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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-Od21 <br /> • Building Deparkment <br /> Date'�teceive�� f + (� ( �, <br /> 4, Phone Contact fcr Permitting ��� ���_ �`�' `� <br /> Owner's Namll r`�1��� S�Sb n �PSi VI i Owner Phone Number ��J �� � ��� " �-�� Z <br /> �E i �-y,J} / t,, 1� ( + �} �j <br /> 4' 7 T W ,5 7t--��'IG'y1 ,'�G� 1..����— W U/ ` � �-}-� iO � <br /> Owner's Addr,ess � S OwnerPhane Number <br /> II �Fee Simple 7ltleholder Name �_ � Owner Phone Number �! <br /> Fee Simple T��tleholder Address <br /> !� ��� <br /> JOBADDREIIS t2��� S� ��h,S ���'"1 LOT# <br /> susa�vrsioiv S�1.0� �` ��..(c5 paRc���a# �3— ��—�l— �!(�1�.— 6��?GC�—C7 �/{�. <br /> II �T�P,� G/\.!S Cj"�..E}V PH� � � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK RROPOSED NEw CONSTR ADDIA�T C� StGN Q Q DEMOt�tSN <br /> II � INSTALL 8 REPAIR <br /> PROPOSED USE o ��� o CONIM �� QTHER <br /> TYP.E'OF CO STRUCTION Q BLOCK • Q FRAME [�� STEEL Q <br /> DESCRIPTIO OF WORK ����`�'�' ���� � `S i n � <br /> BUILDING SIZE � � SQ FOOTAGE[,_,_,� HEtGH7 � ���� <br /> QBU��QING $ Z�-0� a�� VALUATiON OF TOTA!CONSTRUGTION ��������� <br /> � ' <br /> [�ELECTRtGAL $ AMP SERVICE Q PRO�RESS ENERGY � W.R.E.C. <br /> QPl,�M81NG $ <br /> II ��1 <br /> QM�CNANICA� $ VALUATlOtV QF MECHANICAL tNSTALIATIG}N �✓� <br /> OG�S Q ROOFING Q SPEGIAt.TY �� OTFiEE2 <br /> FINISHED FL�OOR ELEVATIQNS r�� FLOOD ZONE AREA [�YES NO <br /> � L <br /> �.- � 0�Y� c� <br /> BUILDER ��'(��7/1,� �� COMPANY <br /> SIGNATURE� � ��' REGISTEREp Y/ N FEE CURREI� Y/N <br /> Address License# <br /> , ELECTRICI�,N COMPANY � <br /> , SIGNA7UR� REGISTERED Y/ N FEE CURRE� , Y/IV <br /> � Address Cicense# �! � � <br /> PLUMBER. COMPANY <br /> SIGNATUR -REGISTERED Y�/ N- FEE CURRE� � Y'I N <br /> Addres� v � ' Lioense#`_� � <br /> . � , <br /> � MECHAPIIC�IL CQMPANY <br /> SIGNNITUR�` REGISTEREp +„ Y/ N FEE CURRE� Y/N <br /> � , <br /> Add'ress � '" L•icense# �� � , <br /> , II. � <br /> E <br /> or�rE���� � � ,� c,c►nn�i�`ir � - <br /> SIGNAT:URI=,. REGISTEREp , Y/.N , . FEE.CURRE�' . Y,/N <br /> � . i( - � , <br /> Addreist - - - " License# �— � <br /> i <br /> '.RESIDEidTiliAl..'�' Attacfi{2):Plof Rlans;`(2}sets of'Buitding�Ptans;{'t}set of�Esergy Forrrrs;R-O-W.Pemiit for new.construction, <br /> �� � ����a t �Minimum�ten.(>10)working�days after.�submittal:date. Requir'ed onsite,�Con'struction Plans,Stormwater Plans w/Silt Fence installed, _ <br /> Sanitary,Facifities.&�r1�.dumpster;Site:Wortc.Permit for:subdivisionsflarge projeats � <br /> :-...COMMERCItAL Attach=(2)`corripiete sets of 8uiiding Plans plus a L�fe Sa#ety Paga;(1},sef of Energy Forms.R-O-W Permii for new constructlon. -- - <br /> � Minimum ten(10)working days after submittal date. Required onsite,Gonstrucfion Plans,Stormwater Plans w/Silt Fence instailed; <br /> � Sani#ary Faci(ities&1 aumpster.8ite Work Permit for att new pro}ects.Ali cammerciat requirements�must s'neet-camplian��- - <br /> ' .SIGN PERIIfliT i4ttach(2)sets o.f:Engineered Plans... • ' � � � - � . � <br /> �� ""**PROPERTY SURVEY required for eII.NEW..construction. , f <br /> '�'Directioris:l � •,,�..,..� . _. , <br /> - Filfoufiapplication completely. <br /> . - t�rmec'&Cantcactor siga,back af apptication,nofarized = <br /> ; If ove II$2500,a Notice of Commencement is required. (AIC upgrades over$75qq) <br /> •*' Agent(fo'rEti'e�cont`ractar)or�Power of Attorriey{fbr'the oumer}would be sameone with notarized letter from owner authorizing same • � <br /> •-OVER;THE��COUNTER_PERMITTING (copy of contraat requlred) - <br /> ` Reroqfs if sringles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) � ' ` <br /> Drive��iays-Nat over Counter if an public roac�w�iys::needs`I�'OW"'^'�''•��w•�--- �--� '`i' '"""" �`�""'"`' �' """,'�' "" "°` '"" "� `` <br /> �� ;� .��i' :',sj:i�L`� .��.�y:_J..r.i - �� _�...."��fJ.i._.��r'�.`5.������,�;:7�i r <br /> �j � .. �,c`.h;i.}�`'..'•.,:}!;t�'!titRi;7i}• 't.i.%: . ..:t.. :s€t,`; ,,,. ' '°' i <br /> I ` ,. w . ;`�-.,Q' ;� ' ; ;.:'": c�,«; <br /> I ; i�..L'''a �-;9iili7:'.G�;�'i _ ' _c.1' � �:.'''- ' '- ai�`' .. . <br /> �` i'�d!!�-;: ;F ';:• �.-A'a ", 'j - r'f'�'i:� :Jrd✓i�'`-_.f„ . F'{f;.y" i <br /> ( ik.-F,, ,.�cs .c�",�s ,c.n-�I�fi�..'Ii�:/'i."n. ,•��:-, � �� 4. i,:�i.. � _'"_NF'il`-lifij���.,"t`r`.,. '. .... .»+'i � _ <br /> ;. �y "f..y.�:: <br /> a.umo�.�... �� _._..... �.�j ,..rx�r... r a .. .-. , v..u. « . �"' .._ . .. ... . <br /> II - .,:wa:,-i�cs,_r. . . <br />