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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Bullding Departrnent
<br /> Date Recelved � - � .,s; • �':r� 7��� �'� f!z
<br /> -- • �� 'Phone�Contact?for�Permtttin
<br /> Owner's Name p/—���� L��� ��/�l�L-~/.✓ p Owner Phone Number . ��` � -
<br /> Owner'sAddress �° �'��/✓� � � OwnerPhone-Numbe► �
<br /> Fee Simple-TlNeholder'Name�� " ' � OwnerPhone Number -�
<br /> ;�, ,. - •, . . '
<br /> _ A
<br /> Fee Simple Titleholder Address ,• � • � � - - �
<br /> JOB�►DDRESS � (,� ��f� " .tJ GL . I.OT# �
<br /> SUBDIVISION ' = PARCEL'ID#"d ' � �d`t.�`•'�.O/�Q> Opo�j�� p,�Z�
<br /> � _ ` � � - " •(OBTAINEDFROM'PROPERTYTAX'NOTICE)` �� � �
<br /> WORK PROPOSED :• NEW CONST : �•'" 'ADD/ALT �Q 'SIGN �] � "� ��' Q'"�'i" �DEMOUSH - _
<br /> • � e + ,''INS7'ALL �= '��==REPAIR = . ,- .. �
<br /> PROPOSED:USE�. 0�_ � SFR Q COMM�'„ � OTHER', � ' - ` . '� ,
<br /> TYPE OF CONSTRUCTiON_ �-�Q `BL'OCK�' ,'Q ���FRAME, 'Q STEEL. Q� .
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<br /> DESCRIPTIOPI OF WORK Z�/� fi✓ L! �.,,; C i►1�.`C-{
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<br /> BUILDING�SIZE = , , SQ:F007`AGE;-�� , ,: ; '., , HEIGHT:. . . � � - '
<br /> �BUILDING $ �7�,�;��:-:-.. .�:r;�r�. ...: , . . : , _ -
<br /> - �, ��' ��j VAGUATION�F''TOTAL CONSTRUCTION , ..
<br /> . s ; _
<br /> QELECTRICAL $ , AMP SERVICE ' ��Q PROORESS ENERGY Q. W.R.E.C, ,
<br /> OPLUMBING $ � � � �
<br /> ,. j V
<br /> OMECHANICAL $ � ' 'VALUATION�bF.MECHANICAL,INSTALLATION �� � -
<br /> OGA$ [� ROOFING;, Q SP.ECIALTY:Q OTHER� ����Jv
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO ,
<br /> SIGNATURE � ` COMPANY ' a ��/'�c� , �i �
<br /> REGISTERED / N. �E cu�n' /N„.. :
<br /> Address -'"' " - ' �LJcense#'; . ' . -,�
<br /> ELECTRICIAN:�: : „ COMPANY ;: .`�` � _ .
<br /> SIGNATURE - "' REGISTERED Y/ N FEE GURREK 'Y`/N �
<br /> Addre�a _ �- . -. - �L-icense#� ._:� ' � - .
<br /> PLUMBER , COMPANY . - . .� ' .
<br /> SIGNATUitE , � - � - . ; :�REcts.�en; _._-::.,�Y 1-:N� �� e�.cu�en' . Y/N. ; .
<br /> Address . � � .� - . .License# - - - •
<br /> . . � � � . ... � , � . - - . -. ,
<br /> MECHANICAL,��� �,. � „ -.COMP�1Nlf, _ - -
<br /> SIGNATURE " ` ' '� REGISTERED,, , , .Y:/•N. ;�FeE Cu�n =Y/•N,_ � ' -
<br /> Address.�: _ ; : �, , , . � ' ..; .. , - � .License.# " . �,t
<br /> „ . . . .� ,_
<br /> OTHER ., .. .`._,: ` ._ : � � - . • COMPANY . • � ,. ' :' , , .. _
<br /> SIGNATURE. , . � � - . . . . < . ° � � . ,REGIS7ERED .Y/ N. 'FE�C.URRE� ^ Y:l,f�l.,_. � . ,' .
<br /> ;�._ . _ , : ' ' , '
<br /> Address =:i. _ :�,;�� _ -.> � ;s? , � .. .. �.. _ . _ �License#�• - - ,
<br /> - _. .,'�;... - •.;�a.:m �•,E.'. J;;•e.. ;:,�%�5:_, e,§:,:'b��.:�' v:r;<<..:. .... . •. .,
<br /> RESIDENTU,,1L,`. �'Attach4(2)�PI_ot;'Plans;H($):sets.of�Building�°Plans;;�l :sef,of�Ene +FoRns;;R=O=W�Rermit:for"�e construction-•
<br /> _ � �., r9Y . -� ,. .., .. .. !3�.:._. �.
<br /> i,, , ..
<br /> Minlmum�.tem 1A.,1, orking,�d"a,y's;after,;sutimlttal�d"aEe:`:Required onsite;�_ " �� �'"��t,,. �`�" `� ,,�_ � •
<br /> .._ � .:(: )'�n( 1 ConsUucdon�Plans��Stomiwate�'P.lans w%Sllk Fence installed,,
<br /> �Sanitary-Fac�Ildes,8��1:�umP,s,ter;Sl�e�,Vllorlc;Per.mll=:fQr.su6div_I'sibns%lergepi�ojects:,%:�;::��>,::=`��;.. .- ' . - - - � -
<br /> COMMERCIAL Attach(3j eoriiplete"'sets of'Bulidirig`Plans plus a L'�fe Safety Page;(1)set ot Energy Forms.R-O-W Pertnit for new construction:
<br /> Minimum ten(10)working days'aRer submittal date. Required onsfte,;ConsUucdan Plans,Stormwater Plans w!Sllt Fence installed;
<br /> Sanitary..Fadlities•&,.1_dumpstar.^SIte,Work.Perrnit,for all;new:p►oJects:All commerciakrequlrements mu�t;meeYcompllance _ � ;
<br /> SIGN:PERMIT Attacti"(2)�sets of E'aglneered Plahs .,,.,,.,r'.� . . .. ' - . , . -, .
<br /> "'•PROPERTY..S.UR�/,EYreguir�d•fgraJI;NEW;co�sWcUon:;.. ,� ; .
<br /> DlrecUons: � -°u':t - - , ..,. .-- -- - - •
<br /> F(ILout applicadon completely.
<br /> Ownar&Cantractor,sign.back:of appl(caUon,notarized �
<br /> If over 52500,:a�Notice of.•Commencement la required. (AIC upgrndes over�7500) _ . .
<br /> �� �,=f"ri,':��?"':1:k"G` -
<br /> Agent(for tfie contractor)oi':Powet'of Altomey'(for tfie=owner)would be someone writh notarized letter from owner authorizing same
<br /> OVER THE GOUNT�R.PERMITIING`��-•= --(Fiont=ofkApplicatiori Oniy) � ' �
<br /> Reroofs if shingles Sewers -Service Upgrades A/C _ Fences(PIoUSurvey/Footege) _.� ;- - _-- , -
<br /> Drlveweys-Not over Counter if on public roadways.:needs ROW
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