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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> " - Building Department
<br />', Date Received --� � � Phone Contact for Permitting �v`^ -- "'0� •
<br /> Cbwe�ee's:Name � � I�..�11 e� I n �a�� Owner Phone Plumber �D S ��� � ����
<br /> . .,n:�' .��}.:��, �� ;���S as : �)�.a d o� oa..� u� h � ��I�wner Phone Mumber . .
<br /> OW�tel'S�AflflfeSS'
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder•Address
<br /> JOB;ADDRES�i l0�(� I V� �� � ( r I I I I S �� 3 3 5`I a �o�# C�
<br /> .�: .: , .
<br /> S�Bo���S�oN . T �5o n ��b ,P���E�:��� 0 a-a�-a I -a b�b- ae�o o -o a�b
<br /> , - • � ' �(OBTAINED FROM PROPEE2TY TA7C NOTICE)'
<br /> WORK':PROPOSED�, e NEW CONSTR � ADD/ALT Q�- SIGN Q MOVE Q DEMOLISH
<br /> � �� � �" � INSTALL REPAIR J
<br /> PROPOSED USE _ , Q SFR Q COMM Q OTHER � '� '
<br /> TYPE OF CONSTRUCTION � , BLOC � � FRAME Q STEEL Q OTHER _
<br /> DESG13lP,,„T•.ION 40F3 OIdK• , :ea,�� r�`��0� I J ^ �e.S J �'�¢,�� �1►I� I P S c.�.FeS (1�1 .i P��i�Uf�t
<br /> . . ,. _. -. _ ,. '"� :.� .
<br /> BUILDING SIZE. I� , ,,SQ,;FOOTAGE I�� U HEIGHT � •
<br /> BUILDING $:'':;:;�; ,;,;._�;,,,,�`,y �:;:;-'',',�;" -_ ;;YALIIATION:PJF=l'OtAL.,CONSTRUCTIOM
<br /> �~ �.---�����:.. . . � ,�. :� . . .. . � .
<br /> 0 ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C,
<br /> � �
<br /> . PLUiVI�ING $ + �
<br /> MECHANICAL $ VALUATION OF MECHAfVICAL INSTALLATION � � � ,�
<br /> � , . i .�..
<br /> E C� , �
<br /> Q GAS ROOFING 0 SPECtALTY Q OTH R ✓�`�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO � S ��
<br /> ., j�
<br /> ��,�.��� - ����A�v �
<br /> SIGNATURE REGISTERED Y/ IV FEE CURRENT � Y/N
<br /> Add�ess � • License#. '
<br /> ELECTRICIAN • . COMPAMY � �
<br /> SIGNATURE REGISTERED Y I N �FEE CURRENT �Y/N
<br /> Address � � ' License#
<br /> PLUMBER CONiPANY
<br /> SIGIVA�URE ' REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License#
<br /> AI�ECF9ANICAL COMPAMY •
<br /> I SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address . ' License# `
<br /> �,/ i �f n
<br />' OTIi�PZ';��k;-. ' 'y� �� � LUDOUL ���S .iCOMPANY. ��� `+�I e— ' " ' ,
<br /> SlGNA'�URE��� ' � REGISTER�D Y/ N' FEE RRENT •/N •
<br /> -, -., r �j.�—
<br /> �AcicJ�ess ��J cSll �'1 . Y 1 (�lc-j 5 _( �J�S 5�/� --- -- - - i`�icense# _I(,��/�J Z:S��
<br /> RESIDHNI'TiAI..�• • Attach,(2)Plot Plans;(2);sets of Building Plans;(1.)set of Energy Forms;R-O-W Permit for new construction, I
<br />` , _ .,Minimum ten(10)working days.after submittal date.' Required ons6te,Construction Plans,Stormwater Plans.w/Silt Fence installed;
<br /> I . Sanitary Facilittes 8'1 dumpster;.Sit`e Work Permit for subdivisions/large projects
<br /> COMMERCIAL Attach(3)�sets of�Building Plans;(1�)set of Ene�gy Fortris.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 instaileil,
<br /> Sanitary Facilities&�1 dumpster.Slte Work Permit for all new projects.All commercial�requirements must meet compiiance' �
<br /> SIGPI PERMIT Attach(2),sets of Engineered Plans. • �
<br /> *`�*PROPEF2TY SURVEY`required for all NEW construction. , . . , •
<br /> Directions: ' ' ' � ' �
<br /> Fill out application completely. � '
<br /> Owner&Contractor slgn back ot application,notarized
<br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000)
<br />� "* Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> 'OVER THE COUNTER PERMITTING (Frant of Application Only)
<br /> Reroofs SGvvers��,�,-v:�::,SerVice�UpgraiJes�;° ..` A%C � Fences(PIoUSurvey/Footage)�,�.:=£=Y,..�.-., .._,_:+�.,:��:.;;:;w�.,.�;_�..;�,r„3r::,:rr� -„,;;t�-
<br /> � ,F ... . .....� ,., :.;`...�'°� _ �. .{ . . �.:..:..,, ,..
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<br /> � �j i �.,.,.: -;: ,.,. . �. !t �d�;.t•``,1. �;�:;'`-:J v '�i:'`,i') �t
<br /> Driveways-Not ov�r Counter if.on:public,roadways::ne�ecJs ROW •: f..•, . , ''' - '�,
<br /> ;�'. ,_ . :�:�� . . i � :}� 'ir t...i q. .•Sri" .'{i}`•`� _ . c'i,�^
<br /> �.N.¢�,�' . . .� :1Ctc::iii!'�t'". r`c.:_{.�_ "� .�iF'1:.. ';d . ���•r,�.,::ii'`i•�. '_.fc�'.,.�`3 � . ..
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