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813-�so-ooaa City of Zephyrhills Permit Application Fax-813-780-0021 <br /> f. , Bultding Degartment � <br /> Date Rscetved , . • :PFiane-Contact�for Pertnitttn =� — <br /> Ouvner'sName �- �l�Z�l�e�*S iSc.v�1�� �U,,'Ct� . OwnerPhoaeNumber <br /> Owner's Address r"J`�S� ��Q� �J�"• � Owner Phbne Number � � <br /> Fee Simple Tltleholder Name � � Owner PHone Number �� � <br /> t i� , . . � <br /> Fee Slmple Titleholder Address � '° <br /> JOB ADDRESS �� �� `�'��• 't'��t'�4� �' `-� �S��- LOT# C� <br />� �� �� � 11-2t�-Zt • boi�O—O�bor�—bc�i'� <br /> sueawisioN RARCEI.ID# <br /> (OBTAINED FROM PROPERTY3AX NOSICE)• <br /> WORK PRORtiSED '�NEW CONSTit � ' ADD/ALT [,� S1GN°� Q Q pEMO1.ISH <br /> e ,INSTALL 8 REPAIR ' - <br /> PROPOSE4�USE Q SFR . [� GOMM Q OTHER <br /> TYPE OF CONSTRUCTION�': Q BLOCK ` C] FRAME C] STEEL. C]' <br /> I � (� (� _ � <br /> DESCRIPTION OF WORK � ��`�iSC�-fLfL <br /> BUiLD1NG SIZE � � SQ FOOTAGE C��. , HEIGHT. �� <br /> QBOt�DING � �� YALUATION�''"O�FM70TAL CONSTRUCTION' <br />' �ELEGTRICA! $ �'�,�� AMP SERViCE �� � PRt}GRESS ERtEi2GY Q W.R.E.C. <br /> � <br /> QPE:UNIBING ($f.. ^� <br /> � <br /> QMEGHANICAI � � VAt.UATiOt+t OP MECHANiCA�I(+ISTALlAT10N , <br /> �GAS Q ROOFING Q SPECIAI.TY-�,� - OTF�ER � <br /> FINISHED FLOOR ELEVATIQNS ��� FLOOD ZONE AFtEA QYES NO <br /> BUIIDER CdMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE�' Y/N <br /> Address • � License# � " I <br /> ELEC7RtC1AN� �""" COMPANY ��"�`t-�r1 �:�2.i�Tt`tv ►�riC. <br /> SIGNpTURE / � L�fi�. ax REGI3TERED Y/ N FEE CURREK Y/N <br /> Address �0 D �k3`7 �Ctc�t. ` �L , ucense.#:•'�-��3�C�13'�3 � <br /> P�UMBER • . , GOMPANY - :. , II <br /> SIGNATURE � � _REGISTERED Y L.N FEE.CURRE�- Y/N <br /> i <br /> Address License# � � <br /> MECHAPtICAl. ` , � .; CONtPA1dY - <br /> SIGNATURE ' � REGISTERED X,L.N . � FEE CURREP Y/N <br /> Addr�s$• ' � ' . . " _ ' License# � I <br /> OTHER ' � CONIPANY ,� <br /> SIGNATURE ' -- �`ReGISTE�� ' Y/ N'.. FEe.CURReK Y/N� <br /> � Addrea� ,,°; . _ �",• n ` ` License# � I <br /> RESIDENTIAI:' s:;Attadi{2};Ptot:Plans;:.{2}'sets�of'Buildi`itg"Ptan"s;`:(1}sef'of Eisergy�Fomi`s;�F2-0-W'Peimif for new cbnstivatton, ` � <br /> ; Minimum;ten;(10)uworkingjdays;a#kec�su6rinittal date:''Required.onsite,'Gon§tructlon°Plans;3tortnwater Plans w/SUfFence installed, <br /> �,� ,$anitaiy FaGlities,;&�1�,dumpsterRSite`1lVork:Pecmi#.forsubdivf5torisAarge ptajects ' '� "" <br /> COMHEERCiAt. Attach{3}`cbmplete sefs'ofBuifidirig"Plans plu's a Ufe Saf�ty Page;{1}set of Energy Forms.R-Q-W Pemnit for new canstruction. <br /> Mintmum ten(10)woricing days after submittal date. Requtred ons(te,CanstrucUon Plans,Stortnwater Plans w!Silt Fence installed, <br /> Sanitary Facili8es 8 7 dumpster.Site Wark Permtt for ai!nev+r:proJects:Aff cammerclai requfrements a►ust meet c+�mpilance <br /> SIGN P�RMIT Attactf'(2j sets of Eiigineered�,Pians:;�r,-^�.; �°-- _ ,- <br /> ••""PROPERTY.SURVEY reguired_for a11,IV.EW consWcdon. - � , <br /> Dlrections: ,. � � - ' <br /> Ffll out applicatlon ccmpletely. <br /> Owner&Car�tractar slgn back of applEca�on,natariz�i <br /> if over l2S40,a Notice;of Commencement is requtred. (NC upgrades over 57500) <br /> %�.;.V..��..,y,�"�� <br /> " Agent(tor the�aontr'ackor.)ar'Pow`e�of Attoriiep(for ttia ownerj i�rould be�someone with�notadzed tetter from owner authoriztng same <br /> DVER THE COUNTER.PERMiTTING•-- -, -(Front o£Appilca�an Oniyp• -� <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drivewaya-Not over Counter if an public roadways..neeiis ROW ' � - <br />