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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Buiiding Department
<br /> �atE�r2eceived � phone Contact fat Permitting
<br /> owner's Ftame ����'#S �����'"'��-' Owtter Phane Number �;3 '" ��3 -" �f'b l l
<br /> Owner's�Address�,� �3���' ���` �� i��"�� �{ ' �' 3 35Z� Owner Phane Nutimher� �
<br /> Fee Slmple Titfeholder Name Owner Phone Number
<br /> Fee 5lmple Titleholder Address '
<br /> JOB ADDR�SS ��`'s �' i �d� �"�• ► �h t hi I l g� �, 3 3:i�{2.. LOT# C�
<br /> suaalv�sioN' I � �PARCEI::ID# (i-Z.t�-Zt-� tSc�i o- Ib zc�cs -- �t�7 cs
<br /> � �(OBTAINED FROM PROPERTY TAX NOTICE)
<br /> W.OFiff P.,ROROSEg � t�lEVV CONSTR e ADDIALT 0 SIGN Q MOVE Q DEMOLISH
<br /> � � INSTALI.. FtEPAIFt � �_,-,�F f
<br /> PRQPfJSED USE , Q SFR C� COMM Q OTHER
<br /> TYP�OF C�NSYQiUCTiON Q BLO�CK 0 FRAME Q STEEL Q CITHER
<br /> DESCRIP.TION OF�WORK� �"� �C-� 1.��'1C�` re� Y'C�-� ��l 5 Gh�
<br /> • .'�t .'T.�F�^ �'R>� � .
<br /> �. �::.i� r� ��,.�. '
<br /> .: i,.,
<br /> BUIL.DING SIZE. �_,,,_,,, . � . SQiFOOTAGE� � HEIGHT ���
<br /> Q BUtLDING $;�_r._.._:r,-.__,.�:�..,,�_.._--,-;,.. �.
<br /> ;.,t'�`�,:'?;_,� -' ` �, t�� ;:VALUATIONOFTOTALCONSTRUCTION
<br /> Z..�<".(�',;,: .
<br /> Q ELECTRiCAL � � AMP SERVICE 0 PROGRESS ENERGY Q 1N.R,E.G.
<br /> Q . PI.UM�ING � � � ����
<br /> . . �
<br /> Q, MECHANICAL $ . VAI.UATi01�2 OF MECHANiCAL[IVSTA�EATION
<br /> �,as � �oa�ic�� � . , � Z-3! �
<br /> � � � SPEGtALTY Q OTH�R
<br /> FINISHED FI�OOR ELEVATIIJNS ��� FLOOD ZONE AREA QYES [�NO
<br /> BUtLDER ' COMPANY
<br /> SIGNAYURE RECaISTER6D Y/ N FEE CURRENT Y/N
<br /> ' Address License# � . ' �
<br /> ELECTRtCtAN ' . CQMPANY
<br /> SIGNATd1RE REGISTEREp Y/ N FEE CURRENT Y/N
<br /> Address License# �- � �
<br />, - .
<br />� PLUMBER COMPANY
<br />� SIGNATURE � REGIS�REO Y/ N FEE CURRENT Y!N
<br /> Address License# �� I
<br /> MECNANtCAl, CQMPANY
<br /> SIGIVATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address ' License# �, �
<br /> ._ �COMPANY R. ��-n 1�t.�1c��`1� .,.�."�:. • '
<br /> OTHER"i._.,.•
<br /> SIGNATURE� REGISTERF�p Y IV FEE CURRENT Y' N
<br /> Address ��"'b�1� SrL. 5� �C, �"'� cr{���1{� -� ���t `License# ����Z:�--y`���
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<br /> RESIDENTIAL Attach.{2)PEot Plans;(2}sets of Building Plans;{1)set af Energy Forms;E2-O-W Petmtt for new consfructlon,
<br /> , ; Minimum ten(10)working days after submiital date. Required onsite,Constri�ction Plans,Stoimwater Plans w/Silt Fence installed,
<br /> Sanitairy Facilities&'1 dumpster;Slte Work Permlk for subdivisEonsllarge projects .
<br /> COMMER�9«4L �`'Aftach(3)sefs nf Buitding Plans;(1j set of Ene�gy Fotms.R-O-W.Permit for r�ew construcfion. •.
<br /> Minimum ten(10)working tlays after submitkal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> 8anitary Fac3i38es�1 dumpster.31te Work Permlt for aii new proJects.A!1 cammercia!reguirements must ineet comptlance �
<br /> SiGN PERMIT Attach(2)sets of Engineereii Pians.
<br /> *`*'PROPER"fY SURVEY required far all NEW construction. '
<br /> Directions: ' '
<br /> Fill out application completely. �
<br /> Ownec&Gonfraator sign back oE apptication,notarized
<br /> If over$Z500,a Notice of Commencement is required. (A!C upgrades over$5Q00)
<br /> •* Agent{fnr the r.�ntractor)or Power of Aflomey(for the owner)wouid be someone with notarized letter from owner authorizing same
<br /> A;OVER THE COUNTER,P�.RMITTiNG„_„ (Front of Application Onlyj
<br /> .:. ..� .... �.,
<br /> ;12eroofs . ; Sewers � ����Setvice Upgrades A/C Fences(PIoUSur,vey/Footage)':'•`"'"� _"•�°•..� 4 ...�,
<br /> � � �S� i a."1 1 � . . ,. .
<br /> s � [ � , ' t. � ... �
<br /> , Drlveways-Not over Gountgs$iEk.on;p�blic roadways..needs ROW r " � - �;
<br /> � � � . ,'f. t F K • . . " •��- '4�
<br /> s. .. .i� • .s �..... ..._.�.. . . ..r. ..<3' .i , -. 4... �.,� ....-r. .... .._�_�i...w- .a.�.�e�..v �.a��:.�t_ x.S
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