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s�s-7so-oozo ' City of Zephyrhills Permit Application Fax-843-780-0021
<br /> • , Building Department
<br /> Date Received Phone Contact for Permitting �°L� �!S -- �� ��(
<br /> Owner's Name (�7 << � ��1��'� �
<br /> �` ` Owner Phone Number �i 8�,a�3_�.'��. _.
<br /> Owner's Address ��i��3 �--v w, �F, Owner Phone Number�� —�
<br /> Fee Simp(e Tittefiotder Name N � Owner Phone Nurriber�� 1
<br /> Fee 3imple Titleholder Address
<br /> JOB ADDRESS Gs`d 3�1 �-v� ��� LOT# tS3
<br /> SUBDIVISION �c.�ley�l� � H� � PARCEI.tD# �3-�-6-al-Ctl7 4-U�voa-Q�S 30
<br /> (OBSAINED FROM AROPERTY 7'AX NO'itCEj
<br /> W4E2K PR4POSED NEW CONSTR ADD/ALT Q SIGN [� MOVE Q DEMOLISH,
<br /> e INSTALL e REPAIR
<br /> PROPOSED USE � SFR � - COMM Q OTHEF2
<br /> TYPE OF CONSTRUCTION � BL.00K � FRAME 0 STEEL Q CiTNER�— ��I
<br /> C� ,M t t t (� fn n
<br /> DESCRIPTiONOFWORK Kecov-e� 1�1�b<�e �bw�e � ��aY�c��., t����,.. Gr�,d-�. �t� fe t'� ��vn t�i�e
<br /> BUIF,DING SIZE � � SQ Ft70TAGE �� �-�� HEtGliT � � �
<br /> I � B�������' � .c�'��„� .�}� � VAI,UATIQN OF TOTAL GCft�lSTR.UGTtON
<br /> i
<br /> j � �LECTRlCAL {$ � AMP SERVICE Q PROGREBS ENERGY C] W.R.E.C.
<br /> �
<br /> � PI..UMBING � � ���(��
<br /> i l
<br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �(\�
<br /> •4w
<br /> Q GAS Q ROOFING [� SPECIALTY [� OTHER
<br /> FINtSHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES �NO
<br /> �
<br /> BWI..DER �'9 �� COMPANY �c�w��or.�-- �S�cC cS �� cl�t...
<br /> � SI�NATURE 1 REGISTERELI N FEE CURRENT I N
<br /> Address ��i j Lr.f,n e�" cS�-, C��,.r�r t337�� License# ��<1�� �°I �—��
<br /> ELEGTRICIAN • COMPANY
<br /> Si�NATURE REGISTEREt3 Y I E� FEE CURRENT Y 1 t3
<br /> Address � �lcense# �—� !
<br /> PLUMBER COMPANY
<br /> S{GNATtlRE REG{STERED Y/ N FEE CURREtJT Y I�1
<br /> Address License# �^ �
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGlSTERED Y I N FEP GURRENi' Y 1 N
<br /> Address License# � �
<br /> OTHER COMPANY
<br /> SiGNATUF2E REGISTERED Y/ N FEE CtiRRENT Y/N
<br /> Address License# � �
<br /> RESID�NTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construcUon,
<br />� Minimum ten{1�}working days after submittai date. Rsqufred onsite,ConstrucHon Ptans,Skormwaker Plans w/Sitt Fence installed,
<br /> Sanitary Facilities&1 dumpster,Sife Work Permif for subdivisionsllarge projecfs �
<br /> COMMERCIAL Attach(3)complete sets of Building Plans pl4s a Life Safety Page;(1)set of Energy Forms.R-Q-W Permit for new conskruction.
<br /> ivlinimum t�n(10}working days aftec submittal date. Required onsite,Gonstruction Pians,Stocmwater Plans w/Sitt Fence inskafted,
<br /> � Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.Aii commerciai requirements must meet aompiiance
<br /> SIGN PERMIT Attach(2)sets of Engineered Rlans.
<br /> � "'*'PROPERTY SUF2VEY required for all NEW construcfian.
<br /> Directions:
<br /> Fitl aut applica#ton completely. _
<br /> Owner&Contractor sign back of application,notarized
<br /> If�over$2500,a Notice of Cammencement is required. (AIC upgrades over$5000)
<br /> *'' Agent{for the contractor}or Power of Attorney(for the awner}wauld be sameone with notarized ie##er from owner aufhorizing same
<br /> OVERiTHE COUNTER PERMITTING (FronYof Application Only)
<br /> ,Rer�ofs' - '" Sewers�." �� Service tlpgrades AIC Fences{PtatJSurveylFootage}
<br /> � .,,,..;�„ , _, _, `�,.
<br /> �,Driveways-Nat oveP�Counter 1f on�•putilic toadways,.needs ROW
<br /> � , -, ,._,it�::r,• , .. r, -
<br /> � ,r;,.. ��; . _,.:J _ - .
<br /> � „ -. .. , . •.w. , , :.r`, . ... � -
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