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r s�s 'so-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> Date Received Phone Contact for Permitting �j� `U� -- �G��
<br /> owe�ee`s Na�e \(:�f't �!- 6� �Ct��n Owner Phone IVumber �� r ��� "�����
<br /> .,. ' '-d,, >� � I �1� Pa�l 5 F��ch���n ���'1���S�J y�Owner�hone Number .
<br /> Owner:s i4d ress�
<br /> Fee Simple�itleholder Plame Owner Phone Idumber
<br /> Fee Simpie�'itieholder Address .
<br /> J�B:A�DR SS'�. � "1 �J�� )� AV C ZQ �� ,(�'1il�S F I 3 3�� a ���# ��
<br /> � �
<br /> S�eo�V�s�o�' , �nS�-4 L s-i�.�r s �PAE3CEL:Ip�E I��� �--� 1 ��3(��c�c� � �� ��.
<br /> ' . • ' - �(OBTAINED FROM PROPERTY TPJC NOTICE)
<br /> .... ��:.__... .:
<br /> WOliK:PROPOSED' NEW CONSTR ADD/ALT �� SIGN Q MOVE Q DEMOLISH
<br /> � � B � INSTALL � REPAIR J
<br /> PROPOSE I USE, � , Q SFR Q COMM 0 OTHER � l, '
<br /> TYPE OF CONSTRUCTIO►V � BLOCK � FRAME Q STEEL 0 OTHER
<br /> .� n --y- i , r
<br /> DIESCRIP,,TIDNOIF�lIVOlaK� �� c UQr�S ,�f�� 1 I�I.��'-��1� '1��'� �� �r�-r�'C��`" �, °� �al�y � I
<br /> ,,: .�.,.;, _.�,:.�:,.::_:.,;.: .:.......:.. .
<br /> BUiLDING�IZE; ,Sf'a„FOOTAGE �8 V HEIGHT
<br /> � B ILDING . $ ;;,��'±,r';y� �"`�,;�:;?;:. �7 �� ;?UAi`67ATIQN�:OF=TOTAL',CONSTRUC'fION • ,
<br /> � �'.`,lt1�C�`'�:�}�;�"�-'' :,
<br /> Q E ECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.G.
<br /> � P UMBING $ � /�� (,�?/
<br /> ` • � I
<br /> Q ,ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION (
<br /> Q IAS Q ROOFING 0 SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ONO
<br /> BUIH.DER COMPAi�V . .
<br /> SIGPIATUR REGISTERED Y/ N , FEE CURRENT Y/N
<br /> Addre�s � ' License# '
<br /> EI.ECTRIC�AN . , , . • . COMPA(dY � �
<br /> SIGNATU E REGISTERED Y/ N FEE CURRENT Y/N
<br /> Addre'ss � ' License#
<br /> PLUM�E9t Cm�i7PAIdY
<br /> $IGiVAII'U E � REGISTERED Y/ N FEE CURRENT Y/N
<br /> Addr ss License#
<br /> MECIiANI�AL COMPANY ' . .
<br /> SIGNATU E REGISTERED Y/ IV FEE CURRENT Y/N
<br /> Addr ss � License#
<br /> oTw�r��n}:._. : � �Ci �I (.��d G� COMPi4WY. I� �'nC�1� C(���? ���� ' �
<br /> SlCs9VATUFPE!;� i � �REGISTER�D Y/ N FEE CURR NT Y N
<br /> aaa�ess . f �I 3 S P S� . �7 ( h 1 I, � 335� ��License# �I��S��
<br /> ,.r�:� .
<br /> R�SlDEfV7'iAL • Attach;(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
<br /> , :�Minimtim ten(10)working days after submittal date. Requireii onsite,Construction Plans,Stormwater Plans.w/Silt Fence iristalled,
<br /> ' Sanitary.Facilities 8�'1 dumpster;.Sife 1Nork Permit for subdivisions/large projects , .
<br /> COINNlER�IAL Attach(3)sets of�Buiiding Plans;(1)set of Ene�gy Forms.R-O-W.Permit for new construction. • '
<br /> � Minimum ten(10)working tlays after submittal date. Required onsite,Const�uction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&�1 dumpster.Site Work Permlt for all new projects.All commercial requirements must ineet compliance'� � �
<br /> SIGiN PER�IIT Attach(2)sets of Engineered Plans. , . '
<br /> I "*'*PROPERTY SURVEY'required for all NEW construction.
<br /> Directions: ' � ' �
<br /> Fill a �t application completely. �
<br /> Owne &Contractor sign back of application,notarized
<br /> If ove $2500,a Motice of Commencement is required. (A/C upgrades over$5000)
<br /> *" Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
<br /> I
<br /> 'OVER tHE COUPJTER PERMI7'TO�G (Front of Application Only)
<br /> i.:.,...........
<br /> .� Reroofs; , -. Sewers �- �-� Service Upgrades A/C Fences(Plot/Sur.vey/Eootage��.,,. _ _ ,,,_ ��
<br /> ; . � ,., ; , _ , ... . -- - ---- - � •
<br /> i 1 I; ' '' ' ;�
<br /> „, DPiveways-Not over Counter if"or�public roadways..needs ROW , `� � � � , , " •, ,
<br /> � „ ,f �i. .. �.. _ ., , ��rr'�,. - J
<br /> ..:. ,.. r.. ..,... -.. ._ , _.: . . ... ', ° .__, ., . �:, � ' .,.
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