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813-7.80-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> • Building Departrnent
<br /> Date Recelved , .. . �(j ,. � ,�.phone Contact?for PermitUn` ''' o�-� o��7" — 1 �3
<br /> ��_ , t . _ . .,. .
<br /> Owner's Name 1/1 �Cl'►J�� 2.! Owrner Phone Number - � '
<br /> Owner'sAddress �3a� I�. s-l� _ � � Oinner-PhoneNumtier �
<br /> „ . � - ,
<br /> . .:
<br /> F�e Sfmple Tltlehold�r.Nam� � '.° Owner Phone Numb�r ..-
<br /> _ , . a.,, . , ,. , , - - -. , . ..
<br /> Fee Simple Titleholder Address, -,. , � a
<br /> JOB ADDRESS LOT#_ �
<br /> SUBDIVISION ,:� , . PARCEL'ID#'" ' , ' ` - ' � �� .
<br /> . . • _ " `. (OBTAINED PROM PROPERTY TAX'NOTICE)` -' � �
<br /> WORK PROPOSED e NEW CONSTR e ADD/ALT -Q� SIGN _�'r " ' �Q,'" �,:DEMOLISH - ,
<br /> .., -, , B y •..INBTALL � :Br- REPAIR ' �� - . ' . .' _
<br /> PROPOSED�USE- , - [�'_ �`SFR - [� COMM�`�_ Q `OTHER ' � ' ��" �
<br /> TYPE OF CONSTTtUCTION_ "-'Q BLOCK�' `.� � � '_FRAME Q STEEL. .Q� �_� . _
<br /> DESCitIPT10Pl OF1RfORK _• ��Yl �II �0{� , t7�- ��/�-fl _ l�� W 6✓tG10L.�S ' - `
<br /> . �,. _ � .
<br /> BUILDIPIGSIZE��' ' ' SCl.FOOTAGE: �HEIGHT:`. ' • • �� �
<br /> ,,�,3.,. . ,
<br /> =' -�F��;�a..r.. ;3r�r,..,. `. . .. . _
<br /> OBUILDING _ $ VAL-UATION'bF�T01'AL'CONSTRUCTION . � �
<br /> � �a - 3 _ t . � ._ . . ,
<br /> QELECTRICAL $ - % =AMP SERVICE ' Q PROGRESS ENERGY [���,� 'W.R.E.C.�
<br /> QPLUMBING '$`
<br /> QMECHANICAL` $� ,. -VALUia►TION�OF MECHAIVICAL.INSTALLATION -
<br /> QGAS , Q. _ ROOFING.-, Q SPECIALTY,.Q OTHER� "
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. _ NO ,
<br /> BUILDER y .- `
<br /> , .. _ l '�COMPANY ; . . .�(M,Q OW✓l�� .. ,
<br /> SIGN�►TUItE / 1 �� REGISTERED Y/ N. FEE CUR��' Y lN:�,. , , ,
<br /> Addre�� - - � ` "License#° ` " -
<br /> ELECTRICINd�.,-,, " . , • ,. '`"'' COMPANY ' . _ ,; -
<br /> SIGNATURE 1��' REGISTERED Y/ N FEE GURRE� � Y'/N '�
<br /> Addres�`� ` � , . . . , ' :,•.Gcsnse#='' - � ` • -
<br /> PLUMBER . " - COMP.ANY� :;' , '• _ ` .
<br /> SIGN/►TURE - � ,.. - :���S.7EREo; .�,Y'/>.N . ,FEE�cuwzE�� � `Y YN::'�` '
<br /> Address . � � - , , .License#.;, _ - � � � -
<br /> MHCHANICAL"'` � ,y .„ � . . , ' _� ;CQMPANIF,: _ - _ - = ' • .
