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�r■��� -7 0 1 <br /> ' 813•780-0420 City of Zephyrhills Permit Appiication Fax-e�s s -ooz <br /> � Building Department <br /> oat�Rece�YSd — �1.3 ?S� _/a� <br /> Phans ContactforPermittin <br /> Owners Name ,r��J f`. rn�t1C� Owner Phone Number /3-�?9^,�o�S� <br /> OwnersAddreas 3'���t 1°�C1�k0'Pn ��� OwnerPhoneNumber ��� <br /> fes Simpie TitiehoWer Name � � O+�mer Phone Number � � <br /> Fee Simple Titleholder Address <br /> �ae n�oR�ss 3'?�{�1 N ek.koh, R�'�'-- �oT�r ��f� <br /> sueo�vis�or� ��au,cl- ar tto�c`+ FARGEI I� 3`�'�S al-Da�D-OQOt�C?-!!1�'a <br /> (OBTAINED FRbM PROPERTY TAX N0710E} <br /> WORK PRpPOSED e NEW CONSTR 8 ADD/ALT � SICaN � Q DEMfJLISH <br /> INSTAL� REPAIR <br /> PR4POSED USE Q SFR Q COMM Q QTHER <br /> TYPE Of CONSTRUC710N Q BLOCK Q FRAME � STEEL Q <br /> DE$CRIPTIQN OF WORK ��#'� <br /> BU14DtNG SIZE � � SQ fOOTAfisE{� 1fEIGHT C� <br /> �BUIIDIPlG �����_� YAIUATtQN pF TOTAL CON$7RUCTION <br /> QELECTRICAL ��I AMP SERVICE Q PROGRES5 ENERGY Q W.R.E.C. �� <br /> QPLUMBING �� `�� <br /> QMECHANtCA� �6� YR�UATK}N OF MECHANICAi.INSTALtAT10N '� <br /> QGAS Q ROOFING Q SPECIALTY � OTNER <br /> FINISHED FGOOR ELEVATIONS �� FLOOQ ZONE AREA QYES NO <br /> BUILDER U � COMPANY L'#'I f C:Of�'C�t-Cr'CL O� � <br /> SIGNATURE � REOISTERED Y/ N FEE CURREh Y/N <br /> ---�r---�_— � 4 <br /> Address y�a1 ,�,t.j'1�_���;° � trcense# I t=z71..1��7 0 0�, <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE GURRE� Y/N <br /> fiddreas l3csnse# �� <br /> PWMBER COMPANY � � <br /> SICiNATURE � � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# t � <br /> M������ � EG�ISTF� Y/N FEE GURRE� Y/N � <br /> SIONATURE <br /> p�re� Ucense# ( � <br /> OTHER � � G�P� � <br /> SIGNATURE REGIS7ERED Y/ N FEE CURREA Y/N <br /> p�re;� Ucense# � i <br /> � � � � � � � � � ii � � � � � � i � � � � � � iiiii � � i � � � � i � i � ir � i � � � i � � i � � iiN � � ii � � � i � ii <br /> RESIUENSIAI Attach{2}Piot Pisns:(2}sets af BuilGing Plans:(1}set of Energy Farms;R-t7-W Petmit f�new construction, <br /> Minimum ten(10)working days after submittaf date. F2equired onsite,ConsWction Ptans,Starrnwater Pians wJ Siit Fence instalied, <br /> Sanitary Pacilities 8 1 dumpster,Site Wark Pertnit fw subdivisionsAarge projects <br /> COMMERC{AL Attacti{3}compiete sets of Buiiding Plens plus a Life Safety Page;{1)set af Energy Fortns.R-O-W Permlt for new t�nstrudion. <br /> Minimum ten(10}working days after submittal da#e. Required ansite,ConsWCtion Plans,Stormwater Pians w!Silt Fence instailed, <br /> Sanitary facilities 8 1 dumpster 3ite Work PertnR for all new proJects.All Commercial requirements must meet compiiance <br /> SIGN PERMIT AttBCh(2)sets of Engineered Plans. <br /> ""PROPEF2TY SURYEY required fw ati NEW c�sttuctian. <br /> DirecNons: <br /> Fill out application Completely. <br /> Qvmer 8�fi,a�fisctor sic,�back of appiication,notarized <br /> H over 52500,a NoHce of Commencement is required. (A/C upgrades orar S75U8) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would he someone with notarized lelter from rnmer authaizing same <br /> OVER TME COUFRER PERMITTING (Front of Appl'scation Only} <br /> Reroofs if shingles 5ewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Caunter if on public roadways_needs RQW <br />