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s�s- 8o-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �• Building Department
<br /> Date Receive � � � phone Contact for Permitting � �� - �
<br /> f/� 63- 3
<br /> �Owner's Name „l+�1 . � — v�i�'� v�.C, �--- - - --- - O ne er
<br /> O ner Phone Number
<br /> Owner's Addr ss �3 �Gt, �
<br /> �.��
<br /> Fee Simple Ti leholder Wame Owner Phone Number
<br /> Fee Sirc�ple Ti leholder Address
<br /> JOB ADDRES� �' .ZO V • LOT# � ,
<br /> SUBDIVISION PARCELID# t��b'��0���r�0��� "�/_�7� -- - - - '
<br /> � �
<br /> � _ __ _ _ - - � (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROP SED , NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> e INSTALL e REPAIR
<br /> PROPOSED SE Q SFR � COMM 0 OTHER _
<br /> TYPE�OF CO STRUCTION Q BLOCK - Q FRAME 0 STEEL Q '
<br /> DESCRIPTIO OF WORK c
<br /> BUILDIPIG SI E a C � SQ FOOTAGE � �-I HEIGHT J ��
<br /> OBUI DING $ � VALUATION�OFTOTALCONSTRUCTION
<br /> QEL CTRICAL $ � �� � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
<br /> > �
<br /> QPL MBING $ .�i /�Q7�
<br /> �/ ��`� '��
<br /> QME�HANICAL $ VALUATION O M�CHANI AL INSTAy�TION , �j � ���
<br /> I� �"Oa �
<br /> l �C, a►�•� F{abo1 /�f� G
<br /> �GA Q ROOFING Q SPECIALTY 0 OTHER � ��
<br /> FIIVISHED FL OR ELEVATIONS FLOOD ZONE AREA YES NO �, �^
<br /> � � l.�J� � ��
<br /> BUILDER��C �n �,.----- � p� � � �COMPANY ��`��_ �pGI��� c�d�/_S �
<br /> SIGNATURE /r A � � o�/ REGISTERED Y/. N FEE CURRE� Y/N Q�r�
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<br /> Address �d u� �e � Er C � Q,jr License# C 4 G /�^�S O y ��,1rl�i
<br /> ELECTRICI, , / �CO�iIPANY � J/� � �' {��..��
<br /> SIGNATURE �( f j{� .' REGISTERED Y/ N FEE CURRE� � Y/N . a' `
<br /> Address �.� License# �C�?j��I�i��
<br /> � - --- �-�1,,J�i
<br /> PLUMBER - �/�,��� �,�� CORAPANY I ---- �/� �Z���'aE�°.� � z�� '
<br /> SIGNATURE � �}���'_�^-!+__W�`- - REGISTERED Y N FEE CURRE� Y/N
<br /> Address _� __ ti (, �(� License# e �4' �E"j �
<br /> MECHANIC e Ji ` ,�� OMPANY G�.!`Iu �S C �� �v/C� ��-- •
<br /> SIGNATURE ��� REGISTERED Y/ EE CURRE� Y/N '
<br /> AcJdress �j y� � License# C ,��j
<br /> OTHER- CORlI PANY
<br /> SIGN�,TURE. REGISTERED Y/ N .. FEE CURRE� Y/N
<br /> Address License# _ _
<br /> - - �- -�........ .. . ..... . ��i�ri-� - --- - - - -
<br /> �RESIDEN'TI Attach(2):Plot Plans;(2)_sets'of Building'Plans;(1)set of Energy�Forms;R,O-W Permit for new construction,
<br /> . - Minimum,ten.(10)working.days after submittal date. Required onsite;Constniction Plans,Stormwater Plans w/Silt Fence installed,
<br /> , Sanitary;Facilities.&�1 dumpster;Site W,ork Permit for subdivisions/large projects
<br /> COMMERCIA - Attach(2)complete sets bf Building Plans�plus a Life Safety Page;(1)set of Energy Forms.R-0-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> """"PROPERTY SURVEY required for all NEW construction. ` � ' ",. ,
<br /> Directions: � ,� - . .. , . .
<br /> Fill out ap lication completely. �
<br /> Owner& ntractor sign back of application,notarized
<br /> If over$ 500,a Idotice of Commencement is required. (AIC upgrades over$7500) , -
<br /> " Agent(fo We contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE C UIdTER PERN1lTTING (copy of contract required) ' ' , ' �
<br /> -Reroofs if shin� les Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) �, , _ �Y, :;
<br /> Drivewa -Not over Counter if on public roadways..needs ROW_ _=.,�.� •- _. -
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