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e�3asaoozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> '' 8uilding Department �
<br /> DateRecelved ^ Phone-Contact.focPermltNn :_ l �6�� /� YZ
<br /> ,r .. _ : _ .
<br /> Owner's Name � V��r fJ � Owner Phone Number
<br /> Owner's Address ��Z � « T� �/ - Owner Phone Number
<br /> Fee Slmple Titleholder Name � � Owner Phone Number �
<br /> ;� . . .
<br /> Fee Simple Titliholder Address =' -
<br /> JOB�1DDRESS LOT# �
<br /> SUBDIVISION PARCEL ID# �2 'Z� — 2/ � D l80� O o pB e . -v o Z G
<br /> , (OBTAINED FROM PROPERTYTAX NOTICE�•
<br /> WORK PROPOSED 'T NEW CONSTR' ADD/ALT Q SIGN'• Q Q DEMOLISH
<br /> , ��. INSTALL 8 REPAIR
<br /> PROPOSED-USE y Q SFR �. COMM� Q OTHER �
<br /> TYPE OF CONSTRUCTION• : Q BLOCK ~ Q FRAME [� STEEL 'Q
<br /> c
<br /> DESCRIPTION OF WORK z '�l�6 c lv G�iS��TL`r �vG� GsN�%�
<br /> BUILDING SI2E � SQ.FOOTAGE' z�� � , , HEIGHT � � -
<br /> �BUILDING $ VALUATION�OF 1'OTAL CONSTRUGTION '
<br /> z� o�
<br /> QELECTRICAL $ , AMP SERVICE 'Q' PROGRESS ENERGY Q W.R.E:C.
<br /> QPLUMBING $ '
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � (
<br /> [�GAS Q ROOFING •;Q SPECIALTY Q OTHER; � I �/��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDEFt � coMParnr �}�G � ���� C a
<br /> SIGNATUPtE r REGISTERED / N FEE CURRE� Y N
<br /> Address License# �
<br /> ELECTRICIAN : -� - COMPANY � -
<br /> SIGNATUItE ,' REGISTERED Y/ N FEE'CURRE� �Y/N-
<br /> . , , ,� ' <�
<br /> Address , Ucense#.�
<br /> PLUMBER , . , _. - i :COMPANI6., ; ,
<br /> SIGNATURE "� _REGI$TERED - Y./.-N FEE CURREK Y/N -
<br /> AddfASB , LicenSe#�
<br /> . ,. �
<br /> MECHANICAL ? , . . , COMPANY -. �. >
<br /> SIGNATURE , REGISTERED; Y,/,N. FEE 6URRE�' Y/.N .
<br /> Address=` = � .- , . � _ - - License# �
<br /> OTHER ` . . �COMPANY -`:f , � .
<br /> SIGNATURE �� � - � j `REGISTERED' Y/ N._� FEE.CURRE� Y/N
<br /> , „ . . -, . .. ,.. : . . _ . :.. . .
<br /> Addres� - - ' License#
<br /> � 5 .,�...s._. — -y:�. . . �. J 4. .,,-.7: ;! v, '�� � , � _
<br /> �RESIDENTIAL'_, �Attach(2)iPlotcP<.lans;..(2):sets�of�Buflding;Plans;(1-j sef'of Energy�Fomi`s;R=0-V11�Peiinit'for'new�construcUon, � �
<br /> ,•Mlnimumsten;(1,0)wworking,aeys:�ee��s�bmiecar:date:<Required.onsite;�Canstru6don;Pians;Stomiwater Plans w/Silf"Fence Installed,
<br /> Sanitary Facflitles�&�:1�tlumpster,Site,WorkPerrnitforsubd(Vislonsllerge proJects _ _:`��•"' '' "� `
<br /> COMMERCIAL Attach(3)'complete'set9"of Buildirig"Plans plus a Life'Safety Page;(1)set of Energy Fortns.R-O-W Pertnit for new construcUon. �
<br /> Minimum ten(10)working days'after submittal date. Requtred onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciltUes&1 dumpster.Site Work Permlt for all new;projecfs:All commercial requlrements must meet compliance
<br /> SIGN PERMIT Attacti(2j'sets�of'Engineered;Plaris;,,��>,�:^,.t`-� � -_ - •. . ' �
<br /> "•'PROPERTY SURVEY required for,all,NEW_constructlon.
<br /> Directfons: . � , . �
<br /> Fill out applicadon completely.
<br /> Owner 8 ContracMr sign.back of applicadon,notarized _
<br /> If ovar 52500.,a Nottce of Commencement ts requlred. (A!C upgrades over 57500)
<br /> .. ,-:E„�':�-';,�:'<<:;"`";'.
<br /> P�qent(for the oontractor)or Power of`Attortiey(fo�the owner)would be someone with nota�ized letter from owner authorizing same
<br /> OVERTHECOUNTER:P.ERMITrING-=��-• -,(Frontof�ApplicationOnly)���.
<br /> Reroofs if shingles Sewers- Service Upgrades A/C Ferices'(PIoUSurvey/Footage)
<br /> Drivewaya-Not over Counter If on public roadweys..ne'eds�ROW �
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