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813-780-0020 City of Zephyrhills Permit Application Fax-813-78p-0021
<br /> _ Building Deparfinent
<br /> i� � '
<br /> Date Received Phane-Cantac#far PermFttin
<br /> Owner's Name � � �Cf� /�.5 Owner Phane Number
<br /> Owner's Address 0 �� l0 �� �� Owner Phone Number �- �
<br /> Fee Simple Titlehalder Name � � � Owner Phone Number �� �
<br /> Fee Stmpls Titleholder Address
<br /> JOB ADDRESS O O � ��� LOT# C�
<br /> suea�vis�oN �� � PARCEL ID# ��.;2�`�-�1�- ���7 6%'m�04 ^01
<br /> (OSTAINED PRQM PROPBRTY 7AX N0710E�
<br /> WORK PROpOSED , e NEW CONSTR�ADD/ALT C� SIGN' Q Q DEMQLISH
<br /> INSTALL REPAIR
<br /> PROFOSED USE Q SFR Q COMM � OTHER
<br /> TYPE OF CQNSTRUCTION �r BLOCK � C] FRAME � STEEL Q
<br /> DESCRIPTION OF WORK � /C!/A�l.��" �.� I%I�� ,j� � �,{J,,�'L �,/�j/a.���f�
<br /> BUtt»DING S12E � � SQ FOOTAGE C� HEIGHT �,. �
<br /> ���t��i�'�' $ ��,f`Y) I VALUATION OF TOTAL CONSTRUCTION
<br /> �� ��
<br /> QEi,ECTRICAI $ AMP SERVICE �J PROGRESS ENERGY Q W.R.E.C.
<br /> QP�.UMBtNG (y>� � ` (���
<br /> � �u
<br /> QMECHANIGAI,. $ VACUATION OF MECHANfCA�INSTALlAT10N
<br /> QGAS ROOFItVG Q SPECIALTY � OTNER
<br /> FINISHED F1.00R ELEVATIONS �� FLOOD ZONE AREA QYES NO
<br /> BUt�DER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address L`(cense# �- �
<br /> EIECTRtCtAN _, COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address� License# � �
<br /> P�UMBER CQMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �- �
<br /> MECNANICAL COMPANY
<br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y/N
<br /> Address License# �� ��
<br /> OTHER - COMPANY U`I't'ljl� �J'"'�i�t�
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y I N
<br /> Address � �!� �cS� ��it/t�"t�l� �L Lfcense# ���Z'(p„�-�/�
<br /> RESIDEN'ilAt. Attach{2)Pta#P1ans;{2}sefs�of Suilding"Pians;{1}set of�Enetr�y�Forms;R O-W Permit far naw consUuction,
<br /> Minimum,ten_(10)working days after submittal'date. Required ons(te,CanstrucBon Plans;Stormwater Plans w/Silt Fence Installed,
<br /> Sanitary FaclltUes,&:1.dumpster,81te Wark•Permit for subdivistons�large projects _
<br /> . CO�fIlMERCIJ4L Attach{3}complete set's of Bui1ilitig Plans plus a ltfe Safety Page;(1)set of Energy Forms.it-fJ-W Permit#or new canstructlon.
<br /> Minimum ten(10)working days after submlttal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence Installed,
<br /> Sanihary FaciliUes&1 dumpster.Site Work Permit for ali new projeats.Aii cammerdai requiremenfs must meet compltance
<br /> SIGN PERMI'F Attach(2}sets of Eisgineered�Plans:>>
<br /> , """PROPERTY SURVEY required for all NEW constructton.
<br /> directlons:
<br /> Fill out applicallon completely. �t _ ,� ' � �
<br /> Qwner&Contractor stgn back af appiicaUon,nakarized t '. : � ,` �, �� , �°
<br /> If over 5,2500,a Notice of Commencsment is requlred.' (A/,C upg`rades over 57500) - ' �•'� ' � '`.'' e.-
<br /> ` �;, • .; _.
<br /> " Agent(far the conVactor)or Power ofAttomey(for the owner)would be someone with notarized letter from owner authorizing same �
<br /> DVER THE GOUNTER P.ERMItTING - (Front of Apptication Oniy) �
<br /> Reroofs if shingles Sewers :;Service Upgrades=A/C���-•-•yFences�(PIoUSurvey/Faotage) " "' ' - "--� � ��- • r..--.w�,.,.. '
<br /> Driveways-Not over Counter if on pubilc roadways::Aeed's�ROV11•� 'x*� � � ' 4 "''' �� '�•�`. .' ' �, _�i}
<br /> �` ,!. ':r r
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