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. � <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0o21 <br /> Building Department <br /> Date Received Phone Contact for Permittin 8� 3 7��-- �✓�� <br /> Owner's Name ��NNI�/� ��'/ES Owner Phone Number 17� / 7 ��/ �� <br /> Owner's Address <br /> ISSS� G�I�TFVA✓F lYl•'�.?lo C�EArCw�R�k Owner Phone Number � � <br /> Fee Simple Titleholder Name �— Owner Phone Number �� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��7 f�� c?Ef'yyRN/�LS �� 33 S�C� LOT # � <br /> SUBDIVISION ����Q / q�� PARCEL IDi! D� "�� �'2�' Q� 3 O� UOO � O � <br /> (OBTAINED FROM GROPERTV TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN O � DEMOI.ISH <br /> � INSTALL 8 REPAIR <br /> PROPOSEO USE O SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION � BLOCK O FRAME � STEEL � <br /> DESCRIPTION OF WORK N� w Co�vsr�vcrro�/ �' TOl.f//✓IyOM,ES <br /> BUILDING SIZE �— � SQ FOOTAGE I�� I HEIGHT C�� 7' <br /> �BUILDING $ /, / `� VALUATION OF TOTAL CONSTRUCTION <br /> V✓ <br /> �ELECTRICAL s 3 y � o � AMP SERVICE � PROGRESS ENERGY � W.R.E.0 <br /> �PLUMBING $ /f3�. t^ <br /> 7 J <br /> OMECHANICAL $ y � ys . VA�UATION pF MECHANICAL INSTALLATION <br /> �GAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED F�OOR ELEVATIONS �� �� FLOOD ZONE AREA QYES NO <br /> �--�-N-� • <br /> BUILDER COMPANY .G.EN/VH� OM�S <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/ N <br /> Address �ss�� �`N� V� �'?�� C�fA�N�'�F/�i FL,? 7�0 License # G. Ci' C ��,I 8�� � <br /> ELECTRICIAN COMPANY OMon/SoN �`ECTR/C� "�NG � <br /> SIGNATURE REGIS7ERED Y/ N FEE CURREN Y/ N <br /> Address /03�{ .�Cl/ �A !! , f� �3G1 �icense # F� 000 �S7 9 <br /> PLUr�qFR COMPANY P M w P�V�'a�N � <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/ N <br /> Ad�lrees O 27 N' �S F 1/1 W -C► .� �iCense # ��C � a�.5� 0 <br /> MECu�"IICAI. COMPANY U��/O�lIFT PC f/M�8//V� lfERT/Nfi� ��7C- <br /> SIG�' �TURE REGISTERED Y/ N FEE CURREN Y/ N <br /> Address /" •BOX -�•3 q ONFI �!i T L 3h�b f� Ucense # C A� 0 S8 ��O 2� <br /> OTH°R COMPANY C� .�il�ie,�rNb !�/RL�; �OA�/�X,► .ZNC. <br /> SIG" ' TI )p� REGISTERED Y/ N FEE CURREN Y/ N <br /> ����+re5s y�►� S�1°A� c.�NE Be.va SP�e��v�Nree Lt �yi 7 �icense # CC� C OS7 99� <br /> 111111111111111111111111111111111111111111111 <br /> RESI^r"!?inL Attach (2) Plot Plans; (2) sets of Bufiding Plans; (,1) set of Energy Forms; R-O-W Permitfor new constnaction, <br /> Minimum ten (10) working days ai'ter submittai date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COnn"�FarinL Attach (3) complete sets of Bt�ilding Plans plus a Life Safety Page; (1) set of Energy Forms. R•O-W Permit for new construction <br /> Minimum ten (10) working days after submittai date. Requir�d onsite, Constru�:ion Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster. Site Work Permit for all new projects. Alf commercial requirements must meet compliance <br /> Sic=r' r'�^""�T Attach (2) sets of Engineered Plans. <br /> ""PROPERTY 3URVEY required for all NEW construction. <br /> �,,,1�.� [.,.L..J„i�• • . . . . . . . . . . . . ., ._s_i ._i _ <br /> Direc , na <br /> F " ;�� �� a�piication completely � <br /> C' � R Con�raCtor sign back of application, notarized • <br /> r 2 2500, a Notice of Commencemant Is required. (A/C upgrades over 37500) <br /> '• �����'�r the contraCtor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authonzing same <br /> OVE^ T''� �OUNTER PERMIITING (FrontofApplication Only) <br /> Rero� s�r �r��,�i�s Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> ^ °����ys-Not over Counter if on public roadways..needs ROW <br />