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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department � �
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<br /> Date Received. , .,/� - 'j - /SJ „• °-� 52 ; 2. ��.. -
<br /> • Phone>Contact•for�Permittln �i°
<br /> Owner'a Name C � a ���0/NGS 0� Z! �. Pltl��S Owner Phone Number
<br /> Owner's Address �Z Z( �'�� SfK`'� • - Owner Phone Nuri�ber -
<br /> Fee Simple TltleholderName Owner Phone"Numb�r ' ' �
<br /> Fee Simple Titleholder/�ddresa _ - I
<br /> JOB ADDRESS s o� ��Gi �" �D�C�� (t� �l� ` LOT# � I
<br /> SUBDIVISION ~ PARCEL ID# ",�) --Z 6 - 2� � 0,0l0 -.1.6.7 00 - d //0
<br /> � � . (OBTAINED.FROIN PROPERTI6 TAX NOTICE)' i
<br /> WORK PROPOSED ' NEW'CONSTR ' ' ` ADD/ALT �` SIGN= Q Q DEMOLISH
<br /> ,8:.1 INSTAtL � REPAIR" -
<br /> PROPOSED�.USE • Q ' SFR. Q COMM �< ' Q - `•OTHER ' • � '
<br />� TYPE OF CONSTRUCTION � ;Q ' 'BLOGK" " Q FRAME , Q �' `STEEC "'Q - _ �
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<br /> DESCRIPTION�OF WORK � 'T / �n J .cc \ � ,�tiJ(
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<br /> . :, * , ._ FOOTAGE'� ..;HEIGH7}.. ...� .
<br /> BUILDING SIZE' $Q ,��; ,
<br /> QBUILDING $ ,-,.__. ..:• ,...._... `� ._, . , ,
<br /> , . VAI.UATION'O�`TOTAL�COySTRUCTION
<br /> . - ,
<br /> �ELECTRICAL $ p0�:pp � AMP SERVICE �QD �'� _ =PROGRESS ENERGY Q W.R:E.C.
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<br /> OPLUMBING . -•$ - C(�v
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<br /> i Q MECHANICAL $ ' : VALUATION OF,MECHANJCAL INSTAL�ATION. `\OL �,D`�'.`
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<br />, QGAS .. Q ROOFING _Q SPECIALTY;Q;.,- OTHER �,, ��'O
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO
<br /> ��: � � �
<br /> BUILDER , COMPANY' �~ � - ` ' - . . .
<br /> SIGNATURE REGISTERED Y/ N - �F�cutt�� ` �Y/N' ,
<br /> llddress , . ; �.7 License:# ' , �
<br /> ELECTRICIAN, , ' 'vCOMPANY'.�! ` cG/'��'J' ,� �'`%G�-11�
<br /> SIGNATURE '` ' REGISTERED Y/ N F�;curt�K�}``� ='=Y�6N'- '`'
<br /> l�ddress � •X�L-/r �.3� . • . . .� License;#:, ��L✓���.�•3�
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<br /> PLUAABER r.C.OMPANY , - _,• '..:-,.r : ��
<br /> SIGNATURE'"", � ' ,REGISTERED, - Y/,.N,,. +
<br /> - - - . ,_. <c.�,F.EE GURREA� Y�/N•
<br /> Address .. , . _ . . - .�License#� � � � , , .
<br /> , . _. • -,
<br /> MECNANICAL' .` - . . C.OMPANY ' - .
<br /> SIGNATURE� '� ' ` , RE�isTEREo Y,/ N, 5� FE�Cua�n , Y.hN'� - ,
<br /> �.- _ . , , , . . - , - � = � , ,
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<br /> d re�s~�
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<br /> cense#�
<br /> OTHER � . _ ` � � `COMPANY � : � I
<br /> SIGNATURE. ` ` ` ' ' �" ' � - ` 'REGISTEREDs � -Y/ N:,..; ' FEE CURRE� Y7 N.- ',
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<br /> AddresB - . .. . - •� . . , • � LlcenSe#: � . . •
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<br /> RESIDENTIAI;s,a. A�cFi`(2;�Plot�Plaris;-(2)-sets,oft9L�Iding�Plans;�(1):set:of<Energy;Foiins;R=O=W�Pertqlt_farnew'construction, _ " '
<br /> . ,..n. .�
<br /> :�;,-Mlnimum,ten(1A)iw4rltlng,days,atte'submittel`date ':Required�onsite,Constiuctlon Plans,`Stomiwete�"PlariswfSllt°Fence ins#alled,
<br /> ��_�'Sanifery F,adlltle.s;8;.�;dump�ste��Site�Worlc,Permlt:for;subdtvislons/large�prujects.;�:,:�.;.=,.:;: _ ' . � �
<br /> COMMERCIAL Attech(3)�eoniplete sets'of�8ullding Plans'plus a Llfa Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. _
<br /> Mlnimum ten(10)worlcing days after submittal date. Required onsite,ConstrucUoo Plans,Stortnwater Plans w/Silt Fence Installed,
<br /> Sanitary_Fadlitlas&_7 dumpster._Site Work Permif for all new projects:AI4 commercial requlrements must meet compllance � -
<br /> SIGN PERMIT AttacFi(2)`sets ofEngineer,ed::PlaDs..�,�:_�:�;:�-� �. _- � ,. . ' . , . _
<br /> ••'•PROP_ERTX.SURVEY required for all.NEW gonstrucUon. • I
<br /> Dlreetlons: �• -- . -_ . . • - - - ' - -
<br /> FIII out applicatlon wmpletely. ' �
<br /> Owner 8 Contractor sign badc of applicatlon,notarized �' �' �` '� r
<br /> If over 52500,:a,Notice:of.:Commencement la requlred.'(14lC up�ea�des o�er ST500) _, . ,,
<br /> .;:r'.:1:re�;4;.y,1,s:.. .,. ...�.. ..
<br /> '" Agent(for the i:ontractor)or Povtiier of Attomey�(for tFie owner)woultl be someone with�notadzed letter from owner authodzing same
<br /> DVER THE COUNTER:PERMITTING=• ;�=�=(Frontof=i4'p'p1lcaUon=Only)`-'"�"=:`'��;"`° =':; �.<��� " .� . .�.
<br /> Reroots if shingles Sewers S�ice U��rades',A/,C,;'��Fences':(PIoUSurvey/Footage) 9
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<br /> Drlveways-Not over Counter If on public.road,'waqs:iieeds,:ROW;� - ; '
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