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.813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Departrnent .
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<br /> Date Received � � -. Phone�Cont�ct for Permlttln l '"� ��J"c�2. ' � (o � � -
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<br /> Owner's Name � G,✓t Own�r Phona Mumber
<br /> Owner's Address 3 r - � Z �,�,' l . Owner Phone Number -
<br /> Fee Simple Tltleholder:Name •Owner Phone Number ' �
<br /> Fee 3lmple Tttlehold�r Addresa � �.
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISION - PARCEL ID# � � � � -' l,rl U� O '� � t U
<br /> I - � _ (OBjAINED F.ROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED NEW CONS7R ' ' ' ` ADD/ACT -C]- SIGN Q � -0 DEMOLISH
<br /> :B . n�INSTALL e -REPAIR'� - . .
<br /> PROPOSED>.USE Q SFR. Q COMM' '� ' Q � •OTHER " � "
<br /> TYPE OF CONSTRUCTION � Q " ' BLOCK' " Q FRiOifiAE _ , Q ;STEEC ' Q ' . I
<br /> i DESCRIPTION�OF WORK�^` 1J 6= �v�. �I _ �k-e� - b e�c�1 �,b � I
<br /> BUILDING SIZE � u SQ FOOTAGE.� j� „HEI.GHT���,. .
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<br /> QBUILDING $ VACUATIOiV;OF�:TOTAL�COfy3Ti7UCTION . � " � ,
<br /> 5��f o . .. ,
<br /> I QELECTRICAL• $ - AMP SERVICE Q '�-PROGRESS"ENERGY - Q W.R.E:C:
<br /> QPLUMBING $ � �
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<br /> O MECHANICAL $ ' - ; VAL'UATION OF,MECHANICAL INSTALL'RTION. 1�S`
<br /> QGAS , Q, ROOFING .Q SPECIALTY Q., ATHER-
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. y NO
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<br /> BUILDER COMPANY�' " " � ` - ' �- �
<br />� SIGNATURE REGISTERED Y/ N �'��FEE cuRttEn ',Y/N
<br /> Address � -- . ., .! Gcense#=: � -� •
<br /> .ELECTRICIAN;: „ - .�COMPANY, < � :" , � ,. � .
<br /> I SIGNATURE '' '' �GlsreREo Y/ N I ' F�curt�n�`� � '��Y/N'- _ •
<br /> Address - • � -. . .. ,. .- � � . _ • .. �. .,. ,License;# _ :t_'. ., �
<br /> PLUAABER ' �� , C.O,MPANY � , . �.-.. ,'..s- - -
<br /> SIGNATURE"' '` � � � .
<br /> �REGISTERED,. . Y;/,.N,:... _.,FE�CURREA�, , ,�Y-./N_�. :,,;.
<br /> Address � � �:Ucense# �
<br /> - � r �. � � .?. k:
<br /> MECHANICAL ^ ., , - � , ' C,OMP,�ANY , � • -.. .
<br /> SIaNATURE• " ' ' � ` ' � REcisrEeEo. � Y l N, . =�FeE Cuw�n:. Y./:N '
<br /> Addres�r - � ' � , � -• � . . . , � , , � � License#� �
<br /> OTHER � - ��r.�� _'COMPANY _ I:`C _ L�� '
<br /> SIGN�►TURE' REGISTERED Y/ N� FEE CU � Y/N
<br /> Address y�O,,�D�,C�� bj.7,l�s 4. .��' �' - ' ' � I:icerise# �CC� 1.�2�j 2�'S`� ' '
<br /> � � '-- • ' �.�..�';k '•••'. : 1�,-�: ' '.� .,5 ' ,: �.. . . _- . . � . . ,
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<br /> RESIDENTIAI;��_�<<:Athacfi'(2�)�PIotFPlans;:.(2)§ets:'of�Buflding'�Rlans;'(1),`sef of�EnergyryFo"rms;R=O=W�Pertn,ltfarnew co`nstrucd'on,,.
<br /> Mi,nimum,�ten�•(4A)�wori�in da a eq �� � � `
<br /> _.r:� ,� 7.r.z. _:,_, ,, g;, ;jrs:;_iter;subtnittafdat'e.�R""uired�onsite,�:Con'atiiaotlon'Plans;fStomiwaterPlansw/SIItFenceinsfalled,
<br /> `Sanifa'ryFadlttles�&r1�;dumps�er;SiteWo�li�P,,,ermlt;forsubd(v,fsio"ns/large<pro)ects��:,,_:;;.:�. ._ � - -.
<br /> COMMERCIAL Attach(3)�complete-sets'of Builtling Plans plus a Life Safeqr Page;(1)set of Energy Fortns.R-O-W Pertnit for neW construcUon. �
<br /> Minimum ten(10)working days'after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed,
<br /> Sanitary_Fadlides.&..1.dumpster.,_Site Work Permlt for all new:pruJecfs::All.commercial,requlrements.must meet compllence ° -
<br /> SIGNPERMIT Attacfi"(2)set's'of�Engl�ieere.d4:Plens::.�,.;��;;.� . ;,-_;,_ , � , � -
<br /> '•'•PROPERTY SURVEY required_for aII.NEW constructlon. .
<br /> DI'recNons: - ' � - - _ . , ,
<br /> FIII out applfcatlon completely. ,<u,'. . ` s ' ';` i�� .
<br /> Owner 8 Contractoc sign back of applfcaUon,notatized � �. �,
<br /> If over 52500.:a,Nottce of,Commencement la�r�quired._.(AiC up�rades over 57500) ., , _ ,� , ,,,,a,.�,, ; , �, �,�:�, _ '
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<br /> '" Agent(for ttie'contractor)or Power of'Attomey(for tFie owner)woulil be someone with nota�ized letter from owner authorizing same "
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<br /> DVER THE COUNTER,PERMITIING�• -=�(Front=of'AppllcaUortOnly).Y; ,1;'1;,; , : -. _ :_ .- _:� . ._
<br /> Reroofs if shingles Sewers Service Upgrades�A/C ..�:{�Fences�(Plot/,Suivey/Footage) ; , ,�, ., :' . � . '' _ . _
<br /> — � �'":;�f " 'q_. .r's'a 'v:'t�' S: .. � , ' :. ". '„ - , .. .. ' ''(;f , , .,_s x
<br /> Drivewaya-Not over Counter If on publfc rbadways:.n'eeds ROW= �� �' �� .:_��i.:-_ , •-�r, i�
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