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a��-�ao-oo2o City of Zephyrhills Permit Application Fax-e�sasaoo2�
<br /> , Buflding Department _
<br /> Date Recelved t' ' �� .l5 Phone�Contact for Permlttin � �I3 (1 � �
<br /> Owner'a Name �f%�J�� i1-d � Owner Phone Number � 3 " 7�� 7 7�
<br /> Owner's Address ��.�2 T� �l�� UY Owner Phone'Number • -
<br /> Fee Simple Titleholder Name ���v Oweer Phone Number "
<br /> Fee Stmple Titleholder Address
<br /> JOB ADDRESS �f�M� LOT# �
<br /> SUBDIVISION c�'t� �� PARCEL.ID# `
<br /> - � (OBTAINED FROM PROPERTY T/UC NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q - Q DEMOLISH
<br /> •.B. INSTALL 8� � REPAIR ��
<br /> PROPOSED,USE - � Q SFR Q COMM Q OTHER .v• �
<br /> TYPE OF CONSTRUCTION � Q �� BLOCK + -0 FRAME � � STEEL Q
<br /> DESCRIPTION OF WORK ., �/vs��"'lli `1 [ � O/� � rly�i GuDUI'J 2til/� �fi Q/ /
<br /> BUILDING SIZE � 'SQ'FOOTAGE � 1 � , � HEIGHT � � /
<br /> QBUILDING $ .2�� .pp VALUATION�OF?OTAL CONS7RUCTION ,zO5 pj�� �
<br /> QELECTRICAL $ - AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING � $ ' � � ,��1�
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS ; Q ROOFING Q SPECIALTY [� OTHER ��
<br /> T
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPi4Nlf� �« �D�' ��^'��/
<br /> SIGNATURE REGISTERED Y/ N �E Cuwten Y/N
<br /> Address ��� �v � Dl�����S`F� � . J,�.f�f � , Llcense#
<br /> ELECTRICIAN , , �COMPANY - �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURREK' V/N �
<br /> Address ' � _ �� . • License# °
<br /> PLUMBER ` � � . COMPANY � ,r �
<br /> SIGNATURE' � " � -. REGISTERED . Y./..N„ !. .;FEE�CURRE� - '" Y-/N.-
<br /> Addre�s �`, License# -
<br /> MECHI4NICAL' , ' ,COMP .ANY . � .
<br /> SIONATURE ' ' REGISTERED ,.,.Y,/ N . FEE CURRE�. Y/�N
<br /> Address` , ' �� °: ~ . ; License#� ,
<br /> 07HER " ' � ` �,`COMPANY" ,., �
<br /> SIGNATURE - � -- -- � ' � ` ' REGISTERED ` Y/ N... FEE CURRE� Y/N
<br /> Address � _ - • ' ' Cicense# ' -�
<br /> RESiDENT1AL,� Attacfi"(2);P.,lot%P,.lans;�(2)`sets_of�BulldingiRlans;'(1)sefof'Energy>Forins;`�R=O=W Permit for'naw construcUon,
<br /> W�-Mlnimum,tenr(�1,0);working;days,after,;`submlNal dafe.���R'equlred onsife,:Constiuctlon:Rlans;`Stortnwater Plans�w/Silt Fence installe8,
<br /> ' �Sanita"ry''Facllldes:&�.1,,_dumpster�3lte;Work>jPermitforsu6division§/Iarge,proJeots ,-�� `- � " � ; '
<br /> COMMERCIAL Attach(3)complete sefs`of B'uilding Plans`plus a Cife Safety Page;(1)set of Energy Forms.R-O-W Permtt for new construction.•
<br /> Minimum ten(10)worlcing days after submittal date. Required ons(te,Construction Plans,Stortnwater Plans w/.Silt Fence installed,
<br /> Sanitary Fadlides 8 1 dumpster.Slte Work Rermit for all new.projects:All commercial requlrements.must meet compliance
<br /> SIGN PERMIT AttacFi"(2)'sets of Engineered�.Plans., ;:;-�� � , � - -
<br /> ""PROPERTY SURVEY reguired for all NEW_construction. .
<br /> Dlrectlons: .� ;. r: ..:� .'� . , �-- ,
<br /> �- . ;
<br /> Fill out applicaUon completely. ,
<br /> Owner&Contractor sign back of applicatlon,notarized �• •` � �> � ' � �
<br /> If over b2500,a Notice of Commencement is required...,(141C up�rades o6er 57500) - - - �'-�'�.'�;., _�_; ;�'�t �
<br /> ,. � -• _.�-.,' �_: � � :�
<br /> " Agenf(for the contractor)or Power of Attomey;(for tlie owner)would�be'someone with notarized letter from owner authorizing same. � �. ,_.�� :�
<br /> ,,.,, _� � , ,..
<br /> DVER THE COUNTER PERMIT-TING --;(Front�of-Applicatlon Only)-: • � � � - � ' '• �'
<br /> Reroofs if shingles Sewers Service Upgrad,es NC Fences.(PloySurv,ey/Footage) �, � ^' `''"' , � - � '
<br /> ' - -� �r,�',e�� ; _
<br /> .;. ' . . . • , - ., ��... .. ., ,..
<br /> Drivewaya-Not over Counter if on public roadways:.need"s ROW:-� ..: '. ' �.- • - • . . , .,, ; :,,_ _
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