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1�' , �` • � <br /> 813-780-0020 City of Zephyrhills Permit Applicatian �^ Fax-s���ao-oozi <br /> T � Building Deparlmeni � (�/,r�(} <br /> i ����� f <br /> 5 <br /> ' Date Recefved � "'�� Phone Corrtact for Permittin <br /> Owners Name �°�N�l.e��� '�Y�2� Owner Phone Number <br /> Qwners Address ��1.i { �U\M s 5 � Owner Phone Num6er � � <br /> Fee Simple Titleholde�Name � � Owner Phone Numher �� �� <br /> Fae Simple Titieholder Address <br />� SOB A40RESS �� �/ � t ZE' � V L � LOT� �� <br /> SUBQMSION � � PARGELlD# I - (� � -�ft7�p13aU-aa�t� <br /> (t�STNNEO Fl20M PAaPE{2TY T1UC Hpi10E} <br />, WQRK PROPOSED � NEW CONS7Re ADD/ALT Q SIGN Q � DEMOLISH <br /> 1NSTALL REPAIR <br /> I FROFOSED USE Q SFR Q COMM � QTHER <br /> 7YPE OF CONSTRUCTION Q 6LOCK Q FRAME � STEEL Q <br /> DESCRIPTiON OF WORK �� t le �I t��� �cr'-�J '*" <br /> EtUtLD1N6 S12E C � SQ FQOTAGE ���� #lEtGHT �� <br /> �BUILDING � � �r� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRIGAL �� AMP SERVICE Q PROGRESS ENERGY � W.R.EC. <br /> QP4UNi8EFlG �� �� <br /> QMECHANICAL $ VALUATION OF MECHANICAl.INSTALLATIOP! `�" �`{ �� <br /> /y J/�� � � <br /> 0f3A5 Q ROOFING Q SPECIALTY � pTHER � � <br /> Ii Q :)�^�'�( K <br />� FINISNED FLOOR Et.EVATI6NS FIOQD 20AIE AE2EA QYES N (A}'�j_�y j� C <br /> u �p�-Av:g ,�/,t0. <br /> /� ���Vt �� <br /> 6UiL0ER (• V' CQMPANY ��m'�f� 6�� � 'r��� �"�� <br /> SI�NATURE REGISfFREG Y/N �CURRea Y!N � <br /> Addsess 1�} Y1C`J 17s-°. � c! I l.icense# C��t_��7� } �(,�,�!'A�{��� <br /> V" <br /> ELECTRICIAN CpMPANY <br /> S[Ot+IATUR� REGi5TERED Y t N F�CURREN Y t N <br /> Address Llcense# �� �� <br /> P1.UMBER � � COMPANY �� � <br /> SIGNATURE. REGI5rERED Y/N Fff CURREN , Y/N � <br /> Address Clcense#� � <br /> ME.GHANlCAL � � CQMPANY <br /> SIt3NATi7RE R��rst�o �,_Yt N �cuFt�FSa �Y!N <br /> Address Ucense# I I <br /> SI NATURE � F2E�GI�SiERED �,.Y/N FE5 CURREN Y/N � � <br /> Address License#� ( <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111 <br /> RESIDENTtA4 Ariach(2)Plot Plans;(2)sefs ot 9uilding Piens;(Sj set of Energy Fotms;R-Q-W PemtR tor new conslntdion, <br /> Minimnm ten(10]working days after sahmitlai date. Required onsite,Gonstcuc#ian Pians,Starmwater Ptar�s w1 S'stt Fen�instatted, <br /> Sanitary Factlilies�1 dumpster,Sile Work Pertnit for subdiuisions/large projects - <br /> CQMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set af Energy Forms.R-O-W Permit Tw new conslriutlon. <br /> Minimum ten(1Q}wwking days after su5mittat date. Required pns'ste.Constcuction Pia�s,Stmmwater Pians wi Slit Fence�(nstalted, <br /> Sanitary Faa�Tiqes 8,i dumpster.Site Work Pesmit for aH new pmjects.ASt cammerciat reguirements must meet com�iance� <br /> SIGN PERMIT Altach(2)sets of Engineered Pla�s. <br /> '""PROPERI'Y SURVEY required for all NEW consWction. <br /> Dtrections: / <br /> FII out appiiption completely. � <br /> Owner B,CoMractor sign back of applica6on,rrotar¢ed <br /> If over S25D0,a Notice of Commencement Is nequ€resf. {AtC upgrades over 57500} <br /> " Agent(for the conGactar)or Power of Attomey(fnr the owner)would be som�ne with notetized latter from owner authori�ing same <br /> DYER THE COUNTER PERMRTING {Front of Applicatinn Only) <br /> Reroofs ii shingies Sewers Service Upgrades AtC Fences{PtottSurveytFootaga} <br /> DNveways-Not over Counter if on public roadways..needs ROW <br />