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"„-��0-0°1U City of Zephyrhills Permit Application Fax-813-780-0021 <br /> , <br /> , Building Department <br /> Date Received �y�f g � 7 � __ ��� � ����jyr�, <br /> Phone Contact for Permittin / <br /> Owner's R1ame ��� �/'D�e,�' =ef �� pyyner Phone fdumber <br /> O�nmer's Address ��b�Q� �G�h� Owmer Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Eee Simple Titleholder Address <br /> .�o�A��R�ss ��13 ��lGl ���'� Ze�h r��:/�S �L �3�y� �or# � <br /> SUBDINISIOM PARCEI.ID# 3 y rz�"—'1��,�'() �-�O(j 4 0 ^C�D �� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYP�OF CONSTRUCTIORI Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK -�/YS�(! Gyi ��L.f ,(��{/.Pitf � ,U �C.c.. �/�(�' <br /> � BUILDItdG SIZE � SQ FOOTAGE �9�S HEIGHT <br /> UILDING $ O� � VALUATION OF TOTAL CONSTRUCTION � ���'�7� <br /> QELECTRICAL � $ AMP SERVICE Q PROGRESS E �� � I.R.E.C. <br /> OPLUMBING $ - ��I �����.e.vl'- <br /> � <br /> I ' � `, /� - <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIO ` S� ��"- �/"° <br /> � <br />, QGAS Q ROOFING SPECIALTY 0 OTHER � <br /> � <br /> FINISHED FLOOR ELEVATIONS ZONE AREA YES NO r '� �j� <br /> � . � . '� � <br /> ��^�ypo4 �,��„�,�,e� <br /> � <br /> - — IBUILDER--- ------ — — w ✓C PANY f�T'�f6 S/�wl � /� ple.GS" — - _ V <br /> SeGfdATURE C � EGISTERED / N FEE CURRE� ' /N <br />� Address ��� QiN2 �C���--/,i J7/,+1�� Gs, LL License# C��/,3J'�Sb <br /> ELECTRICIAN COMPAMY <br /> SIGfdATURE REGISTERED Y/ IV FEE CURRE� Y/N <br /> Address License# <br /> PLUIMIBER COMPAMY ` <br /> SIGR7ATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Elddress License# <br /> MECHAMICAL COMPANY <br /> SIGR!/4TURE REGISTERED Y/ N FEE CURRE� Y/N <br /> dlddress License# � <br /> OTHER COMPAfdY <br /> SIGMATURE REGISTERED ' Y/ IV FEE CURRE� Y/N <br /> Address ' License# <br /> RESIDENTIAL 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 after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Facllities 8�1 dumpster,Site Wark Permit for subdivisionsAarge projects <br /> COIMAlIERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set af Energy Forms.R-O-W.Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, _ <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGfd PERMIT Aftach(2)sets of Engineered Plans. , - <br /> '"`•PROPERTY SURVEY required for all NEW constructton. <br /> Directlons: - • <br /> Fili out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a fdotice of Commencement ts requ(red. (AIC upgrades over E7500) <br /> "" Agent(for the contractor)or Power of Attomey(for the owner)would be someone wlth notarized letter from owner authorizing same <br /> O!!ER THE COUNTER PERAAl7TING,.,, a,(F.ront of.Application Only) <br /> Reroofs if shingies Sewers �'= �;Service�Upgrades A/.C' Fences(Piot/Survey/Footage) <br /> Driveways-Not over Counfer.if`on,public'roadways:.needs ROW <br /> f , , -„. . • , . - <br />� <br />