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i � e�3-7so-oazo City af Zephyrhills Permit Application Fax-813-780-0021 Bullding Department .� . ' J.- , " " Date Received /-f�,.,f/�, 3 � �""�� i fi LY Phane Gontact for Permitttn f 7TIT1'�7Tf�' . ,;:. : � Owner's Name � ' Z�/S�L� ls I'�"t"'fS � Owner Phone Number ` O S ""'�d�`�� r ' ,i / // ffSdQ�C j92 �F'Y�S1 � � Owner's A Idress �G.Qrhd' �JlsG�- �a� S�'� �"3�� Owner Phone Number � Fee Simple Titlehalder Name Owner Phone Number FeeSimpll TitleholderAddress JQs,aoa I,�SS 85 � �t er� al �,.1,.t`�tS �'�- 3�`1�-- �.oT� .�aZ-- SUBDI1tIS10N ��a�G'��C ��Z�S PARGEI.iD# -�� - �l- C��. � Q I}(.�I��!(a f C� (dBTAINED FROM PROPERTY TAX NOTICE) � WORK PRI POSEA , NEW COMSTR ADQIALT � S1GN Q Q DEMQLISH � � e iNSTALL � REPAIR PROPOSED USE Q SFR Q CQMM 0 OTHER � '1'YPE OF II ONSTRUCi'tON Q BLOCK Q FRAME � STEEL � DESCRtPTION OF WdRK Gl t t� LY l 7`! !L�'� 7`- C�)?tY�.°7� BUlLQlNG SIZE �� SQ FOOTAGE �! �I '�" HElGHT �-�� Tf'�1'�rii"'�Te�r�rl�f"1�i1�'e"t'I�IT1Ti"'ITI�s'k�1Ti"'TITiT1Trr!'7�"T1Tl�l�t�"C'11T1"r"l�s�{�i�c'1�iTiTi�i" , VALUATION OF TOTAL.CONSTRUCi'ION f ca��Q.Q UILDING $ '�;ELECTRICAL $ , AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. i 0��LUMBING $ � ��(� � l:J MECHANICAL $ VALUATION dF MECMANICAL INSTALLATION� � �� ;` � Y �� i � � QGAS Q ROOFING Q SPECtAL7Y � OTHER !� FINISt-tEDI F�04R E�EVR7IQNS �-� F�QOD 2L7NE Af2EA QYES NO j II -�-k-1--1-1-i�a-b-�1-E-F-1�-f-a-1-1-i-1-F-1-f-f-1-N-�1--1-I-i-I--F-i-f-1-�t-b-1-F-�1--E-1--F-1-I--f-I�-1-f-1-1-#-F-3-1-l-1-1-�i-f-�-1-a-f--f-1-�-�-1- J � ,��" ('�'/ `f_ i BUILDERI /�GLi4� i��y��y� � COMPANY L/C!!•f cJ T`l•LTZ' LfGh/Hu�� SIGNATURE � REGISTERED Y/ N FEE CURREN Y/N Addl�ess /S� j�r-� /�G'�� — 2�i/�l �� 3 a"ui- �icense# �/2G D��'�.5"17 ELECTRIGIAN j 1 _� �`�� COMPANY p_/ SIGNATURE U��J �� REGISTERED Y/ N FEE CURREN Y/N � Add ess License# � -� PltlMBE�� COMPANY �� SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Add��ss .�� License# �_ � � MECHAt�tCAt I�� /��.�.� �u GOMP�4[�iY �O�lersr!-�'��sa� ��C SIGNAT i RE REGISTERED Y I N F6E CURREN .Y I N Address �J�I �t2`° �t.- ��Cr ls� 3SY � License# �1�C(� El3��(! � � OTHER�) GOMPANY � SIGNATURE REGISTERED Y I N FEE CURREN Y/N ' II �Address Llcense� � I1111111111IlIlIM11111111 '9t1i11I111IlIlII1111AI111111I111I1 [ IItIAII RESIDE�TIAL Attach(2)Plot Flans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, � � � iVIlnEmum ten('10}warking days afEer sabmItta!date. Requfred onsite,Gonstructian Pians,Stormwater Ptans wt Siit Fence instaiied, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects COMMERGIAL Attach(3)complete sets of Building Plans plus a L.ife Safety Page;(1)set af Energy Forms.R-O-W Permit for new construction. Minimam fen(1 d}working days afEer submitEat date. Required ottsite,Ganstructian Plans,Stormwatsr Ptans w!SESt Fence instailed, �� 8anitary Faciiities&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Pians. "'**PRQPERTY SURVEY required far a11 NEW canstruction. -�4-i•.I{-1.-1-f-#.•1-4.{�f..�-i-1-f-1-f-1-1�--L-i..4.E.�1-I..i..l-�..1-1..1-{-1..�-W�1-I..I..f-f..l-f-i-�.-W-i-�-a-1-f-�-f-b.i-f-i-i-f.a•.le.l..l-h Directio s: , FiII out appliGatlon campletely. Owiner&Contractor sign back of appiication,nofarized , If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) •" Agent{for the contractor)ar Power of Attomey{for fhe owner}would be someone wifh no#arized tetter from owner authodzing same I OVER THE COUNTER PERMITTING (Front of Application Only) Reroafs�ii(shingles Sewers Service Upgrades AtC �ences{PlotiSurveyiFooiage) Drivoways-Not over Caunter if on public roadways..needs ROW � �