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��. <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Recelved Phone Contact for Permittin S� 3 7/(O ° �✓�� <br /> Owner's Name ��NN�7i♦ ��/ES Owner Phone Number `/� / 7 "'���� <br /> J7��m � � <br /> Owne�'s Addresa �SS50 L/6NTwA✓f A?•�?l� C�EA�Cwigtl�R k Owner Phone Number <br /> Fee Simple Tltleholder Name Owner Phone Number �— � <br /> Fee Simple Titleholder Addrass <br /> JOB ADDRESS 3 7 /QL. < E/��7 �/Qly/�� �L 33 5�0 LOT # / J <br /> SUBDIVISION ���NO P17��/� PARCEL ID�i D�'" ��p '"ZI' Q� 3 O" UOO � O/ S� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONS7R e ADDlALT � SIGN � Q OEMOLISH <br /> INSTALL REPAIR <br /> PROPOSEO USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK /VFW CONcS1��P!/GT/D/v -- Tou�N�OM�S <br /> BUILDING SIZE � SQ FOOTAGE /53 l HEIGHT o� `STO� � <br /> �'r'T�1'rr'r"r <br /> �BUILDING $ �� GSO VALUATION OF TOTAL CONSTRUCTION <br /> OELECTRICAL $ 3 y � o AMP SERVICE � PROGRESS ENERGY O W R.E.0 <br /> �PLUMBING $ /f�� C�� <br /> 7 ✓ <br /> �MECHANICAL $ y � ys . VAI.UATION OF MECHANICAL INSTALLATION <br /> �GAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED F100R ELEVATIONS Q ���^ FLOOD ZONE AREA �YES NO <br /> � .J <br /> .i��1--1 <br /> BUILDER COMPANY �EN/VHI� O <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/ N <br /> Address SSO 4GN �R �.�/O �� fyyP�Vql�j(� FL ,? 7�0 License # C�7' C�S 8�(O (O <br /> ELECTRICIAN COMPANY OMo�/SvN �LE�TR�L "ZNG • <br /> SIGNATUR� REGISTERED Y/ N FEE CURREN Y! N <br /> Address �O�y .�Cl�l� �� �A A. f� �3�i1 l.icense t� FC 400 .�57 <br /> pGUr�RFR COMPANY 8Mw P�✓�'Q�N� <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/ N <br /> Qd�irpc5 OJL / � /J � F ✓�Ew ��► � �IC8f1S@ � C �C O � ��Q O <br /> MEC�^^�ICAL COMPANY BAvo,vFr P��M,e�ti�- /7ERT/NCr� v�'7 t..- <br /> SIGP' 1rURE REGISTERED Y( N FEECURREh Y/ N <br /> Address /"• • pX ONF7'Zi T L. ,3h�`'f7 License# I.IqCOJ��(�(O 2 � <br /> OTN�4 COMPANY C�R�G►�✓6 G�/�c,�i ROA'���G �./VC. <br /> SIG' ' T � 1PE REGISTERED Y/ N FEE CURREN Y/ N <br /> A y / •f � �./NE BLVd tSI�R/Ni �//LG. �C ,�y/r �f LiCenSe # G. C� C Q.S � �7 � � <br /> i����������������ii�ir�ii�i�iii�iii�ii�iiiii��iiii�ii���iiii�i�i�ii <br /> RES��r"'rinL Attach (2) Plot Plans; (2) sets ot Bullding Pians, (.1) set of Energy Forms; R-O-W Permit for new construction, <br /> Minimum ten (10) working days aher submittal date Required onsite, Construction Plans, Stormwater Plans wi Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> CO��r^Fpri nl. Attach (3) complete sets of Building Plans plus a Life Safery Page; (1) set of Enargy Forms. R-O-W Permit for new construction <br /> Minimum ten (TO) working days after submittal data Requ'ued onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilitles & 1 dumpster, Site Work Permit for all new projects. AII commerciai requirements must meet compliance <br /> Sic�� ^r^^^iT attach (2) sets of Engineered Plans. <br /> ""PRpPERTY SURVEY requirad for all NEW construction. <br /> �1„�..� s�t..,+.,.�.. . <br /> Direc , �G <br /> F � nni aqpiication completely. <br /> � nr� �. Con�ractor sign back of application, notarized • <br /> i�-�^ � R 2500, a No41ca of Commencemant is requlred. (A/C upg�ades over 57500) <br /> " �' ��� �'�r the contractor) or Power of Attomey (for the owner) would be someone with notarized letter irom owner authonzing same <br /> OvE^ "'r �OUNTER PERMI7TING (Front of Application Only) <br /> Rero� s,r �r�„7ir_s Sewers Service Upgrddes A!C Fences (PIoUSurvey/Footage) <br /> � �����ys-Not over Counter If on public roadways..needs ROW <br />