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� <br /> . <br /> E �� 913-780-OD20 City of Zephyrhills Permit Application Fax•$13-780-0021 <br /> � -�� Buitding Degactment <br /> �:.,, <br /> Date Received Phone Contact for Permittin S 1 ��^ -- � W <br /> Owner's Name I����� i-�-�- 4wner Phone Number <br /> Owner"s Address 5�� �nd�-I��°���� �l 4wner Pho�e Number C� � <br /> EeeSSinpfe.Tittelta[der Name �� � 4wner Phone Number � _ � <br /> Fee Simple TiUeholder Address <br /> JOBApDRESS ��`� i"'i�la ti�U t�.E � • kJt• �� Z LQT# � <br /> susQsvts�au 1'��1�"C�J�� paRca�ina �-"2,�'ZI-��-03�- C�1� <br /> (OHTNNED PROM PROPEA'fYTAXN6TtCEj <br /> WORK pROPOSED � NEW CONSTR� ApD/ALT 0 SION Q Q DEMOLISH <br /> tNSTALt E2EPAift <br /> PROPLISED t9SE � �FR � ��tJMNI � OTHER <br /> TYPE dF CONSTRUCTION �] @LOCK Q FRAME Q STEEL n <br /> UESCRIPTION OF WORK � <br /> BUILDING SiZE S4 FOOTAGE� HE1t3HT � <br /> �BUILDING $�,t21a.F.}-� VALUAT40N OF TOTAL CONSTRUCTION <br /> �—�.,,� _L„ 4 <br /> QELEC7RICAL $ AMP SERVICE Q PROGRESS E[lERGY Q; NI.R,E.C. <br /> ���` <br /> QPLUMBING ($ � <br /> �� <br /> QMECFiANIGAL �> � VALUATION C3F MECNANIGAL 1NSTALEAT30N <br /> QGAS � RpOFING Q SPECIALTY � OTHER <br /> FiNtSHED FLOOR ELEVATtONS �� FLOOD ZONE AREA DYES Rid <br /> BUIL�ER c�(�����f(�� �/� � COMPAfdY 1"GL,V�/���'Y�-�.47�I� _ � <br /> SIGNATURE -! �Juvpc.� REGISTERED N FEECURftE� N �- <br /> Address � �� � � Lloense# � t„i�%t,%t,/1 II��� � <br /> ELECTRTGS13S3 � � GBMPANY � <br /> 51GNATURE REGIS7FRED Y I N PEE CURftER Y/r2 <br /> Address License#�—� <br /> PLLlMBER � ��; ��Isp�o�. Y�Fee cuRREn -.Y!f�P. " � <br /> StGlVATtli2E <br /> Address License# � � <br /> MECHANICAL. COMi'ANY � <br /> SIGNATURE � � REQISTERED �N FEE CURftE� Y/N <br /> p�����s License# �— 1 <br /> OTHER � � COMPANY �— � <br /> g��p�� j REGlSTERED Y! N FEE CURREA Y I N <br /> Address License#±{ � <br /> ! l / 11Ii111t111t111lillllllltllll11111l1111011111110111111111111t111 <br /> RESiDENT1Ri, Attach{2}Plot Plans,{2)sefs af Buitding P3ans;(i}set of Enesgy Forms,R-O-W Permlt for new cansWcEion, <br /> Minimum ten(10)working days after submittel date. Required onslte,Construction Plans,Stormwater Plens w/Silt Fence insfelled, <br /> Sanitary Facilities&1 dumpster,Slte Work Permit for aubdivisions/large projects <br /> GQMMERGIAt. Attach{2}camplate sets of Building P(ans ptns a Lffe Safety Page;{i)set of Energy Forrtts.R-O-W Permit for new canstruaion. <br /> Minimum ten(10}wnrking days after submittai da#e. Required nnsite,Constnaction Plans,Starmwater Plans wt Sift Fenc�e instaited, <br /> Sanitary Facilities&1 dumpster.Site Work Pertnit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2}sets of Engineered Plans. <br /> ""PR4PERTY BtSRVEY requi�ed far a[(NEW canstrvet(on. <br /> . . . . . � . . oe . . � . . . � . . . . a . . o . . a . ._a, .��_ <br /> DirecHcurs: <br /> FllTout application camgCetefy. <br /> Owrser S�Can#ractor sign baek of apptication,notatized <br /> If over S250Q a Notice of Commencement Is requtred. (AIC upgrades over 57500) <br /> " Agent(for the contractor)or Pawer oi Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIT7IN{3 {capy of cantraat requiredj <br /> Reroofs if shingles Sewers Servica Upgredes A/C Fences(PIoUSurveylFootage) <br /> S�riveways-Nat over CounYer it on puhflc roadways..needs ftOW <br /> � <br />