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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � • Building Department .
<br /> Date Received �� �� �(j phone�Contact forPermlttin —
<br /> Owner's Name G—� kJGi f C� ��r 11 �'i Owner Phone Number `.3
<br /> Owner's Address � ' � Owner Phone'Number ��� ��� � 7 7 �
<br /> Fe�Simple Tltleliolder.Name � - - Owner Phone Number. '
<br /> Fee Simple TItI�holder.Address
<br /> JOBADDRESS II Q_Ct C ' S!� �� � �� �� �3�` LOT# �
<br /> SUBDIVISION , PARCEL ID# `
<br /> . (OBTAINED F.ROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED �_NEW CONS7R ADD/ALT Q� SIGN Q = Q DEMOLISH
<br /> INSTALL B REPAIR - -
<br /> PROPOSED�1.USE - Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION �s Q'' ' BLOCK '" Q FRAME � STEEL 'Q
<br /> DESCRIPTION OF WORK' Ce i� � `FQ�^ ' � �/(�', � �
<br /> BUILDING'SIZE' SQ FOOTAGE � HEIGHT ��
<br /> OBUILDING $ VALUATION;OF�TOTAL CONSTRUCTION ' ` '
<br /> QELECTRICAL - '_$ � ��'�p � AMP SERVICE •Q PROGRESS ENERGY [� W.R.E.C.
<br /> QPLUMBING �$ '
<br /> �G��23 . ,
<br /> QMECHANICAL' $ ' VACUATIQN OF MECHANICAL IfVSTALLA7'ION
<br /> � ' pA��
<br /> S
<br /> . �
<br /> QGAS Q ROOFING Q SPECIALTY.Q OTHER - •
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
<br /> BUILDER COMPI4NY` � �
<br /> SIGNATURE REGISTERED Y/ N FEE CURREK Y/N
<br /> Address � License-# �
<br /> ELECTWCIAN; . )� Q��� .�COMPANY `l�IOty�.,� (�N LP�`
<br /> SIGNATURE �"�i�y��!�/7��.'�'L �' REGISTERED Y/ N FEE CURRE� ' ��Y/�N
<br /> Addre�� ' � , License.# �
<br /> PLUMBER `� _ .. � - , COMPANY ��.... .,.- • . ,
<br /> SIGNATURE` " :REGISTERED. Y.,/r.N� ' �-.�FEE�CURREK :. Y�/N. : .
<br /> Address License,.# �
<br /> t,... �: 4� �`, - `
<br /> MECHANICAL' �' ' - - , , � . , .C.OMPANY,. , �;_
<br /> SIGNATURE� � �' ' ' �r f REGISTEftED , ;,1,.Y./ N, . ._„- FEECURRE�,. Y-/�N -
<br /> Addresa'�' ' , : ` l ` � � - ' Licens.e#
<br /> OTHER " � u � � �;COINPAPJY , � � .
<br /> SiGNATURE° `-`a � , •'= • , , � . � ";
<br /> � 'REGISTERED' Y/ N:r.. FeE CuwtEn . Y I N
<br /> Addreas °•`,� � -• " � � � Cicense#
<br /> E,-. ....5� .. .� •5..,: ,, ;. .... ... ' . /' - � ' .. '^ .. ' .
<br /> RESIDENTIAL'•}�-.Attaoh(2),;Plot�.P.,laris;:_(2)�'setscof<Bullding+Plaris;'(1)'se't of Energy�Form'sC'R=0-W Perrnit for new construction,
<br /> , ;.s r.Minimum.ten�(•1,0);working�cfays;after,°submiftal`date:'�Requlr"eiJ onsite;-Constiucdon:Flans,Stormwater"Plans w/SIItFence installed,
<br /> __ _ ' �Senilary'Faplllti;es&:_1;dumpste_r,�Site,Work;Permitforsubdivist�ns/Iarge.proJects ,;; ,:= � �" ' -
<br /> COMMERCIAL Attach(3)'iioFnpiete seC§`tif'Buittltng Plans"plus a Ufe$afety Page;(1)set of Energy Forms.R-O-W Partnit for new construction.
<br /> Minimum ten(10)working days'after submittal date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides 8 1 dumpster.Site VVork Permit for-all new�pro)ects.All commercial requl[ements.must meet compllance � � '
<br /> SIGN PERMIT AttacF�'(2)"sets of'Engineer.edsPlans.; , �.� • _. : _ ` � � •
<br /> "••PROI'ERTY SURVEY required for all NEW_construction.. •
<br /> D)rectlons: •- ,._ . � � � � � `
<br /> Ftll out applicatlon completely.
<br /> Owner 8 Contractor sign back of applfcaUon,notarized �
<br /> If over 52500,a Notice of Commencemenf Is required. (A/C upgrades over$7500) ',
<br /> , :�,;,m,•.;-; - ° . ;,�,..�..,.��,._:,_...�:-.,•,.�
<br /> " F�qent(for the-contractor)orPower'of=Attomey'(fo�the'owinerj would tie someone with notarized letter irom�owner authoniirig'same. _, a
<br /> DVER�THE COUNTER.PEiiMITTING-����-�v>�-_(FroM�of dlpplication�Only�.:.,......�; '' �� � ii � � �=�.-'r.�-:•sz I, ' - " ;,
<br /> Reroofs if shingles Sewers i Service.Upgrades.�A/G� •Ferices(PIoUSurvey/Footage) � - , , ,... �:�`-- � - � �
<br /> Drivewaya-Not over Counter if on'public roailways.�n`eeti"s ROW,",�, �:� � .;- -... _.� � ,.'..`.�`��.l��f. µl;'. P.J -, .
<br /> . ..,_..��.�...... � ...�.,......�.,,.r. .. p::���...f:
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