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813-780-0020 City of Zephyrhills Permit Application , Fax s�3aso-aoa�
<br /> Building Department -
<br /> Date Received. r ' Phone�ContacEfor:Pe�mittin �'� � '
<br /> � � r�.�.s-rt�. ,_.. , .._ . „, .
<br /> Ownee's Name @f e. � '�'fn`� �w,,,�'�Ownar Phone Idumber �v 3—�S���7 I
<br /> Owner's Address � � � V� v� � O 3 1� Owner Phoee Number � � �
<br /> Fee Simple Tltleholder Name - Owner Phone Number
<br /> Fee Simpl�Titlehold�r Addresa � �
<br /> JOB ADDRE3S � J� �. LOT# �
<br /> SIIBDIVISION � � � - PARCEL ID# '� , . � - ' ,`
<br /> , ; -' ; ` , (OBTAlNED,FROM.RROPERTY_TAX,NOTICE), �
<br /> WORK PROPOSED NEW CONSTR ' ' ` ADD/ACT" [�` SIGN`= Q� '�Q DEMOLISH
<br /> , , INSTALL B -REPAIR' - ` . - •
<br /> PROPOSED.USE' • �._ .Q ` SFR. Q COMM ' ' Q �� •OTHER • � , ,
<br /> TYPE OF CONSTRUCTION� ,Q ' 'BLOCK' ` Q FRAME ', [� 'STEEC ''Q � � _ "
<br /> DESCRIPTION OF WORK' 3 e.sOa"` � � � -
<br /> BUILDING SIZE � � ' �i SQ,FOOTAGE, ���. _ � .;.HEI,GHT���,: ' . .
<br /> QBUILDING $ c� a- - :--• ; ,.� , , � ,
<br /> , � (f� : . VAL'Ul�►TION:�F'-TOTAL'CONSTF�UCTION
<br /> QELECTRICAL , $ ' " . .AMP SERVICE " - :�'Q `-PROGRESS'ENERGY ` Q W.R.E.C.
<br /> QPLUMBING $ � - �s' . -
<br /> � _ _ � ���`�� � .
<br /> QMECHANICAC $� ' � : VACOATION OF;MECHANICAL�NSTALL/►TION. �
<br /> QGAS , Q ROOFING ,Q : SPECIALTY .Q -OTHER ,, _ -
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA' QY�$. ,NO
<br /> BUILDER COMPANY" ';' 'f ` . - �- ' -' ' .
<br /> SIGNATURE REGISTERED Y/ N `'��FEE CURREK ' ` " Y/N� �
<br /> Address - - -, : � ' .� _� -License#'i� ' '��
<br />� ELECTRICIAN: . - " =-�C'OMPANY�='.�`• . . ,. . ,._ . • _ - , .
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<br /> SIGNATURE `�� ,
<br /> REGISTERE 5 Y N,t� , .,F�yGu�� ' �' =�Y.:�N`� '`�
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<br /> Accareas� . = u�ens@�#:�..: ,,-;:. . ,
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<br /> , �.. _- _ , . • . � � .. _:, � - ,.. _ . .
<br /> ' PLUMBER" - .COMPANY.=-.•_ � - - �
<br /> SIGNATURE'�` ' � ` , REGIS7ERED , Y:/..N�i . .,yF:E�,CUwtEn:��,,�:,A �Y�L:N..
