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813-780:oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> ' • Bullding Departrnent I
<br /> Date Recetv�d : � �. ' `, �`� = ��� _ , ��`� ' �
<br /> - - -'°' Phone Contact<for'Perrrm(ttin' �
<br /> Owner's Name J7'I'� G�G �i-Tl�/��-L ,�/J O�wner Phone Number b ��—' /O 3"Q�� ��
<br /> Owner's Address ��i ��/` 11� `Z-ff//� Owner•Ptione Number � � �
<br /> Fee Slmple Tltleholder;Name�� � " _ - Ownee Phone Number '�
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<br /> Fee S(mple Titleholder Addre� ., - � . _ � � �
<br />, JOB ADDItESS '� �� �/�/,�<lJ Z'I�I�-S � 6-, . �/�L�7g! 12Z�/77'/ y LOT# �
<br /> SUBDIVISION ` � PAttCEL'ID# • • _ _ � ,-_; ,,,;,.;. .;.
<br /> ` ' ' ' � ` - �'' (O�TAINED FROfdI PROPERTY TAX'NOTICE�' - ""
<br /> WORK PROPOSED '` NEW CONSTR ADD/ALT �Q' 31GN Q�` � � [�t�; _ �DEMOLISH - .
<br /> ,. � B e INSTALL .�'_��REPAIR � � � � �
<br /> PROPOSED>USE� Q:� SFR Q °COMM'' Q OTHER ' ' ' �'
<br /> TYPE OF CONSTRUCTION_� t 0 � -�BL'OCK�'.`Q; ''FF2AME, . �,� STEEL Q. .. � - --
<br /> DESCRIPT10P1-OF WORK � ' � � �
<br /> BUILDING SIZE: , -:$Q:FOOT�IGE: ,., HEIGHT:a..�,°-, . _ •
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<br /> QBUILDING $ �x�;:�:;:.. ..,�-., . � , : .
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<br /> .. , � � � VALUATION'dF TOTAL CONSTRtJCTION 1
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<br /> QELECTRICAL $ -AMP SERVICE Q PROGRESS ENERGY [�. � ,W.R.E.C.,
<br /> 3 .'. .
<br /> QPLUMBING. $' ' �
<br /> Q MECHANICAL � � $ � �VALUATION OF MECHA�VICAL INSTALLATION
<br /> _ �`f 9�, oC� : : � .� , _
<br /> Q�S Q:. ., ROOFING:,.;� SP.ECIALTY Q- OTHER' "
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YE$_ NO
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<br /> BUILDER COMPAN1f `` " �
<br /> SIGNI�TUP2E REGiSTERED Y/ N. ��E CURRen', Y L_N,-= _.
<br /> II - , - = �
<br /> Address . _ ` Ucense#�� � � �
<br /> ELECTfZICIAN� . ' ',:, , '� 'COMPANY � '°,; . . , _
<br /> SIGPI�►Tl1ftE - �5"' REGISTERED Y J fV FEE GURRE� Y/N �"
<br /> �ddress ,_ , . , .. = :::L•tcense:#; ` � . ., .
<br /> PLURABER � � _ C.OMPANY;. - . , , _ .
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<br /> SIGNATURE �'° " � , :REGIS.TERED�,� - , . ���:;Y/4N . � FEE_CURRE�''' .. : 'Y/N' ' `
<br /> Address � ' � '` - .. License#�• - _ - - .
<br /> MHCHANICAI: '`. ' . ,,�-j/y���Y: _ . - ,COMPANY;� �1��OC S.� ,,.R-/�1 �:'-%��{J `
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<br /> SIGPIATURE �`` G�% � ���I�(!f�_ . REGISTERED�' , ,. �Y:/.N:� ; . ;�E.curt�n., < _Y/�N<.'�..,s_ --, .
<br /> Address;. ,,y' /7/C@N /�� �%�I L%�,l �� `�I .r , ,.Licensa#�-�Ig�►� �J�..�.� ' .- , .
<br /> � , ,^y }� ' � �-.�. ,,., , ' i�'.; -' .. ' ;.�i: -.'__ " .... � , ' , _ '; .. ;. �-.- ,. . _' ' .
<br /> OTHER . . . . . . ,. . >,CORAPANYL - . ,• '; -- _
<br /> StGWAYURB. .'��� .., , .. - , : : , .� ,.. _ ,... _:: . • - : -- � � :.,.: _ ,:,<. : �;.
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<br /> _ ,,REGISTERED Y L..N<; ,-FE�:GURF3E�` _Y/�Ne e , - .
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<br /> Addeess _ ,�1��- � .z.. . .. �-- •� ° ' . _.��License'#� .�:
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<br /> RESIDENTIAL:: `AttacFi,`2�::.P•,lotsPlans h 2�"sefs'.of,Bulldin �Plans•` 1 `seY'of�Ene� ��Fomi"��R=O=W.+Pertn `fornew,° n c�
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<br /> `^ �. ) ,. ...� ,�.,�.. ,. . - 9 � ), .., . r9Y . s..,. lt. _,.go stru..t1,on;:,.,� _, .
<br /> Y , ':MlnimumT:tens:1,0, woiktn da s a ': �a� � ��" -.: + �
<br /> `"� (,..,���_.,., 9:} Y..;,_�e�.$uti;mittaf�dafe;+Requliedonsite;�'ConsUticBon�Plans;4Stortnwater.Plansw/SIItFenc,e,(nstalled,, _
<br /> .�..:.`4�^:. ...l. �.._.�.e. . . .�.� ' .
<br /> Sanitary�Fa,cJlides,�s51.�c�uipRster,Site Wortc:{Per.mit�qr subtlivislons/largefpro)ects •xS 3 '.`.r.� . � ° - -~= ' �' -`
<br /> COMMERCIAL Attach(3j'eomplete sets of'Bulldi'ng Plans plus a`Life Sefely Page;(1)set of Energy Forms.R-O-W Permit for new construc�tion: ,
<br /> Minimum ten(10)working days'after submittal date. Required onsite,C,o,nstructlon Plans,Stormwater Plans w/Sllt Fence installed,:, ,
<br /> SaNtary,Fadlides�,1 dumpster..S(teyWork,Permitforallnew'projects':�All-commerclal.requirementsmust,meeYcompliance . .
<br /> SIGN PERMIT Attacti"(2)"set§of'Engineeied�Plans:+;�,�;r{r:-,:`'`=_`.�".. , : - � , ' - �
<br /> "'"PROPERTI!SURVEYreguired;fgrall:NEW;constcucy,on..��.-,:._: : ' - " .' , , ...
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<br /> Directlona: ..., � -. ,� _ _., .. � ----- -_ . •
<br /> Flll:out applicatlon completely.
<br /> Ownar&Contractor sign.back of appl(caUon,notarized
<br /> If'over 52500,a;Notice_of'Commencement Is�required. (A!C upgrades over$7500). ._ •
<br /> .. �,�'�.,:;,-�,�..��?:: _ :
<br /> Agent(for the contractor)"or:Powe��of Attortiey'(forflie:owmerj would be someone with notarized letter from owner autho�izing same
<br /> 'DYER"TFIE.COUNT�R•:PERIYIITTING�---•=;•�(Front'of�Application�Only)-,=� �j �
<br /> Reroofs if shingles Sewers Seroice Upgrades NC Fences:;(PIoUSurvey/Footage) .- •
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<br /> Drlveways-Not over Counter if on public roadways.:needs ROW
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