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o��-,����� Gity of Zephyrhills Permit Application FaX-s�a-zsaoo2� <br /> Building Department � <br /> - ':.,s . <br /> Date Recaived;, " Phone Contact for Permittln �j J 7�� – �p 1� <br /> Owner's Name �� �� � �=��1�5 Ownar Phone Number �f�"/�O" 7~J J <br /> Qwner's Address �O Q�� �✓�� ���� ��'o Owner Phone Number � � <br /> Fee Simple Titleholder Name Owrner Phone Number �—^ �� <br /> Fee Simple 7ltleholder Addresa <br /> JOB AdDRESS '���T�D �d4�14' �LLJ1I L�/ni . LOT# [� <br /> su�o�v�syo� ��/� �u.�! ��� �aacE��o� � "�'��'- �r-��f.�D-- G'f.��D4 4�t��f <br /> (QBTAINED FROM PROPERTY TAX NdSlCEj <br /> WORK RROPOSED , e NEW CONSTR�ADQ/AI.T �,� SIGN Q CJ DEMOLISH <br /> INSTALL REPAIR <br /> PRQP05ED�lISE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCT10N Q BLOCK " Q FRAME �. STEEL Q <br /> DESCRiPTtON t3F WORK �� R"�- ��7r��f e o�c-� ,� �om N�aU�v o� 7`�t1 �i� �� <br /> BUILDING 51ZE � � SQ FOOTAGE C� HEIGH7 ��� <br /> QBUILDING ��—� VALUATION`OF 1'OTAL COPISTRUGTIOfV <br /> �]ELECTRICAL �.�� AMP SERVICE Q PROGRESS ENERGY Q W.E�.E.C. <br /> QPLUMBING � i� <br /> MECHANtCAI $ `r.y p� 4w,, VALUATION OF MECHANICAL INSTALLATION <br /> cJ Ort�O „CX✓ .. <br /> QGAS [� ROOFiFtG Q SPECIALTf � CiTHER <br /> FiNISH�D FLOOR ELEVATIONS ��� FLOOD ZQNE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address LEcense# � � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE GURF2E� Y/N <br /> Adclress Liaense# � —..--.� <br /> PLUMBER � � COMPANY <br /> $RGidATIli2E REGIS.TERED Y/ N FEE CURRE� Y/N <br /> Address I.icense# � ���� <br /> MECHANICAL �"�' caMpnNv �A,Hoe S �rsp�-nJ� �sf��,/�...�.�� <br /> SIGNATURE ���, r ��� REGtSI'ERED Y! iV FEE CURRET Y!'W <br /> Address �}�� /'7f/G/l� /C�x� �'�ll� Licensa# �A"��'��'�� J <br /> OTiiER ,COMPANY <br /> SIfiaNATURE REG1S`fERED Y! N , F�e CURREt� Y J h1 <br /> Addreas License# � � <br /> RESlDENTIAt Attach'(2)..PtoFRlans;(2)sets of�Buililing`Plans;(1)set of-Energy=Fortns;R-O•W Perinitfar new constructlon, <br /> Minimum:ten�(1.0)working;days,after„subici{ttal date. ReqiafreiS onsfte,Constitic@on Plans;Stormwater Pians wl Silt fierrce Instaifed, <br /> Sanitary FaclltNes:&:1:.dumpster_Site Wor1c�.Permit forsubdivislonsAarge proJects <br /> COMMERCiAi. Attach(3)camptete sets af Suitding Plans plas a t3fe Saferty Page;(1)set of Energy Forms.R-O-W Permit for neui canstruction. <br /> Minimum ten(10}wacking days after submittai date. Requirer!ansite,Constnac�an Plans,Stormwater Plans w!Silt Fence tnstalted, <br /> Sanitary FaciliNes&1 dumpster.Stte Work Permit tor all new projects.All commerclal requlrements must meet compllance <br /> StGN PERM{T Attach(2)sets of EngiaeeredcPlans. � <br /> "'*PROFERTY SURVEY requiced far aii NEW cans#ructlon. <br /> Directians: <br /> F#li out appi9ca�on completely. <br /> Owner 8 Gontractor slgn back of appltcatton,notaeized <br /> If aver;2S00,a Notice of Commencement is requlred. (AIC upgrades over 57500) 7.,; ,,� .,�, <br /> ...,,. . � - <br /> " Agent(for khe contractor)or Power of Attamey(for the owner)would be someone with notarized letter.from owner_autho�izing same <br /> DVER THE COUNTER PERMITTING =•(Front of-Applibad'on'Onty)�� . � , , <br /> Reroofs if shtnglss Sewers Service'Upgrades A/C� �°"Fe'n"ces(Plot/Survey/Footage} - ' . ' _ • <br /> Drivewaya-Nat over Counter If on.public:roadways..neecls ROW ';• ' ' , � ; <br /> 's +. _, ,.� ,, •�:{_ _ _ ' .. <br /> �* /"� <br /> . _: ,. r_ � _ _.- ,__-..:.�._ -----_•._�,-__ __. _a�:_.__�.... r:-.�_ .__.�__�._.N.�_�_.�_ ._s_...�___._....� <br /> i <br />