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<br /> � ' 8�3-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 �'
<br /> � Buflding Departrnent
<br /> Date Recelved �. c, , , , S . ��
<br /> / ' � " "� Phone Contact'for:P'ermittin �'�: '
<br /> Owner's N I me �� �-�L wner.Phone Number ���'.� �''��b_�
<br /> Owner's Address �o - 0' • yu,�� ` 'Owiner•Phone Numb�r ' -�
<br /> Fee Simple Titleholder'Name � : � • Owner.Phone Num6er �
<br /> Fee 31mple�Titleholder Address- .,. � ` .,, . . ,
<br /> JOB ADDRGSS '^ , . ' G L07# �
<br /> SUBDIVISIAN ' - .� PARCEL ID# p� - . . :` Oc�� O�� /�O -
<br /> ' ' ' ' �� , ' .'�(OBTAINED FROM PROP.ERTYTIU(�NOTICE) � ,
<br /> WORK PROP,OSED ' � NEW CONSTR "• ADD/ALT •� - SIGN �Q Q'; '_DEMOLISH -
<br /> .. ' B y._ INS7;ALL e:. =. �REPAIR . � " � .
<br /> PROPOSED USE._ , Q::" SFR" [� COMM` `Q ' OTHER" ` � ..
<br /> TYPE OF CONSTRUCTION:� `Q BL'OCK�', '�Q�� �` FRAME � STEEC. Q' .. , �
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<br /> DESCRIPTI N OF WORK Q ,��,�. '. �i9G� , �'4��
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<br /> BUILDINGSIZE'-� ' �SQ_FOOTAGE ..� , kHEIGHT,� . � •
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<br /> .. . QBUILDING $ _�'s.;i,r;..;�. ��:�,;,�.c_ :.. . ,
<br /> , • : VALUATION:OF TOTAL COMSTRUCTION '
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<br /> QELECTRICAL $ � 'AMP SERVICE �Q' PROGRESS ENERGY [] W.R.E.C.
<br /> PLI MBING ' I
<br /> � .` $ � �' . . : ��
<br /> ��
<br /> M CHANICAL � $ 'VALUATION.OF.MECHANICAL INSTALLATION •=���� I
<br /> � 3 � , �
<br /> Q�►{ : .Q, - ROOFING;�Q SPECIALTY Q. OTHER � J-�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO l � ,
<br /> ',• �s _ -.,,.; '
<br /> �UILDEit - COMPANY� ' ' � '
<br /> SIGNATURE REGISTERED Y/ N. , �e cuwzEn' ,: '.Y/.N . � ., , ,
<br /> Address - License#� �
<br /> , 3� �
<br /> ELECTRICiAN..:: .,.: , �� ` COMPANY r' , ` ' - -
<br /> SIGNATURE ' _ '"' REGISTERED Y/ N FEE GURREK ' ':Y/N
<br /> Address - . , , . ,. • . ' , f ,... .. •L-Icense:#: ' � . .. � �
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<br /> PLUMBER � � , , - - - � � �
<br /> . . . C.OBAPANY�_ `..' �• _ , _,.
<br /> SIGNATURE ' . � . _ -Rects.7E�D� _ :�,Y./:-�N • -•FEE_Cu�rter.� . .:Y/`N." :
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<br /> Addres� - - - - , . ...lJcense#� - _ - -
<br /> MECHANICAL:;' . . �. ,.� _,COMPANY. _ ��. �. ,_ � , . - - "
<br /> SIGNATURE ��.` `��[ REGIS7ERED: `N� ,;FEE_CURREP - =YII-N''� � - �
<br /> F.`.,
<br /> �4ddress`I,� � - /�_ �� ;�� �� r�� ,;Licen,s.e# S .�
<br /> OTHER I . ` ' _''� ' ` ' ..,.. _. .. . COMPANY; _ . _. - � . . . _ . � ,
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<br /> SIGNATURE. , _. .,_. � _ _ • . �.�;, -
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<br /> REGIS7ERE0 Y/ N_<; '. : , . ,
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<br /> .:FE�`CURRE�' �:Y:/;N:". :,
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<br /> �d�B�E s;,v.��,,z . , ,.. .. . UC811S9�#�.
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<br /> '{. `n�u'<. "t "'`4.,`:" " " .7,��['.'1`x..%,�. L :L ). ..}:::V.��.;,�
<br /> RESIDENTUU:I _,`�Attach.'(2),PIot;Plans;:(�);sets=of�Buildl'ng,Plans;:(1)=sef.of.�Energy�Fomis;�R=O=WyPerrniE:for;new;,canstrucbion,: _ - .
<br /> -.�-� . . _. _. ,<.. :.. .: :. ;,
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<br /> ,:: Minimum;.ten:,(.10)�worlting;days�after,isubmittal�d"ate:��Requlrsd''onslte;�Consfructlon�Plans;,Sto'rmwate�:FlanswL Stlt Fence lnstalled,� .
<br /> � �--- � �`Sanitery:FedllUes�B:�tidumpster�SlteFWortc:•Pe[mit`.for.:sutidivi.'slons/large:`pro ` ,;}'`;'."'•�, - � , = ' _ � ' �
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<br /> C,OMMERCIAL't Attach(3j`�complete`sets"of Bulltlin"g"Plens plus a Life Safeqr Pege;(1)set of Energy Forms.R-O-W Permit for neW constructlon.
<br /> Minimum ten(10)working days'after submittal date. Required onsite,Construcdon Plans,Stortnwater Plans w/Silt Fence Installed,.
<br /> Sanitary FadliUes�1 dumpster.SIte.Work•Fertnit for all.nei�irproject's:i411;commercial.cequlrements_must.meet compllance �
<br /> �SIGN.PERMIT AttacFi'(2)"§ebof'Eng1ne_'er!sila..P..la[is:�;�;��s�'y.':,�,:�=.•=. �. " . - �
<br /> � ••••PROP.,ER1_-Y,..SUR1l�Y regulred for�all iVEW.cons.tructlon:.:,.. ^�--_ - _ - � ' .
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<br /> . .�.fy:.'i:.. ,r,� ..r,:.' • "^ ". ___ ...
<br /> Dl�ectlons: - ..._._ _u
<br /> Elll.out appflcatlon completely.
<br /> Owner$Contrector sign back:of applicatlon,notarized
<br /> If over'E25�00,a Notice,of Commenc�ment la required. (b1fC upgrades over 5T500),;__, F- • _ _
<br /> .. I�� � .'s�,�a�:.:_.. ._. ..;. . ..�.:.,_.w, _�. _ , .� . � -
<br /> AgeM(fur ttie°confr�ctor)�O�:Rower ofAttortiey(fo�the owner)would be�someone with notadzed letter from owner authorizing same
<br /> 'OVER'THE-CO�JNTER�:PEf�Ml1'fING-=;=�-'""(Front-of-AQplication"Only) ;,.� "__� � ' ' -
<br /> Reroofs if shing es Sewers Service:Upgredes,A%C Fences(Plot/Survey/Footage) _ -- -
<br /> ..... ....-r�._. ---_-,:-,_ ... •� �.�.: <:`. = - - . - -, - . ,
<br /> DNvewa -Not over Counter if on';publ�ic roadways.:'n''eeds ROW J ' � � �
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