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a�s-7so-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> l�.A
<br /> I
<br /> Date Received c7` �-C��" Phone Contact for Permitting ��� �a2 — ���
<br /> Owner's Name �� � ��G � �-��� Owner Phone Number ���J' 7��- ���-
<br /> Owner's Address �3�� $� � � 1� �11t.`�1 Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS J���� ��.�'Ni A��., � \I-l.,� LUT# �
<br /> SUBDIVISION , PARCEL ID# �2'ZlP"Z�' ��`��` � C�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B N TALL.STR� REPAIR � SIGN Q Q DEMOLISH
<br /> PROPOSED USE Q SFR Q COMM � OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK �.N�1'�1.1.-1.���S�p�rsC' W�ND9t'°'�S I'�c�n �X'`t'��'10���00{'LS� ��CtS`CinlG'�ta►�.Qfl�l(a.
<br /> BUILDINGSIZE ��� �C ��__,_.1--SQ"FCj(5"I"AZ',E �� '� HEIGHT �� �
<br /> �BUILDING �/"$�` ���,� VALUA ON OF TOTAL CONSTRUCTION
<br /> �
<br /> QELECTRICAL' $ / MP SERVICE � PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ �� � ����
<br /> QMECHANICAL $ �� VALUATION OF MECHANICAL INSTALLATION ���� /�� V
<br /> �
<br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �l'i ��c.� �
<br /> 9 �
<br /> BUILDER � COMPANY �� �`II.A-c1 v���1�2.�1,t,T1o� �� �Q�1�� � C
<br /> SIGNATURE f REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ��1� ��'�� 41 License# ���1���
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> PLUMBER � � COMPANY —�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL N.� COMPANY '�
<br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N
<br /> Address License#
<br /> OTHER �[ COINPANY �'
<br /> SIGNATURE ` '� F2EGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy FoRns;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 8�1 dumpster;Site Work Permit for subdivisions/large projects
<br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)'working days after submittal date. Required ansite,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 compliarice
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> "'*PROPERTY SURVEY required for all NEW construction.
<br /> Directions:
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over 37500)
<br /> `= :R .i ...
<br /> "' Agent�(for�the<contracto�)•ot'PoVV�r`nf`Attor�ey(for the owner)would be someone with notariied�letter from owner autho�izing`same�
<br /> OVER THE COU 4 e :c,- , .�,'c': -.:.;_ .�,r . �� -
<br /> ,f,. ��: '
<br /> NtER''P�ERMITTING�'�' ;(Frontof;Application Only) ,;- �;�;�,;:,, '�: �
<br /> ,,:r.. F,;:;.
<br /> t3 ;f'�E,7,�,��. �:PtfilGi' • � ' •
<br /> Reroofs if sfiingles.,,;;.;,;Sewers,;i�,�..�,,�eririce:Up�rades A/C Fences(PIoUSurvey/Footage) �•�•�-� -�^�_•:_,��:-�•..:�•,: -; ,-r.;; ; `
<br /> I'� :,ry°�i:;�•• ; 3m�:t;a�i; ,�'��,'-n,,% _� �' btt�:.,u„� , .;.,;� -,�,:.7 ;° '.
<br /> ..�.�� S_:..r"�.",.,,'• %+„!'.; `` '
<br /> Driveways-Motover•Counter,it.o��ubli�•GOadways..needs ROW " {�"`�`�'-'��°'`�"A`���"��^�-'°4"•.�•:-
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