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813-780-0020 City of Zephy�hills Fermit Application Fax-813-780-0021 <br /> �— 8uilding Qepertment � <br /> C; - � _. <br /> Date Recelved phone Contact tor Peimiltln - ��� <br /> T <br /> 1� <br /> Owner'sName OvunerPhoneNum6er ��J C4a��',7cv� <br /> , ..... _ <br /> Owner's Addcess _� � �.��� Owner Phaae Hnmber �..-� � <br /> a�s 1a,�. }... <br /> - . . .. <br /> Fee Simple Tlpeholder Name Owner Pfione Numb2r � _ ..�� <br /> Fee Slmple Tllleholder Addresa . _ .,,„_ , <br /> . . <br /> d08 AbORESS �` 1' i 5. . . i � �OT# �� <br /> .. . <br />'� . ... . ._ . . . <br />� . SUBpIVlSION �� . . � PARCEi.lD1! . :ev( � ' — .,' " -""f� <br />' {08TAIttED FRQAt PftOPERTY SAX NOTICE) <br /> WORK PROPOSED e NEW coN5TR Q ADD/AL.T � SIGN C] Q DEMOLISH <br /> INSTALL U REPAIR <br /> .. - <br /> FROPOSED U$E Q SFR Q COMM �� OTNER " <br /> TYPE OF CONSTRUCTION Q BLOCK Q � STEEL Q <br /> FRAME ". <br /> DESCRtPRON OF WQRK . ,;,�}. <br /> SUlLOfNG S12E �� S4 F047Af+E�� tiEiGtiT �� <br /> .. . <br /> I <br /> � _ . . . .. . .._ . .. , . .. . , <br /> . .. . . _ .. <br /> QBUILDING �� VAL.UATION OF TOTA4 CONSTRUGTION � <br /> QELEC7RICAL �� AMP SERVICE Q pROGRESS ENERGY Q W.R.E,C. <br /> QPEi1MBIN6 �� I <br /> �MECNANICAI $� �y (�� VAlUAT10N OF MECHANIGAL 1NSSAlLATiON _�� �� � � <br /> ���r �� ( � <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISNED FIOOR EI�VAiIQNS �� FIOOD ZONE AF2EA QYES NO <br /> -a-1-i-�H:.E-1-L�I-i=N�hi=L�-p�`+'+'�-�b�i-1=�4�f=1-f�l-i�='.�.'.-'�".;:.'. '-rr:�=`.-C-C�'.'.-R1=1�i=�4�1.i�.�-L.i-1-i-1-:=i�:�'.�: <br /> ... .... .. . . <br /> � . . , _ ... <br /> BUILUER COMPANY " <br /> .. ......_. . ...� <br /> , SIQiNATURE .,. ._ . ... . .. . . . REOISTERECI Y/ N . FEE CURRE� Y/N .r <br /> `. <br /> . . -... . � .. . .. . ...... .. . .... .. _ .... _ <br /> . . . ._. . . .. . <br /> . Address Ucense# � <br /> .. ,.. ,. . . . . ._ .; .. _ <br /> ELECTRICIAN � � �COMPANY � <br /> SIGNATi1RE R£GISTERED Y J N FEE tzURftE3. Y J N. <br /> . .- .. _ . . <br /> Address License# �'� u� <br /> . , _ <br /> . _ , _ � <br /> PI.UMBER � � COMPANY <br /> SIGNATURE REGISTERED Y/ N � FEE CURRE� Y/N. ' <br /> Address � .� �icense# � . � � <br /> :.... , <br /> .. ..... . . .. _ . ,.. _... <br /> MBGHANIGAL COMP.ANY /T'j�'"'��Lri .S�}`�!'J�C�S C��- Pr�SLO � <br /> SIGNATURE iiEGISTEREO �Y.I'N fEE CURREA Y I N <br /> Address � � � �� t�i���l�.S � � l.icense# !i/T(���Ish'7b . � <br /> QTHER COMFANY �— _. � <br /> SIGNATURE FtEGISTEREII _Y I N FEE QIIRRE� Y/N <br /> Address License#� <br /> Illlltlllllllll�llltllllllllllllllllllllllllllllllllllllllllllllllll <br /> RESidENTlAL Altach{2)Piot Plans;(2)sets of Buitding Pians;(t}sei of Energy Forms;f2-O-W Permit for new construcflon, <br /> Minimom ten(14}warking days afler'sabmittal date. Requtred onsite,Canstructlon Ptans,'Siorrnwater Plans w/Sfit Fence instalted; <br /> Sanitary FaclUUes 8 1 dumpster,Site Work Permil tor subdlvislonsliarge prajecls <br /> COMMERCIAL A(tach(2)complete sets of Building Plans plus.a Life Safely Page;{7)se(oF Energy Forms.R-O-W Pemtit tor new construcUon. <br /> Mlntmum ten{1a}working daps after submittal dafe. Requtred pnstfe,Construc!lari Ptans,StoRnwater Plans w!Silt Fence Enstaiied, <br /> Sanilary Faol�ille§d 7 dumpster.Site Woric Permit for ail new proJecis.All commerc(ai requiremenis musl meel compliance <br /> SIGN PERMIT All'ech(2)sets oF Engineered Plans: <br /> ""�"PROPERTY SURVEY requlred for alt NEW constructlon. <br /> ......._ <br /> �i..'.�:•F.:=•.�:::r,..r.�:..i�-'.�;-'e:'.: 3'�' C .-:��=i�/-•.=�=i%i�'�'-'rC�-i=l�i�t-i-i-i-�-S�i=rA`-'��:�:�i�'�i�'�'-''-'+�'.-}+�+- <br /> Dlreclions: <br /> ', F01 but appllcation complelely. <br /> I Owner&ConRraclar'sign back of appiicalfo�,notarized _ <br /> it over b2304.a NnHca at.Commencement is required. (AlC upgrades ovar$7500} <br /> �I "" Agenl(tor the cqnlraclor)or Power of Atlomey(tor the owner)would be someone with noterized letter from owner euthorizing saine <br /> OYER TNE GOUNTER PERMITTiNG {copy of contrect requtred) <br /> ' Reroois if shtngtas Sewers Service Upgrades R1C Fences(PIoUSurvaytFaatage) - <br /> �� Drlveways-Nol over Counler If oo pulalic roadways..needs ROW <br />