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<br /> � a�aaso-oo2o City of Zephyrhills Permit Application Fvc-813-780-0021
<br /> - Building Department
<br /> Date Receiv�d �� 3 '78� _ !`(��
<br /> � • Phone Contact for Permitting '
<br /> Owner's Name � � Q- � � � Owner Phone Idumber . a�o�" 7�� ' 3�0
<br /> Owner's�Address 3�� (� 7��� �� '� Owrner Phone Plumber
<br /> Fee Simple �tleholder Name Ownar Phone Mumber
<br /> � :.
<br /> Fee Simple itleholder Address �.
<br /> �-ti-- -- — L ----- - — --^ --- --- - ---
<br /> JOBADDR SS -3 ��' ��T��i(JE'.� � 11,5' _ , LOT# �
<br /> SUBDNISIO PARCELID# � oKO �� CJ�� �D�o (�7 <�
<br /> (OBTAINED FROM PROPERTYTAXNOTICE)
<br /> WORK PRO OSED eI NSTALLS;R,� REPAIR � SIGN Q Q DEMOLISH
<br /> � PROP.OSED USE Q SFR Q COMM' 0 OTHER
<br /> TYPE�OF C NSTRUCTIOW Q BLOCK - Q FRAME 0 STEEL Q
<br /> DESCRIPTI N OF WORK Y ���S� �/C vttY�'N —OLl�T � �6� � �6m �a7V��
<br /> �UIL`DING S ZE SQ FOOTAGE .HEIGHT
<br /> 06 ILDING $ VALUATION-OF'1'OTAL'CONSl'RUCTION
<br /> QEL C.l'RICAL , $ AMP SERVICE �Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPL MBING $
<br /> OM CHANICAL $ = �� r' � VALUATIOfV OF MECHANICAL INSTALLATION
<br /> J
<br /> OG,S Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED.F OOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ,
<br /> ECECTRICI COMPANY �
<br /> SIGNATURE J REGISTERED Y/ N FEE CURRE� Y/N �
<br /> s
<br /> Addres Cicense#
<br /> PLUNJ�ER:: COMPANY "
<br /> SIGNATURE � -REGISTERED `Y�/ N 'FEE GURRE� Y/N
<br /> Address - License#, � -
<br /> 't MECHANIC� � ~ CONiPANY A-J�12�s/' �le������
<br /> SIGFIATURE' � REGISTERED Y/ N FEE CURREn Y/N
<br /> Add�ess ��l i�/�eN , ZB /LLS �3 Lic,ense,# ��d���7� '
<br /> .�:vif'i , .. . . "
<br /> OTHER<� ��� � � COMPANY
<br /> °SIGNA'T,UREC'� � " � REGISTERED Y/.N FEE CURRE� Y/.N
<br /> �da�ess<„ . t;:,: , - , ., - ' License#
<br /> � , .
<br /> :±..RESIDENTIAL :�.: AttacFi:(2)iPlot��P.lans;"�(2):sefs�of�Buililing'Plans;•^(1)•set of Energy,Forms;R,O-W Pemiit for new.�construction,
<br /> , -;•.,;,.;:;.�;,�K=,,Minimum;�ten;(,1'0.);w,orkingydays after.su6mittal.date. Requir'ed'onsite;�Constniction Plans,Stormwater Plans w/Silt Fence installed,
<br /> - " � Sanita.ryf�Facilities;&;1;,dumpster Site;Work P.ermit'for:subdi'vi§ions/Iarge,projecEs_� , ' - �
<br /> >. CO�AAMERCI Attach`(2)'complefe'sefs of'Building`Plans plus a Life Safety Page;(1)set ofEnergy Forms.R-O-W Permit for new constructlon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanftary Facilitfes 8�1 dumpster.Site Work Permit fo%all new p�ojects.All comme�cial requirements must meet compliance
<br /> ='SIGN PERMIT �AttacFi(2)sets ofaEngineerQd Rlansc�', �� .
<br /> � - ****PROPERTY SURVEY_required for_aII.NEW construction. -
<br /> :`Dicections:_ ,..:,;.:-,..� ,:.,.. ,.,
<br /> Eill'out a plication completely.�
<br /> Owner& ntractor sign.back of application,notarized
<br /> If over$�500,a Notice.of Commencement is required. (A/C upgrades over$7500)
<br /> " Agent(fo tHe cont�actor)or Power�of Attomey(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> � :01LER THE=C �UNTER,PERMIT.TING.'..�,;;;,(copy of�contraet-requi�ed) � -
<br /> Reroofs if shin les Sewers ,,,Seniice lJpgrades.A/C �•, Fences(PIoUSurvey/Footage)
<br /> - Drivewa -Not over Counterf if on public roadways::needs•ROW_;
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