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� s�:�-7sa-caaza City of Zephyrhills Permit Application �ax-813-780-�621 <br /> � Suilding Department <br /> Date Received <br /> Phone Contact for Permitting ( ) __ <br /> � � � � r � � � � vtri <br /> Owner's Name 1 G• 2, 1 Qwner Phone Number G �~ (���� <br /> Owner"s Addrass 1 � � J� V I�Q, l.l,�i Owner Phone Number g i 3 �� Sl� I� � <br /> Fee Simple Titleholder Name � Owner Phone Number 0 1�5 � �� �o I �/ I <br /> Fes Simple TitleholderAddress <br /> JOB ADDRESS � �l � � / i IJ • � ►1 N h� �1 �, , -'��-( LOT# I C� <br /> SUBDIVISION Z e h }�'� I I 21 �► �s PARCEL I�# <br /> (DBFAItdE D F ROP.9 PRDPE RTY TAX tlOTICE 1 <br /> WORK PROP05ED NE4^l CC}E�STR 8 ADD,ALT � SIGtd � � G�P�.IOLISH <br /> � <br /> IRlSTALL REPAIR <br /> PRQPOSE�USE SFR � COCAM � OTHER F�nI c-�- <br /> TYPE OF CONS1f2UC11QN BLOCit � FRAME � STEEL � <br /> DESCRIP110N QF WORK I �I'1 C l'.. i� � � Z� ' /Q i <br /> ( <br /> ----.,__._..,..,.. <br /> BUILDING SIZE SQ FOOTAGE H�GHT <br /> �BU1LDItdG $ GG � � VALUATION OFTOTAL CONSTRUCTIQN <br /> �ELECTRiCAL $ Ah.1PSERVICE � PRC�Gf2E5S ENERGY � 'rV R E C <br /> �PLUh�4S�P1� $ � �� <br /> OMECHANIGAL $ VALUATIOPd OF Pv1ECHANICAL IPJSTALiATI0t�7 -�f I � / ��I� <br /> � � �j ( <br /> �GAS � ROOFING Q SPECIALTY � OTHER <br /> �IPIISHED�LQ�R ELEVATI01dS —•------...............� FLOOD ZONE AREA �YES NO 1 ��' <br /> [ <br /> Bt11LC1ER �� �/��vy� 'J � COMPANY • � n Jw'v� C/ <br /> SIGNATURE � (.. �[/""/('� � - REGISTEREC Y? �`I, FEE CURRE� Y �Pd <br /> Addreas License# <br /> ELECTRI CIAN CO M PANY <br /> SIGIdATURE � REGISTEREC Y f I�J FEE CU�REI� Y 'IV <br /> Address License# � � <br /> PLIiMBER � COMPRNY <br /> SIGNANRE REG�STE�CEC Y + N FEE C��RRE� Y P. <br /> Address ; License# <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTEFtEG Y ' N FEE Ci!RREt Y N1 <br /> Address Lkcense# <br /> O?HER CO M PANY <br /> SIGNATURE � REGISTEREG Y J N FEE CURRE! Y%N <br /> Address � iicense� � —j <br /> i i 1 f 1 1 ! 1 t 1 1 1 I t 1 1 i 1 ! 1 I 1 i 1 i 1 t 1 1 ! 1 t 1 1 i 1 1 1 1 i 1 i ! 1 i 1 i 1 1 1 i ! 1 1 1 1 ! l 1 1 I 1 1 1 i # 1 <br /> RESI�ENTIAL Attach(21�lat Plarts. (2j seis af Bu�l�ng Pkans (1�set of Energy Forms R-O-Vt�Permit for neuv construdion <br /> h4�nimum ten q10j working davs after submrttal date Required onsrte Construction Plans Starm�.vater Pfans�dr`5dt Fence instalied. <br /> Sanitarv Facilrties&1 dumps�er Site'Nork i'ermit for subckvisions.riarge pro�ects <br /> COMMERCIAL Attach(3j complete sets of Building Plans plus a Life Safetv Page i1?set of Energ���orms R-C���^J Permii for ne�v eonstructian <br /> h4�nimum ten(10)wwking days after submEttal date. Requ�red onsite Construdrr,m Piens Storrr€water Pfans r�'Silt�ence instafled. <br /> Sandary facEkities 8,1 dumpster Site WorK Permit for aii r�ew prQ�ects All com�neraal�eqwrements must meet compliance <br /> SIGN PERMIT Attach{2j sets of Engfneered Pfans. <br /> ""PROPERTY SURVEY requrred for ali N��,'construction <br /> �irectians. <br /> Fili out applieatian completeh,� <br /> Owner&Contractor sEgn back of appiication notarized <br /> If over$2500,a Notice af Commencement is required. (A!C upgrades over$75Q0) <br /> "" Agent(for the contractor)or Po��er af AttomeV{for the o�srner�wwoufd be someone 4rith notanzed letter from awner authonzing same <br /> �OVER THE COUNTER PERMITTING ±Front of AppiicaEion Q� <br /> Rero�s d shingles Se��vers Sero�ce Upgrades /�C �Fences oUSurvev F�otage) <br /> Driveways-tVot over Count�r if ort pubf[c raadways nee�RO�R+ <br />