F-F-I�ba-4-i-.`--0-'r-''-:-'��G-i--0�F-S-��Fi-i.1�FJ-1-i- <br /> . ......��i <br /> BUILDER �j����.JY v" I COMPANY �2S'� �►�.��Wit1 (����'C'�'f`tc�024� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N I <br /> I <br /> aaa«ss �''i0t��ern �e e t4ce!�m e ec�ae FL 33C � Cicense# ��3�JSZS�jf�,a2 � j <br /> El.ECTRICIAN � � CQMPANY I <br /> SIGNATURE REG7S7EREQ Y 1 N FEE CURRER Y 1 N <br /> Address � � I License# `---` � _ <br /> PLUMBER � � CQMPANY � � ; <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �icense# � � _ ; <br /> MECHANICAL � � COMPANY � <br /> SIGNATURE REGISTERED _Y J N FEE CURREA Y J N f <br /> Address License# �-.--__.� � ; <br /> OTHER COMPANY � � <br /> SIGNATURE REGISTERED Y� N FEE CURRE� Y/N � <br /> Address License tF (---_-^'- � � <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItlllllllllllllllll i <br /> RESIDENTIAL, Attach{2)Plot Plans;{2)sets of Building Plans;{t}set of Energy Focros;R-4-W Permit for new construction, <br /> Minimum ten(10}working days after submittat date. Required onsite,Construction Plans,Stormwater Plans wt Silt Fence instailed, i <br /> Sanitary Facililies&1 dumpster;Sile Work Pe�mit for subdivisions/large projects <br /> CQMMERCIAL Attach(2)complele sets of Building Pians plus a Life Safety Page;�1)set of Energy Porms.R-Q-W Permit for new consWction. � <br /> Minimum ten{10)working days after submittai date_ Required onslte,Construction Plans,Stormwater Pians wt Siit Fence instalied. <br /> Sanitary Faciiities&t tlumpster Site Wark Permit for aiI new projects.Ati commerciai requirements must meet compiiance � <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'PROPERTY SURVEY required�or all NEW consVuction. <br /> � • , • • • I--Mi-i-1-J--L-i..R-i..c.i.• S-t.i-�-.I-� 4.i.i-i.a-S�.i..La- <br /> Di rections:, <br /> Fill out application completely <br /> , Owner&Contractor sign back of application,notarized <br /> If ove�$2540,a Notice of Commencement is required. {AtC upgrades over$7500) <br /> " Agent(tor the conlractor)or Power of Attomey(far the owner)would be someone with notarized letler from owner authorizing same ' <br /> OVER THE COUNTER PERMITTING (copy ot contract required} <br /> Reraafs if shingles Sewers Service Upgrades AIC �ences(PioUSurreytFootage} <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> � <br /> �i � - <br />