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a�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � , -' Building Department
<br /> Date Received G—2 �i ' g �� z ��/ -- � J�"--�
<br /> Phone Contact for Permittin
<br /> Owner's Mame �� - �jP� a • ���ifC� Owner Phone Mumber " '� (�Q
<br /> �/ �0,� � ��s �� feT
<br /> Obmer's�lddress (`p p " Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Tftleholder Address
<br /> JOB ADDRESS CL/O� � �L S • � ���� . �f'G-��✓C � LOT# �
<br /> suBDivisio� `"/� •e �,��ZE PQ►RCEL ID# ��y��'i ����D/�4-�� —03�0
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> VIlOR!(PROPOSED e NEW CONSTR� ADD/ALT [� SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE � SFR Q COMM 0 OTHER
<br /> TVPE OF COIdSTRUCTION � BLOCK Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK I(� X pc �O6LC ��(�/�/YJ/L/
<br /> BUILDING SIZE (� ,p( SQ FOOTAGE c��� HEIGHT
<br /> O�BUILDING $ (jp VALUATION OF TOTAL CONSTRUCTION
<br /> i. 3o -
<br /> �]ELECTRICAL $ . n � AMP SERVICE ��� 0 PROGRESS ENERGY Q W.R.E.C.
<br /> 6�
<br /> OPLUMBING $ ��p.���
<br /> (�( W ' I i"""
<br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION v
<br /> �� � � ��
<br /> OGAS [� ROOFING Q SPECIALTY Q OTHER .
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO -� / / ` � 3
<br /> , i,i a����`�J
<br /> , U ''2..
<br /> � e
<br /> BUILDER ��ORA ANY L�,��/�G'/� <L�S jOf� �+`�
<br /> SIGMATURE ,� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � /�` E s' �`�jf L(cense# ����(� �[O
<br /> ,
<br /> ELECTRICIAfd �f�� � COIlAPAfVY l��� G � �/�
<br /> SIGNR,TURE � G , REGISTERED Y/ N FEE CURRE� Y!N
<br /> Address /� � _, ' J � License# ����i� �
<br /> .
<br /> PLUMBER COMPANY
<br /> SIGIdATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Alddress License#
<br /> .U ��GG�� O ����l/
<br /> MECHANICAL COMPANY
<br /> SIGf�ATURE � REGISTERED Y/ N FEE CURRE� /N �
<br /> Address �09 �J� �.�.�.� � License� C�� �d c/ "/ �
<br /> %�G
<br /> OT�O� ��� COMPANY �Glvi����� ��5 ` f �
<br /> SIGPIATURE .�����2'vJ'� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address / '�,� 11�lj' �% � � � � License# ��7'
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;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 installed,
<br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsAarge projects
<br /> COMNIERCIAL Attach(3)complete sets of Build(ng Plans plus a Life Safery Page;(1)set of Energy Forms.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 installed,
<br /> Sanitary Facilities&-1 dumpster.Site Work Permit for all new projects.All commercial requlrements must meet compiiance
<br /> SIGfd PERMIT Attach(2)sets of Engineered Pians.
<br /> """"PROPERTY SURVEY required for all NEW construction.
<br /> Directions:
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over ST500)
<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 COUMTER PERMITTING (Front of Application Only)
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drivewa s-Not over Counter if on ublic roadwa s..needs ROW _
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