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ei�-�eaoo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building DepartmeM � <br /> �(���� <br /> Dab Receiwd Z� � Pfane CaMact ior P � - <br /> Owner's Name N ti{�-'�1 Z Lw Owner Pha�e Numbar �� �'" <br /> Owner's Addrass �� 2 25 �►P��^�"� � <br /> Fee Simple Titlehddsr Nsme �� � Owner Phone Number <br /> �s�mpe�nenaa..naare� (�� <br /> JOB ADDRESS CJ � LOT* �y.=.,=+—� <br /> SUBDMSION [F��� PARCEL IDM Z � . ' � Ob 1 -1 <br /> (OBTAINEb FROM PROPERTV TAX NOTICE) <br /> WORK PROPOSEO � NEW CONSTR e ADD/ALT Q 31GN Q Q DEMOLISH <br /> INSTA�L REPAIR <br /> PROPOSED USE �� SFR O COMM Q OTHER <br /> TYPE OF CONSTRUC710N Q BLOCK Q FRAME � STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SI� �Z1 .X ��� gp FppTAGE� HEIGHT � <br /> +�BUILDING $ 1� VALl1AT�ON OF TOTAL CONSTRUCTION ��p���• <br /> �ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0 <br /> �LUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ( NO <br /> � <br /> BUILDER ! � COMPANY � „'l 1"l!� <br /> SIGNA7URE REGISTERED Y N FEECURREA N <br /> � � 1 F� �Z,p� ���# 1 oZS2i u � <br /> � �,p <br /> ELECTRIGAN /'�y�//,l L ��/��� //n C' COMPANY W L.�L.1�--� C��C-l(�- ---� ��b��!�t'I l�" <br /> SI(iNATURE �'��-�'�"�' "C-�'-�� REGI&TERED N FEE CURRE� N <br /> ,,�,.� � ` IlS �# <br /> PLUMBER �a���/' l /-f' `S-C-�� RCOMP�Y� l.l�l'� �1"UJR�I 1��IO,'l� �✓C <br /> SIGNATURE CitLl�- —T� <br /> ,� S ��# 14�1p25 1 <br /> MECHANICAL �� C_.K.1tiC"� COMP�o N 1SF cu� Y N <br /> SIGNAlURE <br /> ,� h 1 s ��# <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREO Y! N FEE CURREA Y/N <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RE�DENTIAL Attach(2)P1ot Plans;(2)sets d Building Plans;(1)set of Energy Fartns;R-0-W Pertnit for new constnx3ion, <br /> Minimum ten(70)working days aRer submittal date. Required onsite,ConsWdion Plans,Stamwater Plans w!Sitt Fence installed, <br /> SanMary Facililies 8 1 dumpster;Site Work Permit for subdivisbnsllar9e Prajec4s <br /> COMMERqAL Attach(3)complete sets of Building Ptans p�us a Life Safety Page;(1)set oF Energy Fortns.R�W Pertnk for new construction <br /> Mmimum ten(10)workirg days after submittal date. Required onsite,ConsVUCtion Plans,Stormwaler Plans w/Sitt Fence instalted, <br /> Sanitary Facilities&1 dumpster Sile Work Pertnit for all new projeds.All commercial requirements must meet campliance <br /> SIGN PERMIT Altach(2)sets of Ergineered Plans. <br /> ""PROPERTY SURVEY required for all NEW constniction. <br /> DirsCtions: <br /> Fill out applicatian completey. <br /> Owner 8 CaNracta sign badc of application.notarized <br /> H over:2500.a Nolice of CommencemaM is required. (AIC upgradss ovar 57500) <br /> ° A9eM(fa the contracta)a Power of Attomey(tor the owner)would be someone with ratarized letler trom awnar authorizing same <br /> OVER THE COUNTER PERMITIiNCa (FroM of Application Ordy) <br /> Reroofs if shingles Sewers Service Upgretles A/C Fences(PIoUSixvey/Footape) <br /> Drfveways-Not rner Counter if on public roadways..needs ROW <br />