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\ <br /> a�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> . -� -� Building Department <br /> ..+: �.� <br /> Date Recelved Phone Contact for Permltting ��c3 ��� -- �Q 2O <br /> Owner's Name � �� Ownet Phone Number <br /> L4C2lM <br /> Owner's Address ���•�� Owner phons 4Vumber �- � <br /> F"ee Stmplc Ti#lehotder Name � � Owner phone Number �^� <br /> Fee Slmple TlUeholder Address <br /> JOBRDDI2ESS �L "I� � { T�Y . �!�i 2 LOT# �� <br /> sueaivisioti �21(K�'C 1.(,1,���'.Y"1'�.C�,,,� PARCELIO# QZ`�' —o`�ts�'Zo(�C�O—O'��Cb—C�1c"� <br /> (dBTAtNEO FROM PROFERTYTA7t NpTtCE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q � DEMOLISH <br /> INSTALL �REPAIR <br /> ��oQos�o us� �" s�R � coutn� � o�r�s�s� <br /> TYPE OF CONSTRUC71qN Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIP'iiON OF WQRK � '�'-QYQt�� t <br /> BU)LalNC,S1ZE �- � SQ FqOTAGE C� HEIGNT �� <br /> BUILDING $����VALUATION OF TOTAL CONSTRUCTION <br /> �ELEC7RICAL �� AMP SERVICE Q PROGRESS ENERC3Y � W.R.E.C. <br /> QPlUMBING �� <br /> QMECHANICAL $ VALUATION pF MECNANICAL(NS7ALLA710N <br /> �� <br /> QGAS di ROOFING Q SPECIALTY � OTHER <br /> FIMISNED F�OQR ELEVATtONS �� FCOOD ZQNE AREA QYES NO <br /> BU(LDER �I ' `��� {}/1 � COMpANY ��U�SC4.h�„I� � �ICJ <br /> SIGNATURE i N�`�"'��' REGISTERED ��N FEE CURftE� � /N <br /> Address ; � \� �.�;1� L�.- s�r.x.rit Licensa# L����{�"-C � <br /> SIGNATUE2E � � COMPANY �_ Y 1 N � <br /> REGIS7ERED Y 1 N FEE CURREh <br /> Address License# r� �� <br /> BLUMBEki. COMPANY � <br /> SIGNATURE � �c,l�re[xEn Y f N FEE CURRE� Y!N <br /> Axldress License# �- '-� <br /> MECHANICAL � � COMPANY � <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y I R1 <br /> Address Llcense# � �� <br /> SI N TURE �_ � R O�S E�n Y! N FEE CURRE� Y/N � <br /> Address Llcense#���` � <br /> IIIIIIIIIIIIIIIt11111111111111111111111M11111111I1111111111111t11M1 <br /> REStBENTlRl. Attaoh(2}Ptot Pians;(2}sets of Buiiding Pfans;(1}set of Energy Forms;R-O-W Permit for rsaw canstruction, <br /> Minlmum fen(f Q}woricing days after submittal dafe. Requlred ons(te,Construc6on Platts,Stormweter Plans w/Silt Fence insta�ted, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsllafge projects <br /> COMMERCIAL Attach(2)complete sets af Building Pians plus a Life Safery Page;(1)set of Energy Forms.R-O-W Pertnit foe new construction. <br /> Min{mum ten{S4}warking days after submiftal date. Required onslte,Constcuction Plans,StomtwaEer Fians wi Sitt Fsnce insG3tied, <br /> Sanitary Facitities 81 dumpstec Site Work Permit for aii new projects.AII wmmercia�requirements must meet compiiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans, <br /> ""PROPERN SURVEY required for al(NEW constructlon. <br /> -,_.�:... . . . . . . . . . . . . . . . . . . . n . . . . . . . . . e . . . . . . <br /> Ditectiwu: <br /> Fill aut applicatibn completely. <br /> Ownar$Contractor sign back of appi3cation,nfltarized <br /> !f over$2500,a Notice of Gommerseement ts required. jAlC npgrades over$7500} <br /> " Agent(for the wntractor)or Power of Attorney(for the owner)wquld be someone with notarized letter from owner authorizing same <br /> OVER THE G4UNTER PERMfi"itNG {copy of cantract required} <br /> Reropfs if shingies Sewers Service Upgrades AJC Fences(ptoUSurvey/Footage) <br /> Driveways-Not over Counter if an public raadways..needs ROW <br />