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` _ _T <br /> ' a��-��o-oa2o Cifiy of Zephyrhills Permit Applicatian Fax-813-760-0021 <br /> ' � 6uilding Department L��:� <br /> 1 <br /> Date Received Phone Contact for Perrnitting -- <br /> P I P A B ' <br /> �r`s Name '� Qwner Phone NumGer v' ; .� �$� <br /> �`'1 t;3 @c�c�t Ur � <br /> Owner's Address � •� � ,� Owner Phone Number i <br /> �� <br /> Fee Simple Titleholder Name ����� Owner Phone Number � ; <br /> � � <br /> � � <br /> Fee Simple Titleholder Address ' <br /> JOB ADDFtEISS ,5�'7 4.OT# J /1 � <br /> � <br /> SUBDIVISION � � PARCEL ID# �1-"2(,�- � -i c3 .�3• �St3t5- CS ,cl� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSEq NEW CONSTR ADD/ALT Q SiGN � MOVE O DEMOLISH , <br /> I e INSTALL � REPAIR <br /> PRQPOSED�USE Q SFR � CONfM �� OTNER �.—f� <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEI. Q OTHER � <br /> � � T t-' 'Tzs'-�a.•i <br /> DESCRIPTICIN OF WORK �� ; i ) . ` "�J� ' � , <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> ��„ �s <br /> �V� BUILDING � VALUATION OF T(JTAL CONSTRUCTION <br /> � E�ECTRICAL $ AMP SERVICE � PROGRESS ENERGY O W.R�E.G. <br /> � <br /> ��f PLUMDING , � � � <br /> � <br /> � [� MECHANICAL � � VALUATION OF MECHANICAL INSTALLATION <br /> � <br /> [� GAS �� ROOFING � SPECIALTY Q OTHER <br /> F1N(SHED��.OQR ELEVATIONS (� � FLOOD ZON�AREA .QYES QNO <br /> � <br /> �e���an�88ffiP�B s��m^�u�u��o p9a�oE a <br /> , ' BUII.DER � rA COMPANY ��I [J�i� �l u . 7 • _ ; <br /> StGNATURE � REC�ISTEftED I I�1 FEE Cti��7 Y N i • <br /> Addreis ��JR�� (.�� �! �4 Ct �� �v�?'��J License# �(,,,(f�, {?j� �v�2,,,, � <br /> ELEGTRIG�AN COMPANY <br /> SiGNATUR� R6GISTEREA Y 1 N FEE CURftEN7 Y/N ` <br /> Addr Iss License# � I <br /> PIUMEiEft� CC?MPANY <br /> SIGNATURE REGiSTEREa Y I N FE6 CURRENT Y 1 N <br /> Address License# �_ � <br /> ft�ECHANIGAL CC}MPANY <br /> iIVATURE REGISTERED Y/ N FEE GURRENl' Y I N <br /> - Address �.icense# �^ i I <br /> QTHER ,) COMPANY � <br /> 51ui3taTU�h'c RcGi�T�Sti^u Y I S`: FEE CURRENT Y J N E <br /> Address License# � � <br /> f@L'C7GUnGVNV �'�,.0�"�,I�I@am6�l%��B�V9flV9pyp p�CR98��921f�11� 9��'i@V� �' � � � d'OWl9d <br /> - RE�I�JE�iTl.4� A#tach{2�P1at Plans;{2)sets af 8ui!ding Plans;{1)sei of�nergy F�rms <br /> Minimum ten(10}working days after submittal date. Required onsite,Construcfion Plans,Sanitary Facitities&1 tiumpster <br /> COMMERCIAL Attach{3)sets of Building Plans;(1)set of Energy Forms. <br /> Minimum fen{10)warking days after submit#a(date. Required ansite,Gonstructian Plans,Sanitary FaciSities&1 dumpster <br /> ' All commercial requirements must meet compliance. <br /> SIGN PERMlT Attacl7{2)seks of Engineered Plans. � <br /> "`**PROPERTY SURVEY required for al!NEW canstruc#ion, , <br />' :"°4��BVtl9V➢VV " ° �� <br />� rections: <br /> Fill oiat a�piieation completely. <br /> Owner&Contractor sign back of application, notarized <br /> tf over$25Q0,a Notice of Gomme�cement is required. (AfG upgrades over$5000} <br /> *' Agent(for the contractor)or Pawer of Attorney(for the owner)would be someone with notarized letter from owner authorizing sams � <br /> OVER THE G4lltVTER PEE2M]T'('1NG {Fronf of A�plication Only} � <br /> Reroofs Sewers • Service Upgrades A/C Fences(Plot/SurveylFootage) <br /> Dr'sveways-Nat over Counter if on public roadways..needs ROW <br />