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<br /> 813;�so-oo2a City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � , Building department
<br /> Date Reeelved Phone-Carr#act for Parcntttin
<br />� a -
<br /> Qwner's Name �'U�-�i"rl� �7���►,�-�s �..L C Owner Phone Humber g�� °�.�f��3 Y�"
<br /> Owner's Address �:-��� �� c v�� 5 � Owner Phone Number � �
<br /> II Fee Simple Tltleholder Name �� � Owner Phone Number � �
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<br /> Fee Simple Titleholder Address
<br />' S An�.� �-S (-�-�G v� ��
<br /> JOB ADDRESS LOT#
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<br /> SUBDIVISION � � PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NQTICE)
<br />� WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH j
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<br /> ' INSTALL 8 REPAIR
<br /> I PROPQSED USE Q SFR Q C{)MM C] OTHER
<br />' TYPE OF CONSTRUC710N Q BLOCK R Q FRAME C] STEEL Q
<br /> DESCRIPTIONOFWORK �� ��=C�~«�` ��'I � S�"� V�'¢'"'��
<br /> BUiLDiNG SIZE �` � SQ FOOTAGE C�� HEIGHT ���
<br /> QBUI�DtNG ($—"— ._ _,. .., -
<br /> L , � VALUATION QF TOTAL CONSTRUCTION _
<br /> I QEIECTRICAI. ($ �y��-� r�-'-°� AMP SERVICE Q PRQGRESS Eh1ERGY [� W.R.E.C.
<br /> � r
<br /> QPLUMBING ($ �
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<br /> QMECHANICA� r$ VALUATION OF MECHANICAl.INSTACIATlON
<br /> L���:
<br /> OGAS . Q RQ4FII+IC� Q SPECIALTY �� OTHEF2 I
<br /> FINISHED FLOOR ELEVATIONS ��_-� FLOOD ZQNE AREA QYES NO I
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<br /> BUICDER COMPANY I
<br /> SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N
<br /> Address License# �— �
<br /> EtECTRICIAN �Csv ��'S F{ f2o�e2f �(1 z�'Zf ,�Ll7�l'�`2� �'„�C
<br /> � COMPANY �
<br /> SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address License# � ��
<br /> PLUMBER CBMFANY
<br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � �
<br /> MECHANICAL , - COMPANY
<br /> SIGNATURE REGISTEREO Y% N FEE CURRE� Y/N
<br /> Addrsss 4 License# �— ��
<br /> OTHER COMP/.1NY .t
<br /> SIGNA7URE ' ReG�STe�� Y/ N FEE CURRE� Y/N
<br /> Addrsss License# �� �
<br /> RESIDEPlTIAI: Attach�2}Plof P#ans;(2}sets=of=8aildiitg'Plans;{1}set of-Energy°Forms;R O-W Permit for new canstruction,
<br /> Minimum:ten;(�1.0)-woricing days after"submittal date: Required onslte,Constivcdon Plans;�Stomnwater Flans.w/Silt Fence installed, � � �
<br /> Sanifary 6acpiUss.&,.1.,dumpster Site Work�Rertnit far-subdidistonsllarge proJec� � "
<br /> CONIMERCIAl. Attach{3}comple#e seEs of Buildirig Plans plus a l.ife Safety Page;(1}set of Energy Forms.R-O•W Permit-#ar new conshuction.
<br /> � Minimum.ten(10)working days after submittal date. Required onsite,Construction Pians,Stormwater Plans w/Silt Fence installed,
<br /> San{tary Faailities&1 dumpstar.Site Worfc Permft for all ne+nr projeots:All cammercia!requtrements must meet complfance
<br /> StGN PERMIT Attach'{2}sets afEnglneered Plans:., �'.�
<br /> "'"PROPERTY SURVEY required for all NEW canshuctlon.
<br /> pirectlons: � .
<br /> Ffll out applicadon completely. ' � ,'. � -
<br /> Owner$Contra�tor sEgn back of applicaUon,notarized _ -- �__ . � � � `
<br /> ff over 52500,a Notice af Commencement is required. (A►C upgrades over�7500) ` "'� ."•:','�
<br /> " Agent(for ttie contractor)or Power of Attomey(foc the owner)would be someone with notarized letter from owne�authorizing same
<br /> —__. _ .�.-,c�->:��__ . r...>
<br /> dYER 7HE COUNTER PERMITFING (Front of�Application Only) , , . ,-,, � ¢s�V:'•,
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) �� ,, ,, , - .. ,- - 4 ,
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<br /> Driveways-Not over Counter if on public roadways..needs ROW � . _,. .�.,.. .�, . - � _ Mf i
<br /> ..�._ �.., . . .. . ,._ �.�,,.,t�,.,,�,:-,._.-�,. �.. .
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