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813-780-0020 City of Zephyrhills Permit Application Fax-813-780.0021
<br /> � • Building Department
<br /> Date 12ecelved . , . � `-phone-Contact%for'PernNttin'��� - � '
<br /> Owner's Name l/-e " �� � C� .v /'C� � � Own�r Phone Number '
<br /> Owner's Address � �• �' �" - • �� � Owne�•Phone Numb�r '
<br /> Fee Simple TlNeholder`Name��- ` ` � �F ' • Owner Phone.Numb�r":�-. . _
<br /> , _ �:��._. ,. , , . . , . _ . "�--
<br /> Fee Stmple Tltleholder�Address, . ` ' � _� ,�., - . .. `
<br /> JOB ADDRESS � �J �p�JL� Qr(� � ` ' LOT# � ,
<br /> SUBDIVISION .:µ: . _ � - ��a�c��iu# l.Z��'"�/„6U�(3 —��6Z�— G D� � �`
<br /> : • • � �� � � � � � �(OBTAINED FROIL4 PROPERTY TAX'NOTICE) `
<br /> WORK PROPOSED ' NEW{ONSTR : " ��� 'ADD/ALT Q' -`SIGN ��Q � ' . Q` 'DEMOUSH -
<br /> , _ B� '., INSTALL ��8.� .-_REPAIR -� - -. : ,. � . ,
<br /> PROPOSED:USE• . . Q� SFR. ` ,:`[� , ;COMM��. 'Q ' OTHER , :. � ; _ . '
<br /> TYPE OF CONSTRUCTION„ ;'Q". BLOCK' ;' ;Q'� -':FRAME , � .STEEL, -Q„-,;.-.a ,,.;, .� - - _
<br /> _ ' �.
<br /> DESCRIPTION OF WORK r`e Gi� ' " " � �(�- -.`f( S ' ' ,.
<br /> BUILDING�SIZE"' , � `'$Q.FOOTAGE: . ;HEIGH�`; . �-, ,'� ' . .
<br /> � _ °
<br /> ,. OBUILDING $ '�;.��:«;��,, ,-..,.e,�:....... . , _ . , _,
<br /> • ,. _, -- ��, _ '•VALUATION�F`�`OTAL�`CONSTRtJCTION
<br /> ELECTRICAL $ • �-AMP SERVIGE �j�Q� ��/ PROGRESS ENERGY [_]: 1AI.R.E.C.
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<br /> QPtUMBING •..- $ , •- ' - `
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<br /> [�MECHANICAL' $ ' � ' .._VALUATION.OF.MECHANICAL,INSTALLATION -- �-f'=' /:
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<br /> QGAS , .�Q;. ;_ROOFING,c;��Q SPECIALIY°Q- OTHER � - . �r
<br /> FINISHED FLOOR ELEVi4T10NS FLOOD ZONE AREA [�YES. NO : . l��..,� � �
<br /> : ,.'s�:_.. .. . . . , �. : .
<br /> BUILDER COMPANI(' ::� " -� • ' ' `
<br /> SIGNATURE REGISTERED Y/ N. - FEE CU��°`.,,,. �`�Y/:N._- _, „
<br /> Add�e�s _ _ ,�.,, . ,,. , ... � ,. . � � .
<br /> , , . � - .. _ - ....�. : .�.
<br /> 'l:lcense#
<br /> ELECTRICIAN� . �n~ ,. �..v�-' -„ , .� :.`'t,:COMPANY '` .,� .�
<br /> SIGNATURE y REGISTERED Y/ N F�¢uriite� `Y7 N' : ,� "
<br /> Address ".-, i n'a1;� ',Licen'se#���/i �O�''.� -
<br /> PLUMBER ��;4 . 4 , . , ,COMPANY� > > . . ,�. �
<br /> SIGNATURE � � . _ t REGISTERE - ` '- y, . .
<br /> , a; .�> <Y/-�N,:;; ;�_cu�En. .Y7N:-.
<br /> Address ,— �. � .� . ,.. _ : , .Ucense#t. . .. - .
<br /> .-,�; �. F•r- , . - � � .. _. .
