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$��-7so-�42o City af Zephyrhills Permit Application Fax-813-780-0021 <br /> � " ��r" Building Departrnent <br /> Data Received Phone Contact for Permiriin �i� Z�f;�. – C�� <br /> Qwner's Name Owner Phone Number <br /> nA �� � <br /> Owner's Address � 5� � ��0 R. � � Ownar Phone Number <br /> �aSliirpleflttetiolderNam��.�— �. ftwrrer�Rhone�PSumber� �� <br /> Simpie TiNehoider Address ' <br /> dRESS t2fl�2- PU,►rYY..h�1� .Z h �"hil �%y335 2. �oT# �� <br /> ISION �j (��t�) T��t''� PARCES,ip# ���,Q c.t'�:��0�)-- �I C� <br /> (O$TAINED F(tOM PROPERTY TAX NpTICE) <br /> - WORK PROPOSED � NEW CpNSTR� ADDIALT � SIGN Q Q DEMOLlSH <br /> ISdSTAti f2EPA1Ft <br /> P.EtOFOSEU USE � SF�t � ,G{JMM ,� �3'�'k1�2 � <br /> TYPE OF COP�57RUCTION Q BLOCK D FRAME � STEEL Q <br /> DESCRIPTION OF WORK � L,.{w� [ <br /> BUII.DING Si2'E �—� SQ FQOTAGE��i HEtOHT [__!� <br /> BWLDING $y��tQ t r�___� VAIUATiON OF TOTAL CONSTRUCTION <br /> _,��.,,i,� <br /> �ELECTRkGAL $ AMR6ERV4CE- � PRl�GRES3EtVERF.,Y �_ W.R.�.C. <br /> �� <br /> QPLUMBING ($ �!�( <br /> � _� <br /> QMHCHANICAL $ VALUATIdN OF MECHAN{CAL{NSTALLATi0f3 <br /> QGAS ROOFINC3 Q SPECIALTY � OTHER <br /> FINISHED FLOOft ELEVATtONS �--� FLpOD ZONE AREA QYES NO <br /> REGISTERED Y J N FEE GURftE� `Y I N <br /> suxc��x .i `� _ .. =' �ao��r�av �Gl.o{ Cijl�t' C �� .,� <br /> SlGNATURE � J��� � <br /> Address �� � �.T"i t�� Ltcense# C(�iLS. �t3��`Lr�!' I <br /> ELECTRICIAPI � � COMPlWY � <br /> SIGNANRE a�c�sT�fl Y!N �ecuru�En Y!N <br /> Address License#�—y`�� <br /> PLtFiulBECt �; ���a �f{R^ . FEE CURREA Y l i�. . <br /> St+i i�t�3R�� <br /> Address License# �� <br /> MECHANICAL � � GOMPANY �� � <br /> SIGNATURE ftEGISTEREO Y I R� FEE CURRE� Y/N <br /> Address L'scense#�—� <br /> OTHER � � COMPANY � <br /> S1UYaA7URE � txEc,�sT� Yl.N . t�Ecurt�tF1, Y1N <br /> 74r�s]ress Licensa#.� 1 <br /> � l111l1 { ! ! 1l1I111111111111111111111111111111111t1Itt1I11III / IIItItI { <br /> RESIDENTlAL Attach{2)Plat Plans;(2)sets of Building Plans;(1)set af Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(i0)working days after submittal date. Required ortsite,Canskruction Pians,Stormwater Pians wl8iit Fence insta8ed, <br /> Sanitary Faoiiities&1 dumpster,Site Work Petmit for subdivisionsi(arge projects <br /> COMMEI2C(Ai. Attacfi(2)comptete sets oI Bu3idEng Plans pius a Lita Safety Page;{t)set flf Ener3y Farms.F2-O-W Permit for new consWction. <br /> ' Mintmum ten(1p}wnrising days after se�bmitta!date. Required onsite,ConstrucGon Plans,Stormwater Plans w/Sflt Fence instailed, <br /> , &anitary Faciliiies 81 dumpster.Site Work Permit for all new projects.All cpmmercial requirements must meet camptiance <br /> . SIGN PERMIT Attach(2�sets of Engineered Plans. <br /> •`"`PROPERTY SURVEY required far att NEW constructlan. <br /> Dtredions. <br /> \.. �11EQ(143���IOCk�6dFik�'!�2[�:. <br /> Owner&CoM�actor'sign 6ack of application,notarized <br /> If over�2500,a Nottce oi Commericement is requlred. {AlC upgrades aver$7500) <br /> `" Agent(for the contractor)or Power of Attorney(for the owner}wouid be someone with notarized terierfrom awner aufhorizing same <br /> OVEFL 7HE COUNTER PERMIITING (copy of conVact requirad) <br /> Reroofs ff shingles Sewers Service Upgrades AIC Fences(PlotlSurveylFootagej <br /> Driveways-Mot over Counter if on puhlic roadways..needs ROW <br /> � <br />