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<br /> 813-780-0020 City of Zephyrhills Permit Appiication Fax-813-780-0021
<br /> Bu1{ding Department
<br /> Dafe Receivad• �. .- � ' Phone Contacf for Perrnitting -- •
<br /> o.wner�s,Nai►ma ���. �(�. ��Q f—S Owner Phane Number �� '��a '�1 ttf ,
<br /> Owner'.s Addresst ��� � l.�i t f')`�-(��� �/1�,� l�"01� .1-�t 5�Ob' Owner Phone Num6er
<br /> Fee Slmple Titlehalcler Name Owner Phone Number� ' �
<br /> Fee 5imple Titleholder Address
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<br /> JOB ADDRESS.•, w.J � "I'� I Q��(t��.. �I/r. �t t`�j � . ���I� LOT# ��
<br /> SUBDIVISION �� � ;PARCEC:ID# f �'��-��—���—������ --�� Cf�.
<br /> ' • � �(OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK`PRl7pOSE0'' e NEW CONSTR e ADDIALT C] SIGN [� MOVE Q DEMOLtSN
<br /> � ��� ` INSTALL. REPAIR 1
<br /> PROFQSED USE , C�/ SFR Q COMM Q OTH�R
<br /> TYPE OF COPISTFZI�CTIOW Q BLOCK Q FRAME Q STEEL Q OTHER
<br /> DESCRIP,T;ION,OF�W. ,ORK (.'��A'� t-�,�a4+ �e-�1�� .I`I � 1�0.f e„ �lAf2(lS cOf�1i t� S uar�i 1c���P(� �tiT�1�'�cV'�
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<br /> BUILDING SIZE. `e„�. . � ;SQiF007'AGE C��,� HEIGHT �_�
<br /> Q BUiLDING $��"'���' h.;':°.��''�m';:�-.��::;;.. 4;-`. ,.., ��/ACUATION`OFTOTAL.CONSTRUCTION y ,�
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<br /> Q E�.ECTRICAL � � AMP SERV{CE � PFtOGRESS ENERGY 0 VIt.R,E.G.
<br /> Q � P1.UMBING � � I�'i'r���� 1� ��i�`� �
<br /> r� y �
<br /> Q MECHANIGAL �$ , � VAt,UATICIN OF MECHAIVICAL(NSTAI.tAT10Nj��V��
<br /> � ��� ��r�
<br /> Q GAS � ROOFING Q SPECIALTY Q OTHER C� � ��'�n
<br /> FINISHED FLOOR ELEVATIONS , FLOOD ZONE AREA QYES QNO�J���
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<br /> BUiLpER ' GOMPANY
<br /> StGNATUR� REGISTEREO Y/ N FEE CURRENT - Y/N
<br /> Address l.icense# , �� ' �
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<br /> ELECTRICIAN GOMPANY
<br /> SIGNAYUFtIE REGISTER6p Y/ N �FEE CURRENT Y/N
<br /> Address � License# � �
<br /> PLUMBER C�MPANY
<br /> SIG111ATURE ' REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License# � �
<br /> MEC}iANiCAL COMPANY
<br /> SIGNATURE REGisreRED Y/ N FEE CURREN7 Y/N
<br /> Address ' License# 1 . I
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<br /> dTHER`'.__... �M /�� n,, r� j �/ COMPAi�II( ��t 1(�{)#`ti ' �-
<br /> SI(�NATdJRE 4 CN" ��1� I��C..L �,UOO(,/� \ � �� REGISTER�D Y% N FEE CUR EN7 '/N
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<br /> - - Aclilr��s - .��I.�_S� �J�- Z� I'1- ("I1d�I S �� ��JS� �`License# I�''��i�Z����
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<br /> 32ESIdENT1AL , Attach.{2}Ptot Pians;(2}sets af Butlding Plans;(1}set o€Energy�orms;R-O-W Permlt for new constntction,
<br /> . Minimum ten(10)working days after subrrmittal date. Required onsite,Canstriiction Pians,Stormwater Plans w/Silt Fence installed,
<br /> Sanitaty Facilitles 8�1 dumpster,Site Vlfork 1'ermit far subdivlsiansllsrge proJecks . .
<br /> CC3iNMERCiAL Attach(3)se#s o#?Buflding Pians;(1)sef of Enetgy Forms.i2-O-W.Permit for new construction: •
<br /> Minimum ten(10)working iiays after submitkal date. Required onsite,Canstructian Pians,Stormwater Plans w/Silt Fence installed,
<br /> SanEtary Fac9tlties&1 dumpster.Site Work Permit for a]t new projects.Att commerciai requirements must irieet comptiance'
<br /> SIGN PERMIT Aftach(2}se#s of Engineereii Plans. , '
<br /> "*'PROPER7Y SURVEY required for all NEW construcdan. '
<br /> Direations:
<br /> Fill ouk application completely. �
<br /> Ownec&�antractor sign.baak of appiication,•natarized
<br /> ' If over$2500,a.Notice of Commencement is requlred. (A/C upgrades over$500a) � _ . . ,
<br /> '* Agent(for the contractor)or Poviier of Attomey(fo�the owner}would be sorneone wlth notarized letter from owner authorizing same
<br /> 'OV6R THE COUN7ER PERMtTI'ING (Front of Application Ontyj � ,„� � ' � .: „
<br /> Reroofs � �Sewers � Service Upgrades A/C Fences(Plot/Survey/Footage) � ,
<br /> Driveways-Not over Counter if on public roadways..needs ROW �
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