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a�s-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-fl021
<br /> Building Department
<br /> Date Received �--�—��/j phone Contact for Fermifting ��� �������
<br /> Owners Name �—N���'�... rn� Owne�Phone Number j�'" 1 C1 U!'"GY�3 �+
<br /> Owner's Address �V� 1.�� Cy'i� 7 Of"� i!r �l��i� ��ner Phone Number �! �
<br /> Fee Simple Titiehoider Name �� Owner Phone Number �� �
<br /> Fee Simple TitSehoider Address
<br /> JOB ADDRESS �,J�+� 1 lUnTl�I �O� V f' ►I � �1� li S �� �✓� j � LdT# ��
<br /> SUBDIVISiON �^ � PARCEL ED# (,l�+��"�al ( `���� '�D�� �����
<br /> (OBTAINEO FROM PROPERTY TAX N0710E)
<br /> WORK PROPOSED e �vEw coNSTR 8 ADqlALT � SIGN C] Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE 0 SFR Q COMM � OTNER '
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEE� �
<br /> :
<br /> DESCRiPTIOAS OF WORK �"'t V(}t�
<br /> SUfl.DttlCo SIZE � � S0 FOOTAGE UI��� HEIGHT C���
<br /> QBUILDING �6 � VALUATION OF TOTAL CONSTRUCTION I F,J� � 7 �
<br /> �ELECTR�CAL � � AMP SERViCE 0 PROGRESS ENERGY 0 W.R.E.G
<br /> �PLUMSlNG � � � �n �
<br /> �� U
<br /> QMEGHANIGR� $ VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS � ROOFING Q SPECIALTY �� QTHER �
<br /> F{NiSHED FLOOR ELEVATiONS FLOOD ZONE AREA �YES NQ� ��
<br /> BUILDER � � COMPANY
<br /> SIGNATURE � REGISTERED Y I N FEE CURRE� Y/N
<br /> Address ticense# �— �
<br /> ELECTRICIAN � � COMPANY
<br /> SIGPIA7URE REGIS7ERED Y/ N FEE CURREA Y I RI
<br /> Address License# �� �
<br /> PLUMBER � COMPANY
<br /> SiGtdA7URE f2EGISTERED Y/ N FEE CURREt� Y/N
<br /> Address License# � �—�
<br /> MECHANiGAL � � CONIPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �— �
<br /> OTHEF't �C.� !"'ICtC�{�X�V"� COMPANY IYIQrI W�'7� �C!.
<br /> SIC,NATURE REGISTERED N �EE CURRE� Y 1 N
<br /> Address t,l��� � �� �� (�� 3�y �icense# ��C i3a S50 5�
<br /> � � e � � � eeta � eat � tea ' � s � e � e � � � reteeolllllBlldllllllllllllllMIIIIAIls1
<br /> RESIDENTIAL Attach(2)PIot,Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-d-W Permit for new construction,
<br /> Minimum ten(1 d}working days after submittal date. Requiced ansite,Constructian Pians,`Stormwater Plans,wf Silt Fence installed,
<br /> 5anitary Facitities&1�dumpster,Site Wark 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 /> Mi�imum ten(1 d}working days af#er submittal date. Required ansite,Construction Pians,Stormwater Plans w!Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans. �
<br /> "'*PROPERTY SURVEY required for aii hlEW cons#rucfion.
<br /> f1 ■ • t • f ■ • ■ ■ • Y ■ ■ ■ ■ ■ ■ ■ � L 1 ■ ■ ■
<br /> Directions:
<br /> FiH ou#appiication completely
<br /> Owner&Contractor sign back of application,notarized
<br /> If over$2500,a Notice of Commencement is required. (AIC upgrades aver$7500}
<br /> •; Agent(for the contractor)or Power of Attomey(for tfie owner}would be someone with notarized tetter ftam owner authorizing same
<br /> OVER THE CQUNTER PERMITTII�G (Front of Appiicafion Onty}
<br /> Reroofs if shingles Sewers Sen+ice Upgrades A!C Fences(PIoUSunreylFootage)
<br /> Qriveways-Not over Counter if on publict�oadway's'.needs ROW` -�� .� �� `?� ,�v;'' `•� � � ��`` _ 4, , ;�
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