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813-780-0020 -City of Zephyrhills Permit Application Fax 813-7a0-0021 <br /> • - Building Department <br /> Date Received <br /> • Phone'Contact•�for Permlttln �:, <br /> Owner's Name � � l/(f /�' 6,Qwner Phone Number , <br /> Owiner's �/ '�f � � Owner Phone Number <br /> - <br /> Fee . � <br /> Fee Slmpla Titleholder Nari+e-•-�a- Quirner•Phone Number <br /> I " <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 7`7' �1"� >��- FL 3 35ZI LOT# <br /> SUBDIV1810N:_ „ �: PARCEL 111* i <br /> r+ <br /> (OBTAINED FROM PROPERTYMAXNOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT- 'Q SIGN Q Q DEMOLISH <br /> } INSTALL 8.. ':REPAIR <br /> .I; i <br /> PRQPQSED;:USE•. SFR Q :,"COMM, OTHER <br /> if <br /> TYPE°OF CONSTRUCTION. BLOCK •. ,Q FRAME. Q, STEEL [ ; <br /> DESCRiPTION-of WORK <br /> BUILDING SIZE � ''SR'FOOTAGE,=•. .-HEIGHT <br /> ILDING $ VALUATION'OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ . AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C: . , <br /> 4r <br /> QPLUMBING <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ��v <br /> C]GAS ROOFING Q SPECIALTY.. OTHER ��" <br /> FIN SHE FLOOR ELEVATIONS FLOOD ZONE AREA =Y.ES NO <br /> :BUILDER COMPANY /`}' F12�—�v 67 <br /> SIGNATURE a REGISTERED I Y'/ N FEE CUR <br /> rREE� Y'/' <br /> Add cs lfl/f M11, 4C, IPA40� 0, r /77v 't eense:# t; 'I 2 7 a�� <br /> ``'-ELECTRIGtAN:- -COMPANY <br /> ?5,:SIGNATURE REGISTERED Y/ N . FEE CURREt` Y/Ni <br /> Address <br /> f•.. 'License:#." I .. ... <br /> ` =P.LU COMPANY. <br /> K.,.•,SIGNATURE" :REGISTERED. . Y/ N .FEE-CURREt` <br /> f,t Address '.License•#.) <br /> MECHAN1GAl` = CQMPAIVY <br /> :SIGNATURE ?.' REGISTERED I Y/•N FEEICURREP. . <br /> Aitdr- <br /> 0S x>. .l tense.# <br /> SIGNATURE r;rax3: REGISTERED 1(/.N. FEE-CURREn" Y/N <br /> Address::. License'!it Hi Hee H.14-ti-ifliff,ki <br /> 'REST°EN 61' i0.tta n 2, PC"t Pi` `s=" •n e` '+s ii i ? ?ia's�'1r s` f!= >= R O Pe i `Tr riew::: stiuctton <br /> rtn t:fo c;on ;N,t , <br /> �. ... �,•. ... ;:.:_ ui felled is : w . Minimu . tens>1'0;;intojitlii"''"a` afte�xsi�t rriittalai ate:`:Re aired°ahsite Gon§tructlon Plans,`Staonwater'Plans w/:SiltFenca i s <br /> O <br /> �. <br /> agl•:.-.y.. q <br /> Santta: Faciilties' =t clam sie ;;3[_ ;W;.c}rte i?esmitfor.saiidivisioristta e' ro acts <br /> GOMMERGIAL Attach%(2)=complete-sets of Building'Plans pars"a`Life Safetji'Page;(1)set of Energy Forms.R-O W Permit fcir new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt FenceAnstalled,,. <br /> 4s` Sanitary:Facilitles&1 dumpster.Site Work Permit W-ll;neiar pTofects:All commercial requirements must meet-compliance <br /> MiPERMIT <br /> i`•''a`' ""PROPERTYrtSURVFY,requiredfor,.aII,NEW,cons ttuctlon...... <br /> fl6.Vul"application completely. <br /> f t flvwner&Contractor,sigh;back of applicat on,notarized <br /> '"'lf:over'$2500;-a°N.otice,ofCommencement Is required. (AIC upgrades over$7500)' <br /> Rgent(far`ttia coniiactor).or°PowerioYAttomey`{ftir'ttie'ouvnet)viro''bid-tie i6meone with notarized letter from owner authorizing same <br /> ?'fiOVEftwTHE CQUNEt2 P,ERfY41TTING,,.., (copyof�contract requited) <br /> ;Reigbfs':i8sfiingles S®viers. `Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> :Dirlveways-Not over Counter ifon pa6lic`�oad`w'ays::rieeds ROVU <br />