<br /> INECHANICAL , , „ � - ,. -.COMP _ !: - _ �
<br /> SIGNATURE . ,. , .- ��- ., . . F;�' . ,. • .r . . ANY._.,,.:: " �;' _ :.�.;:t�•.,, ..,�..
<br /> REGISTERED;,� .. :Y./':N:.;.� .;�FEE,CURREN.; �:Y./�V_�'' .
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<br /> Addresa.,,.:,,,�., , ... ;. ,.. - �•
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<br /> . . _. ... � ;. :.,,. ,.�_.� , ,;License:#
<br /> OTHER ._. ,:�. ,,.�._I:�; �i° . � , , :E;:- ., , ,. :.�,.<��„ _ =`' . . , . - , .. . . . ., . -, . .. _.
<br /> :; , .CO�IAPATIY�: - - �y - -
<br /> SIGNATURE,- �,� �b. . . _ :4..._ _ r ,..:,: _ ..,. x-�: .,._.. .. �r. .. . . ..�•.,,<.,..,; , :._�
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<br /> REGISTERED_ .,Y/ N,:; ; �-�FE�:CURBE� =�;Y/;N.:` :
<br /> /alddPeSS , ,. . - - '` �': ` - , �- _, . . . _ . . -. -' -. - , .
<br /> �_;;: a�:�r.;;,�"_ _ ,:�;,,; ,-Ltcense#
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<br /> RESIDEN11ALi =�AttacFi„(2`,P1ot;Pla'ris;;"2:"sets•.of:Buildln``':Rlans;.���7�"s''etof�Ene �Fortns;;R�O�W-P.err`rilt:for,new`constnic�ton �- � ,.
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<br /> ..�:4•,,.Miniinum�,tenw(;1;0.);�'rArking;day;s�aiteri's`utiKiiittal�date;�Reguli�ed onslte;-ConsfruoHon�Plans;vStoimwater",.'Plans w/Siit Fence.(nstalled,-
<br /> �.�,.:-,:.�� > � . . < <...... ,._,.,�:. , -• . I
<br /> � Sanftary Fadlides&s�.dumRsterwSlte�Wor�c Per,�niE�or subdlvlslonsAanBe;pinJects;�r7-`s��-;�; ��";=�=r�:= �- - -� -''�'•�'�.-'-� ° '.- .
<br /> � � COMMERCIAL Attach(3j`coriipl'ete'"sets of�Bu1ldlrigzPlans plus ahU�fe Safety Page;(1)set of Energy Forms.R-O-W Permit for new canstructlon.
<br /> Minimum ten(10)working days'aRer submittal date. Requlred onsite,.Constructian Plans,Stortnwater Plans w/Silt Fence installed,.,
<br /> Sanitary_FadliUes,&1.dumRster.,Site.Work�Permit•for�Il�newfprojects:��All'commercial:oequlrements:musYmeet'compllance . .
<br /> SIGW PERMIT AttacFi'(2)"`§ets of'En'g'�neer,ed�Pl'ans:�ti?;ts;:�sK`' ... _ . . _ "`.' , ' '. ' .
<br /> ""PROP.ER7'1'SURVEY:reguired;UQr„a11�NE1N:constnictioq: - � ' - " �` - - - - , ' - -
<br /> - - = :.3.. „�_
<br /> �Dlrectlons: •- =�:�=:`:ri<:,-;�;:a�;=: �y ,. _. ...._ _..._.._. __ _ .. . .
<br /> FfU out epplicaUon completely. I
<br /> Owner&Contrectorsign back:of appl(caUon,notarized
<br /> If over�2500,a;Notice of.Commenc�ment la.require�: (�11C upgrades over E7500),�, . �•- ._..
<br /> . ..,._.._ .1..,:...:..,:<M�.: ._ _ ._ :_ . _ _'
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<br /> AgenF(for tFie contracfor):or:Power of Attomey(forthe�owner).would:be someone.writh notarized letter from owner authoNzing same
<br /> 'OVER THE COUNTER.PERMITTING�="--;~":�(Front�;ofyApplicatlon Only)~�� ' '
<br /> Reroofs if shingles �Sewars Soryice:Upgredes'/VC,' � Fences,.(RIot/Survey/Footage) __ .. - -
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<br /> Drlv�ways-Not over Coun4er if on public roadweji�.:needs ROW .,„ `
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