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/ <br /> a�s-�ao-oozo City of Zephyrhills Permit Application Fax-813•780; 0021 <br /> Building Department <br /> Date Recelved Phone Contact for Permittin 8� 3 7� cv -• �/ ��� <br /> Owner's Name ��NN�7" 0 /�/EJ Owner Phone Number `/�/ 7 ��/ �O <br /> Owner's Address <br /> �JJ �./6�/TWA✓f (�[•�2�� C�EI�INHl�/l�k- Owner Phone Number � <br /> Fee Simple Titleholder Name � Owner Phone Number � <br /> Fee Simple Titleholder Addrass <br /> JOB ADDRESS 3 l� �/l� D` rL 33 5�1 U LOT # [�� <br /> SUBDIVISION ��LpNO P/Ql�/� PARCEL ID�t D3"�(o ~ Zl � �� 3 D� UQO � O/ � <br /> (OBTAINED FROM PROPERTY TAX N0T10E) <br /> WORK PROPOSED � NSTALLSTR 8 REPAIR � SIGN � Q OEMOIISH <br /> PROPOSEO USE O SFR Q COMM � OTHER <br /> 7YPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL [� <br /> DESCRIPTION OF WORK /V�W CON�fT'�'Pf/CT/O/ti/ "" TO G�JNy(I ML�S <br /> BUILDING SIZE S4 FOOTAGE /�� I HEIGHT a��� y <br /> 'TTTfr'T"P <br /> �BUILDING $ // /�O VALUATION OF TOTAL CONSTRUCTION <br /> II <br /> OELECTRICAL $ 3y �� AMP SERVICE � PROGRESS ENERGY O W R.E.C. <br /> �PLUMBING $ �3�a �' <br /> �MECHANICAL $ y � ys VALUATION OF MECHANICAL INSTALLATION <br /> �GAS Q ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR E�EVATIONS 9 �/�� FLOOD ZONE AREA QYES NO <br /> -�--F-�- <br /> BUIIDER COMPANY �LENNf�/2 O'►/�S <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/ N <br /> Address SSO �/(rl'/�1✓A ���/ �LE/y�IQ�/R71�/(�F4,? 7�0 License # C�i' C�5�8 �� � <br /> ELECTRICIAN COMPANY dMon/.SoN �LE�T��� "t�G • <br /> $IGNATURE REGIS7ERED Y/ N FEE CURREN Y/ N <br /> Address � �{ .�l/J� � %A l� � f� 33�i1 License # FC DOO �S7 9 � <br /> PlUrnqFR COMPANY BM {N P�CVM�O//V �' <br /> SIGNATURE REGISTERED Y/ N FEE CURR6N Y/ N <br /> Adctreas 63�7 I� � 1 F V/EW 'L- 3 License # C�C � a�5� � <br /> MEC��^1ICAL � COMPANY �AyOtiIFT PtvM�61N�� /7EHT/N(t� � �7C- I <br /> SIGP �TURE REGISTERED Y/ N FEE CURREN Y/ N <br /> Ar!�ress /-• D•[7pX�.308 9 ONFI �1�NT L 3y`7� �Ieense # CI��OJ` (� (p 2 <br /> OTN�? COMPANY C� .S��R,C,N6 ly�a��; ROA�/tiXr ZVC• <br /> $IG' ^ TI 1pF REGISTERED Y/ N FEE CURREN Y! N <br /> A•�rlress � BLV� Sf�R�/Vbl�//GG. ���Vlr �f LiCenSe# C- C'(,� �s / 97 / I <br /> 111111111111111111111111111111111111111111111111 <br /> RES�^'""'Tinl Attach (2) Plot Plans; (2) sets of Building Plans. (1) set of Energy Forms; R•O-W Permit for new construction, <br /> Minimum ten (10) working days ai'ter submittal date. Raquired onsite, Construction Plans, Stormwater Plans wi S�It Fence install�d, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COnnr�FarinL Attach (3) complete sets of Building Plans plus a Life Safery Page; (1) set of Energy Forms. R•O-W Permit for new construction <br /> Minimum tan (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Pians w/ Silt Fence inscalfed, <br /> Sanitary FaCilities & 1 dumpster Site Work Permit for ali new projects. All commercial requirements must meet compliance <br /> SIC�! rr^"^i7 Attach (2) sets o(Engineered Plans. <br /> ""'PROPERTY SURVEY required for all NEW construction. <br /> �� 5 ��,...��� � � • • • ■ • • • � � • • • • • ■ • • • � • • • � • � ■ � ■ • � � � � • � • � ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■_.t_�._i_i_iLU_ <br /> Dlrec. �nc <br /> F n��! applic�tiO�CORlplet9ly. <br /> ����� �° Con�ractor sign back of application, notarized ` <br /> r�^� T 2500, a Notice of Commencemsnt fs requlred. (A/C upgrades over 57500) <br /> �• � ���� ���r the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVE^ T''�" �OUNTER PERMITTING (Front of Application Only) <br /> Rero� <�r �r��,nins Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> �--���ays-Not over Counter if on public roadways..needs ROW <br />