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_ � � .81.�-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Departrnent
<br /> DateLReceived �
<br /> �i � - Phone�Contact for Permlttin - �
<br /> Owner's Naml , r(�l,�l. ' �� C.S '�i'K e Owner Phone Number g�,� ��
<br /> Owner'sAdd�ass �Z2 S''�' �2,�-�- (•� �s � �/2 pwnerPhone�Number �� J2��� �
<br /> Fee Simple Tltleholder Name ; L��t� �I t�us� Owner Phone Number
<br /> Fee Simple TOtleholder Addresa ��`�O 7i,tr v�; o i '� 1^ wTZ � S�!R
<br /> JOB ADDRESS � 2� �, -Fr��e� I� r(�,,L�S �(,, 3,35`f� LOT# �
<br /> SUBDIVISIOh1 PARCEL ID# I I --Z�o- Z� —001 O — ��gp D--p2 I O
<br /> (OBTAINEO FROM PROPERTI!TAX NOTICE)
<br /> WORK PROPOSEQ � NEW CONSTR DD/ALT 0 SIGN Q� Q DEMOLISH
<br /> B. INSTALL B , REPAIR
<br /> PROPOSED:UI$E_ Q SFR Q COMM � OTHER
<br /> TYPE OF CON3TRUCTION Q ' 'BLOCK '' Q ME � [J STEEL Q
<br /> S
<br /> DESCRIPTIOI OFWORK remo ba�xb inS�{z��� 32��'Llz�r �n b��t,�aor�-, �ocA;[c� w(�c�Gha'�r
<br /> �UILDING SII '" � � -�}- � SQ�FOOTAGE ��}'I I . HEIGHT .� s�o
<br /> BUjLDING $ g.�O VALUATION'OF TOTAL CONSTRUCTION ,
<br /> QELECTRICAL $ " AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
<br /> PLUMBING $ -
<br /> �
<br /> QM CHANICAC $ VACUATION OF,MECHANICAL INSTALLATION. '�l ? � S�
<br /> � �
<br /> Q�S Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLIOOR ELEVATIONS FLOOD ZONE AREA QYES ,NO
<br /> � _ _ �
<br /> �
<br /> BUILDER `—r; COMPANY �/'-
<br /> SIGNATURE' � REGISTERED Y/ N FEE CURRE� Y/N
<br /> syr
<br /> Address � Ucense#
<br /> ELECTRICI._, , : COMPANY� � '
<br /> SIGNATURE � REGISTERED Y/ N �cu�xe�- 'Y/N
<br /> Addres • . Ucense# •
<br /> PLUMBER � ^�� (�
<br /> �OMPANY � Y, -
<br /> SIGNATURE` , REGI3TERED X./. N. ,FEE CURRE� " Y-/N
<br /> Addre License,# - ,—�
<br /> fUIECHANICAL- ' . - ' - � . ` - .
<br /> COMPAIVY
<br /> SIGNATURE' � � � � REGISTERED Y,/ N - FEE CURRE� YJ•N ,
<br /> Addres ` � . .. . .� -- ' , License#
<br /> �. . . , • . �
<br /> OTHER ' •� - � � „COMPANY �� �
<br /> SIGNATURE'. � - � • � � � `' REGISTERED Y/ N_.,; FEE CURREh Y/N �
<br /> ��: - � . _: . , , " -• .
<br /> Address - ,. - ., � , . • � ' " "Ucense# .
<br /> I
<br /> RESIDENTIAL; : •Attach'(2),.PIot�P:lans;:(2)"sets°.of:Building�Plans;�(.1)'sefofiEnergy;Fortns;'�R=O=W�Perrrilffornewconstruction,
<br /> � - , :Minimum�.terr_•1,0�workin ,da, :after,�submiEtaf:'date.::�R'"uired onsite;:Constiuctlon:Rians;�Stortnwater Plans w/Sflt Fence installetl,
<br /> . . �„�� .9 . �Y$ �
<br /> -:.,.,. ... .
<br /> Sanitary'Facilities;&�.1,;dumpstertSite°Worlc:Permit;forsubdiWslons/large projects , _ ,,, '` ' '
<br /> COMMERCIAL Attach(3)eomplete sets of Buildirig'Plans plus a Ufe$�afety Page;(1)set of Energy Forms.R-O-W Pertnit for new construoUon.
<br /> Mlnimum ten(10)working days after submittal date. Requtred onsite,ConstrucUon Plans,Stortnwater,Plans w/Silt Fence installed,
<br /> Sanitary Facilitles 8 1 dumpster.Site Work Pertnit for all new.projecfs:.All commercial reGul[ements must meet compllance
<br /> SIGN PERM{�T AttacFi`(2)sets�of�Engineer.ed:Plans.;��; ,x;-,:•> - - . - -
<br /> I ""PROPERTY SURVEY required for all_NEW_constructlon.
<br /> Dlrectlons: �I ,. � --- , � �
<br /> Ffll out applicatlon completely.
<br /> Owner 8 Contractor sign back of appltcatlon,notarized
<br /> If over E2500,a Notice of Commencement Is requlred. (AIC upgrades over bT500) '", :
<br /> .. � ,
<br /> Agent(for the ctinVactor)'or PouveF of Attorimey(fo�tlie�owner)would be someone with notarized letter irom owner authorizing same
<br /> OVER'THE COUNTER PEItMITTING--• - �(Front-of Applicatlon�Only) � ,_, �;,�;,
<br /> ;;'�_.�._ .:_.�.::�.,..��,�"�'��:,���.M:.�:���x.
<br /> Reroofs If shingles Sewers Servi ) u
<br /> ce Upgrades A/C Fences(Plot/Survey/Footage ,,s � ��„- .�.�
<br /> I -- - ---�- - - • , .... �1 i,I"1S�?."al. .�"!:':;. ,. -
<br /> �,� a::•1�"1;il fl1£i�r-:I�wa.i:� Sf 1 � ''.—�`(� �
<br /> Drivewaya-Not over Counter if on publ(c roadways:.need's ROW� � ��rra�, , ;� .. � °!' 'i�,���'�«1--;
<br /> i 'tU ".55:�X; 'hf::;):)y(,;: •iR';r;�, ,�.
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<br /> altiL.i7 .1 ;1i�ri:".�! G�j }�.'h.���� �
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<br /> - , '(".i, F.i'(ili"I` 'Su,:ti;i ti3!i.;!+ �.
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