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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ' Building Department <br /> Date Received l 'p I� �13 ��a• _�Qq <br /> Phone Contact gor Permitting <br /> Owner's(dame �.Ju�eS `h �'e2.Q. ���I CI` Owrner Phone Number UJU� '��� � v��`�' <br /> Owner's Address W�0�� �-CC�J-�1'�'�'J � t T• �T T N�jOn ��wner Phone f�umber <br /> Fee Simple Tit eholder Name Owner Phone ftluenber <br /> Fee Simple Titleholder Address <br /> JOBADDRESS ��S �dV�r O'�• � �rl�I�S FI � 3 5y � LOT# �� <br /> SUBDIVISIOP� ��� �/,��C¢Q C l5l�-�OS PARCEL ID# �J S' �S'O�I 'D�� ' 6���—V�loO <br /> (OBTAIPIED FROM PROPERTY TAX PlOTICE) <br /> WORFC PROPOSED e fvEW CONSTR e� ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED UISE Q SFR Q COMM � OTHER <br /> TYPE'"OF CO�STRUCTIOPI 0 BLOCK • Q FRAME � STEEL Q <br /> DESCRIPTIO OF WORK Ql(� (P'�Gl�r S S UCUP S ��F I►m�e�l��C.Q � ��� ��i I PS <br /> � ,,u� a n IL�,{'�L��- <br /> BUILDIYVG SIZE SQ FOOT�a.GE ��� FiEIGHY U " <br /> �BUI I�DING $ r]���v �� VALUATION'OF TOTAL CONSTRUCTION <br /> / <br /> DEL CTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> f �� I_ C/ <br /> �PL MBING $ ' f��� D �!1 J <br /> �' 1 <br /> �ME��HANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � /���� <br /> QGAII Q ROOFING Q SPECIALTY � OTHER f J <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER COMP�,fdY <br /> SIGNAYURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRI.CIAN COMPARIY <br /> SIGPd;�TUItE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ticense# � <br /> PLUfVJBER. COMP�4PlY <br /> SIGM�4TURE REGISTERED Y�/ N FEE CURRE� Y/N <br /> Address License# <br /> NiECHA�iVICAI. � CONiPAP1Y <br /> SIGPJ�►TURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License.# <br /> OTHER� 'Ir ^� COi�PAiVY an Rao�n �G <br /> SIGIdATURE'� � � Q � (�t/Ol� REGISTERED Y/ N FEE C E� Y. N <br /> ,4adress�., (O 3 �� ,5� � �hIrII S- 33 S�/� �icense# C CC(,�j o"�J`�5d S <br /> RESIDEiVTIAL;; i4ttach�;(2j°Piot'Plans�(2):sets of�Building Plans;(1)seYof'Energy'Forms R-O-VV.Permit,for new.construction, <br /> , Minimum.ten„(;TO)workingrd'ays aftersubmittal•date. 'Required onsite,'Con'struction Plans,Stormwater Plans w/Silt Fence instalied, <br /> Sanitary.;Facilities:&�,1;.dumpste.r,Sife� .W.ork�Rermit for,sutidi"visionsAarge projects. ` <br /> COiUiMERCIkL Attach(2)coriiplete"sets'of Builcling Plans plus a Life Safery Page;(1)set of Energy Forms.R-O-W Permitfor new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit foF�all new projects.All commercial requirements must meet compliance <br /> SIGM PERiVII�' Attach'(2)sets of:Engineered Rlans. <br /> II *""•PROPERTY SURVEY required for.ail.iVEW constcuction. <br /> Directions: .- �:. • <br /> Fill out a I plication completely. , <br /> Owner&�ConVactor sign back of ap lication,notarized - <br /> il P <br /> If over$3500,a idotice of Corromencement is required. (AIC upgrades over$7500) <br /> i <br /> '" Agent(fortfi�e cont�actor)•orPower of Attomey(for'the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE CIIOUPITER_;P,ERNiiTTING (copy.of contraet required) <br /> Reroofs if shi i gles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counterif'on,putilic roadways..n'eeds ROW '� t , _ _, _ <br /> � , i,. ,. , - " . , • �� - , , . <br /> d I __ ,. . , ;.. ' " , , ..- _, .. <br /> - - II -- - , � _ - <br />