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813-780-0020 City af Zephyrhills Permit Application Fax 813-780-0021
<br />, , t Building Department .
<br /> � .
<br /> Date Received -Phone Contact for Permitf�n �� r�— �C�!�
<br /> 4wnsr's Name � � G.LJ`� Owne�Phona Number L� °� /�� ���.
<br /> Owner's Address Owner Phone Number � �
<br /> Fee Simple Tltleholder Name � � Owner Phane Number � �
<br /> Fee Simple Titleholder Address
<br /> JOB ADQRESS ✓ /7'�"T �� ��'.C-�i2l3U'��C� LOT# ��.�
<br /> SUBDiViSION � � PARCEL Ib# `� L��p �` (J�'�� �✓�/"� v�/�
<br /> (OBTAINED FROM PROPERTY TAX NQTICE)
<br /> {NORK PROPOSED , e NEW CONSTR� ADD/ALT Q SIGt3 Q Q DEMOl1SH
<br /> INSTALL REPAIR
<br /> PRQPO&ED-USE Q SFR Q COMM � t?THEF2
<br /> TYPE QF CONSTRUCTION Q BL.00K " Q FRAME �] STEEL Q
<br /> DESCRIPTION OF 1NORK
<br /> �"�' i�I'N �'. `c�l.�I�' L?D�� ls c�itd �/41 ��'
<br /> �UiLDtTtG SIZE � �_SQ FOO7AGE[___� HEIGHT �`�
<br /> �8����IN�' 'w � VALUATION�OF't`OTAI,CONSTRUCTION
<br /> I�� J
<br /> QELECTRICAI. � � AMP SERVIC� � PRQGRESS ENEF2GY C] W.R.E.C.
<br /> QPLtlMBING $�'� _�
<br /> ��
<br /> OMEGHAIYICAI $����o �� VAlUAT10N OF MECHANIGA�INSTA�lAT10N
<br /> ��,s o ��aF»� o sP�c�,�..�nr � OThiER "
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA [�YES NQ
<br /> BUtLDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres$ Gcense# �� �
<br /> E�ECTRtCli4td COMPANY
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURFtEA Y/N
<br /> Address License# �� �
<br /> PLUMBER � � COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Ltcense# �� �
<br /> MECHAl+lICAl. � COMPANY �Ifi�� � � �"� �lY�.'
<br /> SIGNATURE I�� REGISTERED Y/ N FEE CURRE� Y/�N
<br /> Address ?�`7'l j�� , ��/r.t� j License# ��� G���"T'� �
<br /> OTHER CBMPANY
<br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N
<br /> Addrsss � LEcense# �i �
<br /> REStDENT1AC Attach{2}Plbt Plans;_{2}sets of Bu1lding Plans,{1}se#of EnergyFarms;R-0=W Permlt for new constructian,
<br /> Minimum,ten{�t0):working days�aftec_submittal date. Requlred onsite,Constnic8on Plans;Stormwater Pians w/Sllt Fence installed,
<br /> Sanitary Faci�llUes;&1,,dumpster Site Woric�Permit for subdlVisionsAarge proJects
<br /> COMMERCIAL Attach{3}casnptete sets of Buil�ing Plans pius a I.ife Safe#y Page;{1)se#of Energ}t Forms.R-O W Petmtt far new construcfion.
<br /> Minimum ten(10)working days�after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w!Silt Fence installed,
<br /> Sanitary Faoillties&1 dumpster.$ite Wot1t Parmit for all new proJects.All commercial requirements.must meat compliance
<br /> SIGN PERMiT Attach�2)sets of Erigineered-Plans..., � -
<br /> """PROPERTY SURVEY required for all NEW construcUan.
<br /> Dlrectlons: ,
<br /> Ftli out applicatlon completely. '
<br /> Owner&Cantrackor stgn bacic of applfcatlon,notatized
<br /> if over�2500,a Notice of Commencement is requirad. (A!C upgrades over ST50d)
<br /> `" Agent(for the contracto�)ar'Power of Attomey(fri�the owner)wauld be someone with notarized letter from owner authorizing same
<br /> DVER'tHE GOUNTER.PERMITTIFtG {Front af Application Only}
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) _ _ _,.. ._.., � ,., _ .� . ,
<br /> _ .., .:,.�.- . ' , �,)�<, t_ � .
<br /> Driveways-Nat over Countec iE on`pubtic.roadways;ineeds:R{31N-�r y � , ,•`��' _ .; . ., :, . ;�'� ;,
<br /> r ,.,,,�... _ .,; , ', °`���E �£ �t', .:,, 'i;;�
<br /> �. :!`��,1. :��r.�,.:i;4:�t..... �� .4 .. , . „ ,� _ 1°�, i
<br /> '�' �,�. }., :r„:,.{._ ;:>�:.` � y R��': . a ._ �-Y':,_Y.i� . .,
<br /> $ . at�t � .... ' _.4x95 -�:t`, � . <c �-_ . -r�.:.::�:....�5, . ' -._ '..., . ..
<br /> y�...e, ..,w`ry�,�n�,,n.'.... w ...a...,-... .,,.w...�.. .cw�_.
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