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813-780-0020 City of Zephyrhills Permit Appiication FaX s7saeo-oo2�
<br /> Building Department . � -°
<br /> Date Received � - -
<br /> Phone�.Contactfor Perinittin -
<br /> Owner's Name � Owner Phone Number 3 S2 � - c�fl
<br /> . ,
<br /> Owner's Address ' 122 3 l7 Jo.� 1`d� C, Owner Phone Number ••
<br /> Fee Simple Titleholder Name � Owner Phone Number
<br /> Fee S(mple Titleholder Address
<br /> JOB ADDRESS S 3 2 �j'�� S7: LOT# �
<br /> SUBDIVISION PARCEL ID# �1-��'�� -�0/ O ^- U 3/D�D �- a�) -D
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ' ADD/ALT � SIGN ` Q Q DEMOLISH
<br /> INSTALL. '�. REPAIR
<br /> PROPOSED:USE Q SFR �]� `CONIM � Q OTHER �
<br /> TYPE OF CONSTRUCTION [�' BLOCK '` � FRAME � STEEL Q
<br /> DESCRIPTION OF WORK �e v O� w,-�-j--��o`�( ��it�c�n�-j� ,���+o.,a 1 (p�� ,a-Ra'
<br /> - \ .
<br /> BUILDIWG SIZE 3 fl� X o`l9� ' SQ FOOTAGE O� HEIGHT-" S�n .Q ��
<br /> QBUILDING $ -�-- ---- VALUATION OF TOTAL CONSTRUCTION
<br /> � 2D0 .
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ � � `�Fp�� ,
<br /> 1�
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS � ROOFING ..Q SPECIALTY Q OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES NO
<br /> BUILDER +�
<br /> �� l�9✓�,
<br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N _
<br /> Addreaa "' �Lfaense# �
<br /> ELECTRICIAPI COMPANY
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURREA Y/N
<br /> Address License#
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRED Y/N
<br /> Address License#
<br /> MECHANICAL - COMIPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � " ' License#
<br /> OTHER COMPANY
<br /> SIGNATURE ` REGISTERED Y/N . FEE CURRE(� Y/N.
<br /> Addre�s � ' License#
<br /> RESIDENTIAL•:. Attach(2):PIot.Plaris;,(2)sets.of:Buflding°Rlans;�(1)set of Energy�Form§;'R=0-W Perrnit for new construcUon,
<br /> Minimum:.ten(A,0)_working days after,sutimittal date::;Requlred.onsite,�Conshucdon Plans;Stormwater'Plans w/Silt Fence installed,
<br /> Sanitery Facilitles,&:7�dumpster_Site>Work�,Perrnit.for.subdfvisi.ons/large•priojects�- ., '
<br /> COMMERCIAL Attach(3)oompl'ete sefs of Building'Plans plus a Life Safety Page;�(1)set of Energy Fortns.R-O-1N Permit for new constnicUon.
<br /> Minimum ten(10)wo�lcing days after submittal date. Requfred onsite,ConstrucUon Plans,Stormwater Plans wl Silt Fence installed,
<br /> SaNtary Facilitles 8 1 dumpster.Site Work Permit for all new proJects:°All commercial requlrements must meet compllance
<br /> SIGN PERMIT Attacti(2)sets of Engineered�P.lans:.; � . � �. ' •
<br /> ""PROPERTY SUR1/EY requfred for_all NEW constructlon.
<br /> Directlons: _ _._
<br /> Fill out applica8on completely. � I � ', ,
<br /> Ouvner 8 Contractor sign back of appl(catlon,notarized � .
<br /> If over 52500.a Notice-of�ommencement i�requirad. (AIC upgrades over 57500) �j � -`• �o `� ' ���o`; --
<br /> " Agent(for the contractor)or PoVirer of Attomey(fo�the�owner)would be someone with notarized letter from ovmer authorizing same � � ' ~ 1 i,,
<br /> DVER THE COUNTER PERMITTING (Front of Application Only) ' �, �� „ .,-. v.��9�.'�°: ,`" • "._7 , �
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) ;f" `''��,t.'' , '=':,` ;,e �
<br /> _ � -�,ti�; � ,;,�., ,. „ , ;{c; � '-1
<br /> Driveways-Not over Counter if on public roadways..needs ROW � �i�:= -••• ° � - �
<br /> �..�z�.,.r_n A..�,•o..,.-.,,�..��,-,�..._.�_ . ��,�.,�. ...
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