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<br /> s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> Dato Received �–a Q� ,� phone Contact for Permitting ��� �� v� �� ` 1
<br /> Owner'sName rU�� UI10.li��IV� �le� OwnerPhoneMumber r3' / �`�_�"� I
<br /> Owner's Address SUQ�I S��1�e� I�;I I �r' I I ���� Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS l_Jv�� c�mmer hl)(I QJ�. h {h��I S F� ,3�� 1 1 LOT# �
<br /> - / D - T n
<br /> SUBDIVISION PARCEL ID# � ��^�1 '��� ��V ^���V
<br />' (OBTAINED FROM PROPERTY TAX NOTCE)
<br /> WORK PROPOSED e NEw CONSTR e ADD/ALT 0 SIGN � � DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE 0 SFR Q COMM 0 OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK -ectr g-�� �e-�oo� 33s u��s C��F7�mber���e a s ha,l� 5h�(� Jf S
<br />' BUILDING SIZE SQ FOOTAGE I� �v HEIGHT
<br /> QBUILDING $ J� � �LJ� VALUATION OF TOTAL CONSTRUCTION
<br /> I /
<br /> �ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY 0 W.R.E.C.
<br /> �PLUMBING $
<br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � 1 � J L �
<br /> OGAS Q ROOFING Q SPECIALTY � OTHER / ?j� �/
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO (
<br /> BUILDER COMPANY
<br /> SIGIdATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
<br /> Address License#
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> OTHER a �fj19i �� COMPAMY ��� U�n �nG
<br /> SIGtdATURE �Y��`'`' REGISTERED Y/ N FEE RRE� Y/N
<br /> Address ��3 �� 5 h ✓rl!I�S ��S License# l.�l�l.���G S�� J
<br /> i i 1 L L 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 1 1 1 1 ! 1 1 1 1 i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 f 1
<br /> I RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> I Sanitary Facilities&1 dumpster;Site Work 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 /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,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 all NEW construction.
<br /> . . . . . . . . . . . . . . . r. ._._.�
<br /> Directions: ' ' � � -
<br /> Fill out application completely. , _
<br /> ..�.Owner&Contractor sign�back of application,notarized
<br /> i '� �r'i;��',',�'r.lf oveF$2500,a Notice�of:Commencement is required. (A/C upgrades�overg7500),������-�`�'�' �-" -- "'-��
<br /> . �,:: , ,.• ,•. ,,; v � �,�^� „ ,. . ; �.....•`=,;s;�",:,:,,�i i
<br /> [-:r t z• I; ;�,i�
<br /> `t-�•-�" ��A ent for�the:contractor or POwer of Attome for the owner would be someone with,notarized letter,from owner.authori�in same
<br /> a� g ( ) _.. , Y� ) , ; . _��, 9
<br /> �; .. ,�::;� t � �. ,. � - ; :;� .. ,.
<br /> � ,..OVER,THE COUNTER PERMITTING (Front of Application Only) t; � �" ' �' � ' ' "" "�" • ,��.aF�'r = j u
<br /> ii �.,. . ,t . �;,i, � . ' ,�,
<br /> �: , . ' : y . Service U • �� � � - `
<br /> 1, f2eroofs.if.shingles_.. . Sewers", pgrades A/C Fences(PIoUSurvey/Kootage)'`__' • •�� �
<br /> \r-..,-.:_�..>.,� . .� v_ s ,..n... ._. . :�>,..._ -,� _..._. � . _o.�..ev^cur.:.+. -ui�-. ...:t�.�G:,..r,v,e�l�,ii:a . "'n
<br /> Driveways-Not over Counter if on public roadways..needs ROW
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