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a�3a8o-oozo City of Zephyrhills Permit Application FaX s�$-�saoo2�
<br /> Bullding Department .
<br /> ., _ -
<br /> : •
<br /> Date Recelved �7�z - �D/ �1
<br /> Phone�Confact forPermttttn / / ��
<br /> Owner's Name �./O�/V J�O LI�/d �!�!�/ Owner Phone Number O� �� /��p
<br /> Owner's Address �� 7 07 ��Jr.�"'J'�S� � /'�/J�e Owner Phone Number
<br /> • _ l�s�v
<br /> Fee Slmple Titleholder Name � Owner Phooe tdumber
<br /> Fee Simpte Titleholder Addresa ,
<br /> JOB ADDRESS J��T p� j�L�le/� �lP. - !G L S �L � �����— LOT# �
<br />, SUBDIVISION o?1�fJE� �.F}/!.($ PARCEL ID# !/�7 o�(pyo�l ��(�� ��D�d d��
<br /> - , . (OBTAINED FROM.PROPERTY-TAX NOTICE)
<br /> WORK PROPOSED � NEW'CONSTR ADD/AI:T Q� SIGN Q Q DEMOLISH
<br /> -:B. INSTALL �REPAIR �
<br /> PROPOSED�.USE Q� SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION < Q' "'BLOCK " `Q FRAME Q STEEL `Q
<br /> DESCRIPTION OF WORK �, �� (. E'DGLT -3 /U� �A'G� e � Q��
<br /> BUILDING SIZE ��`SQ FOOTAGE��, HEIGHT ,
<br /> QBUILDING $ VALUATION'OF�TOTAL'CONSTRUCTION
<br /> QELECTRICAL $ , - ` AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
<br />' QPLUMBING $ ' � ,/
<br /> . c,��`b
<br />' QMECHANICAL $ ����' �� VACUATION OF MECHANICAL INSTALLATION
<br /> � ��
<br /> ��S Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA
<br /> �YES NO
<br /> BUILDER COMPANY'
<br />, SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
<br /> Address Llcense.#
<br /> ELECTRICIAN 'COMPANY ' - ' -
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURRE�" ` Y/N
<br /> I Addre�s . �.'Ltcense# ~ , . �
<br /> PLUMBER �, . •-COMPANY . - �
<br /> SIGNATURE` � :REGIS.TERED. . Y,/�IN�: ,- ;FEE CURREK ' Y�/N
<br /> Address � � License# � -
<br /> MECHANICAL' ; �������� C.OMP.ANY �ffiES f!'" D�A11�e�vf�c�G
<br /> SIGNATURE � � REGISTERED ,_Y./ N . ; FEE CURRE� . Y,/�N
<br /> Addres`s'` ,�/ �!!e/IJ �f ' �iY!'GL$. ����I � � � ` License# G��}G'I>�3�/�O ,
<br /> OTHER • : . ,�`'COMPANY �
<br /> SIGNATURE .. �- - � � � � � RE�is7E�o` Y/ N...:: FeE cu�n Y7 N
<br /> Address, ..- - ` ' � - ' � Clcense# . � � .
<br /> RESIDENTIAL;;�.: �Attacii;(2)„PIot�Plaris;'(2•)set`s".-of�BulldinglPlans;(1)setof-Ene " >Foim's;R-O-W'Peirril�tfor'newconstrucQon
<br /> �9Y
<br /> , �: Mi,nimum�ten;(•1.0);uuorking�d"ayg;after.;submiftal-date:`�Requlred onsite,:Consfiuotlon:Plans,Stormwater'Plans w/SIIt Fence installed,
<br /> . , ...., .•._. .� �
<br /> ' � �� SanitaryFacfltUes�,&:;1,,dumpste_r,-Site'Wor1c;P,;.erm(tfcrsu6diVlsionsAarge„projects. �,,..:�: ' � ' -
<br /> COMMERCIAL Attech(3)`complete sets of Buildfng Plans plus a Ltfe Safety Page;(1)set of E�ergy Fortns.R-O W Permit for new construction.
<br /> Minfmum ten(10)working days after submittal date. Requfred onsite,ConsUucdon Plans,Stormwater Plans w/Sflt Fence installed,
<br /> Sanitary Fadlides 8 1 dumpster.Site Work Permit for all new:projects:All commercial requlrements must meet compliance
<br /> SIGN PERMIT Attach(2)�sets�of Eng,Ineeredr,Plans:, :._:�- � �. � ° � �
<br /> """PROPERTY SURVEY reyuired.for all NEW_construction..
<br /> Dlrectlons: - . . . �
<br /> Fill out applicaUon completely.
<br /> Owner&Contractor sign back of applfcatlon,notarized
<br /> If over;2500,a Notice of Commencement is required. (AIC upgrades over 57500)
<br /> �� .'. '•a�,"rr.�r.';.�{ ., .- . . .. � . ... _:, ..,'-'.a - -'
<br /> _, . , .. - : -.. ,-- �..
<br /> Aqent(for ttie contractor)or'Power of Attortiey(fo�tFie ouvner)would be someone with notarized letter from owner;authorizing same .� -• ; :}i
<br /> DVERTHECOUNTER.PERMI7TING- _-_•(Frontof,ApplicaUomOnly).-� � � - , r �.�"� � � •�.�..,�;;;,•;� _;'�� ' ', _ `
<br /> Reroofs If shingles Sewers `�Se'rvlce Upgrades.A/C Fences(RlodSurvey/Footage) �� �-� -� - , .
<br /> ,� .J.,: �....., . �
<br /> _ _ .� ._ ._ ..-. � -,�Ci:.• J_.�'...�=!f'i:�:�..� .. �. . : � � ..- ' .,� L . ,:�:,,
<br /> Drivewaya-Not over Counter if.'on public roadways{.need's=ROW � - - '" " " �'' ' '`` "`" "J
<br /> �..-� '� ..~ ,�,., , , � �_ ..
<br /> ..,...:.__. . �.,-... .,�....., s,r•n
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