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<br /> SIGP114TUIZE . . , , � � �- . �. � . REGISTERED•, ' , .-YI N:, ~:FEE'CURRE� ._ :Y/-IV'�`
<br /> Address ' ' � . ..� , ..� ...` , - .. ,. :License#. �. , ,
<br /> .. , _ , . . . .- . ,
<br /> OTHER . ;•`_�_. .,; ° . , _ . .�-,�,. , .. - ,COMPANY,.. , ---- -. � .,_ , • - . .
<br /> SIGWA'�URE.. ;�"-�;�'r: , � � '' � � �' �� ;.REG�SfiERED ,. Y/ N-:, - �FE�GURBEP� - _'YJ;N�: : . - ..
<br /> -+�' ., . ..- . �. . . " ". .R - .. Y',� . _ _ `"- y ..: ' ' � -
<br /> MYd�@SS �'i r$- ilC,ii:' _ - I}� t _ " w . . . . �L�CPn�JBR
<br /> _ '�:, :i _ ;}. ��, d„�>. w,si- _ r`r�', _. , . ,., .. _ .. :,
<br /> ..,' �for.new`consfniction ~z, .
<br /> '�Flan's a 2�sets:of4Bulldi'n �Plans;;1',setof�Ene �y�Fomi§;;R=O=W�Permlt. �=.
<br /> RESIDENTIAL�::,;-,'°Attach;,(2•)„Plot, ,(..).,. . 9.. . ( )..,,.., r'9 _ _..::-:. . �:�...;:�; - < "
<br /> .�.Mlnlmurti:.tens:10?worlttn �d"a�/sFatter�,�submlttaf�dafe:?_Requli�ed.onsife;�Cons'tiucHori�Plans,-Stormwater`Plansw(:Sllt Fence instailed,, - �
<br /> .H^, f�rv. �.Le�4e . . .9r-..7..s., . ' ' _.`/jiV;:`7�: . � _.'
<br /> '"�.: SaMtary�Fadpde.s;&�+�R�umpste,r.,,Site;Vllorlc�Per.m�t�,fQr;subdivisloti_s%large pro)ects :_`„,,s� '' :�` '�`: `� ..-
<br /> COMMERCIAt Attach(3j`eomplete�sets'Of`Bulldirig`Plans plus a"Llfe Safety Page;(1j set o�Energy Fortns.R-O-W Permit for new donshucdon:
<br /> NliNmum ten(10)working days after submlttal date. Requfred onslte,.ConsWcUon Plans,Stormwater Plans w/Sllt Fence Installed; - ,
<br /> SaNhary.FaclliUes.&,.1.,dumRster..Site.WoricPermlkforall-'new`projeots:'All�commercial:requlrements•must;meeYcompllance � .
<br /> 81GN:PERAAIT Attacti,(2)'sets of'Engin,eered Plans:?�t^a`.'��`" -.- � - _ � �
<br /> •'•"PROPERTY.SURV�Yragulred;fqr:all�NEW;construcUon; ..__ � " � "
<br /> Dlrectlons: Y�". _ � - , � ._ .__ _ .... __._. _ �-.
<br /> FIII out appflcatlon completely.
<br /> Owner 8 Contractar sfgn•back of.applicatlon,notarized
<br /> If over 52500,a,.Notice of,..Commancement Is required. _(NC upgrades over$7500) .,. �_ , -•
<br /> .. ..,-y:;°^,;;�.H�;;:_;��..;: ,�,.r,:. _ -
<br /> AgenY(for tFi`e contractoe)'qr.Power"of Attortiey�(for�the oinrner)would be someone.writh notadzed IettE�r from owner authorizing same
<br /> 'OdER'THE COUNT�R.PERMITTING=�===�=(FronY-'of%Appllca8on Onlq)��� _ �y
<br /> Reroofs lf shingles Sewers Service Upgredes NC Fences,(PIoUSurveylFootage) - - F � -
<br /> .,...._. .�._.._..__�.,.�.. �_�. .., ,, .:.:�,::;:�r.,..:....:.,..; .. , :_._ ,
<br /> ;- '.4_.,��.:. .�i:;:- .
<br /> D"rlveways-Not over Counter lf on publlc roadways.:needs ROW
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