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—_. <br /> i 813-780-0020 City of Zephyrhills Perrnit Application �ax-813-780-0021 <br /> � Building Department <br /> , � <br /> Da4_Raceived Phone Contact for Permitting � <br /> TI� (T rt —L�Z� <br /> ! Qwner'a Name _;"'� ♦ ►�_�����'�� Owner Phone Number -�£�' <br /> + -- � � <br /> � Owner's Address � � �, i � Owner Phane Number <br /> Eee Simple Titlehoider Name Ownar Phone Number �----�i� � <br /> I Fee Simpie Titiehoider Address <br /> I � <br /> I � <br /> J06 AOpRESS j � Z LOT# <br /> � ��� <br /> ; ,r+� <br /> Sl1BpIVISION PARCELlQt1 � ^(� t,J <br /> (qBTAINEDFftOMPROPERNTAI(llpTICEJ , <br /> ' WORK PROPOSED n NEW CONSTN 8 ADDIAL7 C� SIGN Q Q pEMOUSN <br /> Q INSTALL REPAIR <br /> PROpOSED USE Q SFR Q COtv1M C� OTNER <br /> 7YPE OF.CQNSTRUCTfON ' Q BlQCK Q FftAME � S'FEE! Q <br /> DESCRIPTfON QF WORK +���� lUG��/ � /rC/l� . �U°- �! � <br /> BUILpING SIZE �� SQ F.00liAGE C� iiE1GNT �!__�__� <br /> T��e"r-m�e�'tF-rTr�-e-rr-rrezr-it-rr.rr��r'F�r1�r"�7'r'mnme�s'-rT'rrr'ti�-. 1"r.r <br /> �BUILDWG G$ � VALUATION OF TOTAL CONSTRUC710N • <br /> �_ <br /> QELEGTRtCAI �6 � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING �� �rj�2 r <br /> .� J � <br /> �MECHANICAL $ ��"'jrjy q VALUATIQN qF MECHANICAL�NSTALGATION � �r <br /> �va✓ . <br /> QGAS Q ROOFING Q SpEC1ALTY � QTHER �/�� ' <br /> FINlSHEO FIOOR ELEVATiONS �� FLOOD ZONE AREA QYES NO <br /> -.1-1-i-i-{-�L-i�.�-L-1-{-.{..{-�..{-�..{.-{-�,-i=1-i-1-f-��1-1-t-1-4.i-S-i-1=i�-trL-i=4.l-t-I�i-R-i=i-�.�-{-F-i-i-i-l=i-i-i:i-l-i-i-{-I-i-'.-:- <br /> BUlIDER C4h'IPANY � u � <br /> ISIGNATURE � � ftECa1STERED Y� N � fEECURREh ' Y I SS. � <br /> Aildress Llcense# 4. 1 <br /> ELECTRICIAN � � COMPANY � <br /> StGNATURE � RECaISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> PlUNiBER COMEANY � � <br /> S(GNATURE � � ftEGISTERED Y J N FEE CURRE� Y/N � <br /> Address � LScense#� . I <br /> . .._.._ �.�.._ <br /> MECHANICA� COMPANY r[��r �� �I1 1'S C1-Y- !�H`.SCLJ� <br /> SIGNATURE REGISTERED Y! N FEEQURREA Y(N <br /> Address �„_,�.�1.�X.n-�� L ��� License# �JA �,J �� <br /> .�._, <br /> OTNER COMPANY <br /> SIGNASURE REGISTERED Y/ N FEE CURftE� �„Y I�— <br /> Addross Ucense#�� <br /> 111'lllllll111111l1111111lif111l11 { lIIIt111tflilti ! [ iii-iliilillillli <br /> RESIDENTIAL `Allach(2)Plol Plans;(2)sets ot BuOding Plens;{7)sat ot Energy Forms;R-O-W Permf4 tar nsw construction, ' <br /> Minlmum len(10)working days afler submitlal dale. Required onaite,ConstrucUon Plans,Stormwater plans w!Silt Fence 4nstalled, <br /> Senitary Facliilles 8 1 dumpster;Sile Work Permil For subdlVislona4arge projecls <br /> C6MMERCRAI Aitach(2}complete sets of BuitdEng Plans plus a tife Safety Page;(1)set oi Energy Forms.R-O-W Permfi(or new construclion. <br /> Minimum ien(10)workfng days atker submlttai date. Required qnsite,Coostruciion Plans,Stormwater Plans w/Silt Fence insiatled, <br /> $anilary Fac111Rles&1 dumpster Slte Work Permit for atl new projeds.Ait commercial requirements must meet compiiance <br /> SIGN FERMIT Atlach(2)seta of Engineered Plans. <br /> ""'PROPERTY SURVEY requlred(or all NEW conslruclfon. <br /> -i-i-�-i�C�.%ri-:�1.I�{'•i-M{•�-/-i-i-N=I-i-1-{-4-i-i=d-{-1-1�{«�{-�4-{�1.d-�.i.�-N-4.4{..1-i-•1-d�i-1�4-F=4-�-{-4•F�hl��-1�LF4- <br /> Dlrectlons: <br /> FIII out applicalion aomplately. <br /> Owner&Conlrector sign baok bf applicaUan,notarized <br /> It over 52540,a Notloe o(Commancement ls required. (AIC upgrad'es over$7500) <br /> •' Agent(For the conlractor)or Power of Attorney(for lhe owner)would be someone wflh noterizad leller(rom owner suthorizing same <br /> � OVER THE COUNTER PERMITTlNG {copy ot conirac!cequired) <br /> Reroofs li shingles Sewers Service Upgredes A!C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counie'r if on public roadways..needs ROW <br />