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l <br /> e�s-7so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> , � = Building Deparkment > <br /> , , <br /> Date Received ` Phone Contact fo�Permitting — I <br /> Ovireer's Name Gr{L�,.�- �'��e 1c S S (,1wne�phone Numb�r <br /> �,J� EI, Yk S L � � <br /> Owner's Address �j�3 b �"""t �tv Z � y '?i3��{ Owner Phone Number <br /> i �Fee Sirr`iple Titleholder Name � � Qwner Phone Plumber � <br /> Fee Simple Titlehalder Address <br /> � JOB ADDRESS S��J 6 �°� Y-���o� 2.2p�Yrt��il S L �"�i j�Z- LOT# "C_� <br /> ., ; <br /> �;' SUBDIVISION �� � PARCEL ID# <br /> �.' � (OBTAINED FROM PROPERTY TAX NOTICE) ' <br /> �� WORK PROPOSED NEW CONSTR ADDIALT � StGN Q Q DEMOLISH � <br /> ct i e INS7ALL 8 REPAIR <br /> �� PROPOSED t3SE [� s�R .. � eonnn� 0 aT���z <br /> � TYpE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> i� ` <br /> �� DESCRIRTION OF WORK �� �'�l�`�9�}} T�'^'� 0 Ca{y, �` �r v� .. I <br /> � s E <br /> i� BUILDING SIZE SQ FOOTAGE C_� HEIGHT , <br /> 4 <br /> � QBUfLDiNG � VALUATIQN OF 70TAL CONSTRUCTION <br /> k� <br /> � Qi ELECTRIGAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.Q.- <br /> ;� ��� <br /> � QPLUMBING �$> � <br /> k ` L � <br /> � ; <br /> ', �MECHAMCAL �> � VALUATION OF MECHANICAL INSTR�LATIQN <br /> � t <br /> ' QGAS [� ROOFING Q SPECIALTY � OTHER <br /> t � <br /> ; FtNISHED FLOQR ELEVATlONS � FLOOD ZONE AREA QYES NO <br /> 4 r <br /> � t <br /> � <br /> BUILDER; /"""� COMPANY <br /> � SIGfdATURE ��� " F2EGISTERED Y/ N FEE Cut�tEn Y/N <br /> � - <br /> � Address License# � � <br /> � - <br /> ELECTRICIAfV COMPANY ` <br /> 81GNi4TtlRE ftEGISTEftED Y/ N FEE CURRE� Y/N' <br /> � Address � License# �- � <br /> } z =� , <br /> I <br /> PLUMBER COMPANY � ' ' <br /> ; SIGNATURE REGISTERED • Y>/' N . FEE CURRE� "' "Y/'�N' '- - <br /> I � t . � <br /> ; Address ` License# � � <br /> ' MECHAIVICAL� - � - COMPANY, �, - <br /> i $IGNAT.URE REGISTERED Y/ N�- • FE�cu�En ,.Y./N .�. <br /> . r <br /> Address � � License#, C, - _�� <br /> ' OTHER,, COMPANY - � <br /> 's SlGNATURE REGISTERED Y/ N F8E CURRE� Y/N, _ <br /> I <br /> �' Address License# � <br /> '��:_ � F�r <br /> �'� RESIDENTIAC� 'Attacli`,(2)�Plot Plans;;(2)sets of�B,uilding Plans;,(1)set of Energy,Forms;'R=O,Uy�Perinit`for.new construction, • I <br /> �;'_ Nliniirium ten°(�1.U)°working clays`after-submittal_d"ate. Requi�ed onsite;�Conskrilction Plans,`Stormwater Plans vir/Sllt Fenc4a installed,� <br /> = Sanitary Facitities&1 dumpster,Site Wark Permit for subdivisionsllarge prajecfs <br /> CO6AMERCIAL Attach_(2)complete sets of Building Plans plus a Life Safety„Page;(1)set of Energy Forms.R-O-W Permit for new,construction. <br /> � - , � Minimum ten.{10}worlcing days after submittal date. Reguir'ed onsite,Construction Plans,Stormwater Plans w/SIIt.Fence installed,� <br /> (r, Sanitary Facilities 8�`1'dumpsfer.Site Work Permit for all'new projec#s.Atl cammerciat requirements must meet compliance � <br /> � - SIGN PERMIT Attach(2);sets of Engineered Plans. � � <br /> '- *•**PF20PEEtTY.St7RVEl'required forati N�W construcrian. , � <br /> Directions: <br /> Fi11 aut appiicatian complete(y. <br /> Owner.:8�Cantractor sign back of apptication,notarized <br /> If over$2500�a Notice of Commencement is required. (AlC upgrades over$7500) <br /> " Agent{for the�contractor-},or-Power-of Attomey{far the owner)woulc!be someane w�th notarized letter from awner autho�izing same <br /> •OVER THE COUNTER PERMITTING (copy of contract required) <br /> Rer.oafs if shingles Sewers � 3ervice.Upgrades A1C Fences{PtotlSurveylFootage} � "_ � � � <br /> Driveways-Nat over Counter if on public roadways..needs ROW I <br /> / �`�•�, 1 <br />