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�,�-r�a-ouza Ci#y o Zephyrt�ills Permit AppEication Fax-813-780-0021 <br /> Building Department <br /> ! <br /> r <br /> r <br /> [9ate Received Ph ne Conta�t for Permitt(ng �� �l9 -- CSJ�� <br /> C1�vnePs R1ame /�ia-i� �ct2,-d+ O�rner Phone fVumber ���' 3���"�1 � d,,, <br /> Owner's Address � / /� �a��1 �f���3S Ovimer Phone tdumber � �� <br /> Fee Slmple Titlehotder t�Fame _ __ __ _ __ _�_Owner_P_hone_tduttobar—�---� - ------�---- <br /> Fee Stmpte Titleholde�Address <br /> J�B A�DREs�iS � <��� �tr/�rio-1 � LO?# �� <br /> su�uiv��s�or� �s �``�S PARCEl,1D# � 'j C� 4 UG+G�OC?C? / <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED [� NEW CoNSTR ADDlALt �� SIGN Q [� DEMO�tSH <br /> Q iNSTALI� FtEPAIR <br /> PROPOSED USE Q SFR� COMM C� OTHER <br /> 'i'VPE QF CONSTRUC'f10T� � BLOCK FRAME � STEE� Q <br /> ` iDIESCtt1�T10N OFlNORK �av�t., �c,�o4v.r� d Exi� , or� � � �:Ntit'ewc� <br /> _ 8Ut[.Dtt�G SiZE ��^�� SQ FOQ7 GEC_� tfE1GHT C.�, � <br /> �SUtLDlNG $ .�r^�1.'��.��� VALUATIONOFTOTA�CONSTRUCTION ;�.' '��� <br /> �r <br /> C]ELECTRICAl. $ AMP SERVlGE Q PROGRESS ENEFtGY Q Vtt.32.E.C. <br /> , �..� <br /> ��-�� '�Pl`�'�''`�,'�"� <br /> C]PLUMBING $ ���-{ ���-�� � <br /> � ��� <br /> QMECHANICAL $ VALUATION OF MECHANICAL lNSTALLATIQN � -{�C�'- ,(� <br /> ✓- � <br /> OGAS Q ROOFING SPECIALTY � OTHER � '" ��" Q,�� �I'�U� <br /> � `,Q �G� <br /> FINISHE4 FLOOR ELEVATIONS F1.00D ZONE AFtEA QYES NO � ���,1" ` <br /> "� � <br /> BUlLDER �������� �OM� l�tsvvE �'�5 �t. <br /> �IGNATURE REGI9TERED Y/ N FEE CURRE� Y/N <br /> �,�a�s� c'.�v�t u��1� US-�. � o,��,�. ��a-7 �.T���SQ# �GG tS��a3to � <br /> IEILEC�'RiGtAi+t , COMPANY <br /> StGMATURE REGISTERED Y/ IV FEE CURRE� Y/N <br /> Address !.'scense# �� �� <br /> PLUMBER COMPAF�Y <br /> StGIVATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �� � � <br /> M�Ci1AMiCA�. - COMPAtdY <br /> SiGMAYURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addtess LPcense# �� � <br /> 07NER C�MPAMY <br /> StGMATURE REGISTERED Y J PI FEE CURRE� Y/N <br /> Add�ess �Icense# �— � <br /> RESIDElVTIAL Attach(2)Plot Pians;{2)sets of Building lans;(1)set of Energy Forms;R-Q-W Permit tor new consVuction, <br /> Minimum ten(10}working days after sub ltfal date. Required onsite,Ganstruction P1ans,Stotmwater Pians wJ Sitt Fence+nstatied, <br /> Sanitary Facilitles&1 dumpster,Site Wo Permit for subdivisionsAarge projects <br /> CQMMEi2CtAL Attach{3)compiete sets of Buildfng Ptan pRus a�ife Safety Page;(1}set of Energy Forms.R-t?-W Permit tor new constcuction. <br /> _ Minimum_ten�10j_working days after sub ittat date. Required onsite,Canstruction Plans,Stormwater Plans wl Sitt Fence instailed, <br /> "-� ��� Sanitary Facilities&1 dumpster.Site Wo Permik for all new projects.All commercial requirements must meet compliance <br /> SIGTd P�R1UtlT Attach{2)sets af Engineered Plans. <br /> ""*"PROPERTY SURVEY required for aii NEW consVuctian. <br /> Directians: <br /> Fill out applicaUon comptetely. <br /> Owner 8 Contrackor sign back of applfcation,nokarized <br /> !f aver i250Q,a Natice af Commencement is require . {AIC upgrades over�TSQO} <br /> «« Agent(for the contractor)or Power of Attomey(far the wner)would be someone with notarized letter fram owner authorizing same <br /> Ol�ER TFiE COU�1i'ER PERM11TtMG {Front af Appllca ian Only} �. ' - <br /> Reroofs if shingies Sewers ' Ser'vice Upgrad"es A/ � � �F�nces(PIoUSurvey/Footage) <br /> �riveways-Nat over Counter if on putitic roadways..ne s FdOW.. � <br /> ! <br />