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a� 'laso-oozo City of Zephyrhills Permit Application FaX a�aaeaoo2� �;
<br /> � Buiiding Departrnent �
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<br /> Da�e Recelved � P.hone Contact�for`Permtttin ; D`� �� , = S��
<br /> Owner's Na I e L�Z� ��� Owner Phone Number O l,7 ' � � �oT f f
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<br /> Owner's Addreas G � . L� LJ. Owner-Phone-Number �
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<br /> Fee Simple,INeholder Name � Owner Pfione Number !
<br /> � �z-.r i
<br /> Fee Simple , Itleholder Address ° . i
<br /> � 5- „ - —/ j-
<br /> JOB ADDRESS � �l Z / .S �C. LOT# � �
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<br /> SUBDIVISIO PARCEL ID# - a
<br /> " (OBTAINED FROM PROPERTY TA7(NOTICE�, �
<br /> WORK PRO OSED �- NEw CONSTR �ADD/ALT Q SIGN "Q Q DEMOIISH - I
<br /> I B INSTALL. . B' REPAIR
<br /> PROPOSED USE Q SFR � COMM Q OTHER ,
<br /> TYPE OF C NSTRUCTION Q BLOCK"' Q FRAME [� 'STEEL Q i
<br /> �1 i
<br /> DESCRIPTIONOFWORK �(,. GJf��N L�'D�Gf � �.� Td/lI � � /� � ��/� oZ ��T7y� d/J T�$"
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<br /> BUILDING SIZE � SQ FOOTAGE�� HEIGHT ., ;
<br /> . QBUILDING $ ` �=a�..�-- .. �.�. �
<br /> - - , VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMPBERVICE Q PROGRESS ENERGY Q W.R.E.C. �
<br /> QPLUMBING $ • I
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<br /> QMECHANICAL $ �VACOATION OF MECHANICAL INSTALI:ATION �
<br /> . �9D1�, � - - ;
<br /> QG�S Q ROOFING ,.Q SPECIALTY �] OTHER '
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<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA , �YES. NO i
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<br /> BUILDER i COAAPAWY �
<br /> SIGNATURE REGISTERED Y/ N ' FEE CURRE� Y/N ;
<br /> Addre�s ' License# � '
<br /> ELECTRICI,� COMPANY i
<br /> SIGNATURE'i � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres' . , -Ltcense.�#
<br /> PLUMBER COMP.ANY- . ~ � I
<br /> SIGNATURE� � . REGISTERED �,,Y/,-N . ;: FEE CURREA, Y/�N i
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<br /> Addre � License# - �
<br /> MECHANIC� /j�' � " ,C.OAAPANY 6��i�L�..S � �/�DP�/UC✓�7g$���/�
<br /> SIGNATURE v""""" REGISTERED , .Y;/ N . FEE CURRE�" Y/=N . �
<br /> Addres '=. . ��� � sTj �'�V _� ' • License# ���� . ��.-Ta
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<br /> OTHER • „COMPANY '� �
<br /> SIGNATURE - ' " ' ' REGISTERED `Y/ N..� _����._FEE CURRE� ;`. Y./-N--.
<br /> Addres� . _ . � � ' =L'icense#
<br /> � �. , _ -..�n p, .. ,p..M1 . .-.:' < ._"' _' . :�Y. .,. . .s x ��-,..`.��i a.:;: ..�,_ c <:.t- . . ,
<br /> �. �.� . � . . _ l. ... 1 1 -
<br /> RESIDEWTU4L, -� Attaoh(2).�.PIotP,lans;;(2)`s"ets:oftB�uilding'Pians;'(1)setiofEnergy$Fo`rrris;''R-O=WPeri"r%iffornew.,constructi,on, ., �
<br /> x ,,
<br /> � �F:•.. ���__ ._.,�.....e^� ,
<br /> -.Minlmum�ten;.(:10);workingjdays�after,",�,subiolftaLdate.�:Requfied onsite;=Constniction�Pians;Stormwafer'Plans w%Silt Fence installed,
<br /> ~Sanitary_Facil(t7es;8a7kdumpster.,Sitet:WorkaP,;ermit.for::sutidiyislons/lerge:pro)eats;';='>,,��� `. ' �
<br /> COMMERCI�. Attach(3)coinplete'sets of Building Plans plus a'�Life SafetyPage;�(1)-se�-ofiEnergy+-Forrns.R-O=W-Pem►►tfor-ne�!-oorestn,dto�.� —.
<br /> Minimum ten(10)working days'after submittal date. Requlred onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanihary Facilitles&1 dumpster.Site Work Permit for all`new.proJects:All commercial.requirements must.meet compliance -
<br /> SIGNPERNAII Attach�(2)"sets'of`Engineer,ed�Plans:,;.c:;�<`.d= -�� -: •,.. ' , i
<br /> ""PROPERTY SURVEY reguired.for,all NEIN_canstrucBon.,
<br /> Directlons: � - A -
<br /> FIII out appHcaUon completely. .
<br /> Owner&�Contractor sign back-of appllcatlon,notadzed
<br /> If over�3500,a Notice of Commencement i�required. (AIC upgrades over ST500)
<br /> .. �.-,;.r.w<y;c;;: � .
<br /> I\qent(for ttie'conUactor)or:Po`w`er"of Attomey`(fo��theYowner)would be someone with notarized letter from owner authorizing same
<br /> '�VER THE COUNTER.P_ERMITi1NG.---.-- (Front of�Application Oniy)• � ` ,
<br /> Reroofs if shiigles Sewers Service Upgredes A/C Fences(PlodSurvey/Footage)
<br /> : �.,:. .
<br /> Driveway�-Not over Counter if on public roadways..needs ROW �
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