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<br /> Address - , � _ - , ,. - Llcense# _ � A�
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<br /> AAECMAPIICAL' - :; . �. . � ,, . ,COMPANY J
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<br /> SIGNATURE• " �' - ' � " ,.aE�isrEr�o , Y/ N. ,FE�Curt�n Y,/N� -
<br /> Addres�'' , `A` -� , '� ,. ` , : , � � rc. :License# _ � � '
<br /> OTHER <� . .�'. " � `,�COMPAMY O'�C��a��C-w� ti._`��r?g-�^ — >` , -
<br /> lst.o0.,�_,
<br /> SIGNATURE' .=:`: . .: . J REGisrEiiEn�. �` ; `Y/ N.;..: - FEE.CURi�� ' Y/
<br /> Addr�ss ��;�o���` Y\��� , � ;�, �u' "3�5� -Llcense#`.'�C C C)S-7 �1��� ._ ,
<br /> RESIIDENTIAL��a„`'�Attacli'2 �Plof Plans�,2- sets`;of+8�i�18in"`;`Plans��.1 'set`of�Ene�`��Foitiis��R=O=W`Perrnit for new constnicdori; " � `
<br /> „�:�.;:�Mlnlmum�ten;;(=1A.tarorking.dey��atte'� � .. ,�..).: :,..,_: �Y. . :...� , . . .., ., _ . _ _.
<br /> .. ;� �._)� , ��.) 9. ;:� z�.. >•�. . �,>�.. _.� .,_:,: _. .
<br /> ) r„subinlftal date:�:Requlreif�onsite;�onstiucdon�Plans;�Storrnwate"r''Plans°w/Sllt'Fence Installed,
<br /> __�_•< . . . , .
<br /> Sanftary Fadlldes�,8�:itxdumpster�Slte�Wor1%aPenr`ilt;forsubdivlslo"nsllarge<Proleasy�'`::��.;...�;`._ . ` .:-`,�_� . - - - - -
<br /> COIHMERCIAL Attach(3)�eomplete`seCs of Bullding Plans�plus a Ufe Safety Page;(1)set of Energy FoRns.R-O-W Pertnit for neW.construcUon.-
<br /> Mln(mum ten(10)working days'after submlttal date. Requlred onslte,Construcdon Plans,Stortnwater Plans w/Sllt Fence Installed,
<br /> Sanitary.Fadlides.8�1 dumpster.�Slte Work Permlt.for all new+pioJects.:All commerclal..requlrements must meet oompllance -
<br /> SIGN PERMIT Attacfi(2)'sets'of"Eiiglneered�:Plaiis:#,�=.�y,==: ,;_<- :';. .: � `" , - `, , �
<br /> ••""PROPERTY SURVEY required.for-all_NEW�consWctton.,. _ - • �
<br /> - .:-
<br /> Dlrectlons: �t�� . ` � � ,
<br /> FIII out applicatlon completely. �
<br /> Owner 8 Contractor slgn back of appllcatlon,notarized
<br /> If over E2500,,,a;Plottc�;of,Commencement ls.requlred;,,,(l�l�,Upgradss�over g7500) � � ,
<br /> 't7. ..y.a:y.s• . a mor..:.�.Mr�h�....-e. . a.. :F , .l; , '"' - - . ,
<br /> '" Agent(for the contractorj:oFPovire�of Attomey�(tb�,:Uie�owiier)would"be:sor�eone with notarized letter from owner'authoflzing;same' ' -' ,
<br /> ` -:�-. - ';a..f��Ft�� � � : •:,,. :�-;,_ _ , :. ! �., .i_`r..;._- '�� _'s:r° . >:�:.
<br /> DVER THE-COUNTER.PERMITI7NG::� ..-(�roi�t'of;}�pPllce�on,Only),:;r;i�,:.,� � `i >.-:,�i l�`,�. ::;;�,;r �,' ,f;;,,,
<br /> Reroofs Ifshingles Sewers Seryice.Upgrades;.NC.,.� -Fen�s�:(Rlot%Survey/Footage) r, 'r;� ,.:,����� �:-„ .- -:. ._
<br /> :;� � ,-
<br /> -... ..^_._ �-. - � .r.,•_a+U-s,u:%u+,vJ';.rii+s<.- ..ueai.-y,.�.N�.-..e-: .5,�.7: , i:l;.,_ .. .. c ,..4.e:i�L:. _. �'� � rs .itF:'�,.
<br /> Drlveways-Not over Counter if on publlc roadways:.rieeds�ROW' � ' `"P}� - -- ---�•�•- .-•� ���^ -<n.....` .. ..
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