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J� e��.��o-oo?o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> Date Recelve�d � - Phone•Contact for Permlttin S i 3 g�� _C-�0 7�
<br /> Owner'a Narrie �� G� � � ��� Owner Phone Number
<br /> I Owner's Address �0� � Owner Phone Number
<br /> Fee Simple Tltleholder Name ' Owner Phone Number
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<br /> Fee Simple tleholder Address °
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<br /> JOB ADDRESS ,���� �S 1 � C J^ LOT# �
<br /> SUBDIVISION ������ 'Meb�1s. PARCEL ID# �0�2�' ��–'DD�� ^ �p — O��
<br /> , (OBTAINED FROM PROPERTK TAX NOTICE)
<br /> WORK PROPOSED � NEW.CONSTR' ADD/ALT Q SIGN �� Q DEMOLISH
<br /> - ,B, INSTALL B ; � REPAIR :�
<br /> PROPOSED.�SE � Q SFR Q 'COMM Q OTHER �
<br /> TYPE OF CO STRUCTION - Q'' '' BLOCK " Q FRAME �.� STEEC Q
<br /> DESCRIPTIO OF WORK ��`�� � � ��� \o �A N� v�� ����
<br /> BUILDING SI � SQ�FOOTAGE�� _ ,.HEIGHT�t. _
<br /> QBU LDING $ VALUATION'OF TOTAL'�CONSTRUCTION` �
<br /> / ELECTRICAL $ I c�"� AMP SERVICE a o PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �
<br /> QMECHANIGAL $ VALUATIQN OF:MECHANICAL INSTALLATIOfV �` 6 �" '�
<br /> QGAS Q ROOFING Q SPECIALTY � OTHER� �OV '�
<br /> FINISHED F OOR ELEVATIONS FLOOD ZONE AREA QYES NO �p,
<br /> _ - . �� C� ,�
<br /> BUILDER COMPi4NY'-
<br /> SIGNATURE ReGis7'E�o Y/ N FEE CURREI� Y/N .
<br /> Addre� � License#'
<br /> ELECTRICI�, � , `��. � �� COMPANY J�'~, �S ��'�c r�`'�/ �'�d"'� ''`'e
<br /> SIGNATURE „ REGISTERED Y/ N FEE'CURRE� Y/N
<br /> Addres ���v�a-���`s G�'`�y'Ck jQ t' "(�`��. ,�,L 3��1�7 , �: . ucense#. FC 13 0 05'�f q�,
<br /> PLUMBER '� COMPANY . � �, �.•
<br /> SIGNATURE` � ' , �REGIS.TERED Y./-N I,FEE CURREK ' '" Y•/N
<br /> Address License.# �
<br /> MECHANIC' ' . � ., COM,PANY �
<br /> SIGNATURE � � � � � ` REGISTERED �. Y./ N FEE CURRE� YJ�N� .
<br /> ' . .. . .
<br /> Addres. �`• � ' � . � °- License#�
<br /> OTHE _ ,. . _
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<br /> �,COMPANY .:
<br /> SIGNATURE• ��. � - •� ` � " � ` REGISTERED ' Y/ N.... FEE CURRE�• • Y/N
<br /> Addre . � . ,� F- __ . ; . , ;y. = Ucense# � -
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<br /> RESIDENTI. '., �Attacfi'(2),PI_otiPlans;.(�2)sets.of:Bullding�Plans;(1)'setof�EnergyFortn"s;R=0-W Perinitfornewconstruction,
<br /> � ,.Minlmum:tenr(:1.0)Wworking;d"ays;after submlftal'date.�•R'equlred onslte,_Construcdon=Plans;Stormwater'Plans•w/Silt Fence lnstalled,
<br /> �� �-, Sanit�ry Facllldes;&r,l;dumpster_Slte°Wor1c;Permit for subdivislons/large,proJects. <�_.-- ' � � �
<br /> COMMEI2CIl01. Attach(3)complete sets�of Bulldfng`Plans plus a�Llfe Safefy Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> Minlmum ten(10)working days after submlttal date. Requlred onslte,ConstrucUon Plans,Stormwater Plans w/Silt Fence Installed,
<br /> Sanitary FacIllUes&1 dumpster.Site Work Permlt for all new projects.All commercfal requlrements.must meet compllance ' �
<br /> SIGN PERMI i Attacfi`(2)sets�of�Englneered'Plaris:; � �,�= . v: � . ' . .
<br /> ""PROPERTY SURVEY required for_aII.NEW constructlon.
<br /> Dlrectlons: _ - �5 . -
<br /> Ffll out a�plication completely. .
<br /> Owner&Contractar slgn back of appllcaUon,notarized ,
<br /> If over a2500,a Notice of Commencement ls required.� (AIC.upgrades over 3T500) ,
<br /> .. � ,..t,..a s-:-,.
<br /> Agent(for the contractor)`or Poinrer'of'Attomey(for tfie owner)would�be someone wlth notarized letter from owner authorizing same
<br /> �VER•THE COUNTER P..ERMITTING: w- �(F[ont of Application Only)-
<br /> Reroofs If shingles Sewers „Servlce Upgrades A/C '�� Fences'(Plot/Survey/Footage)
<br /> ,-- ._. �w: , - - ` � . - _ _
<br /> ,:.' .,,I' , �
<br /> Drlvewa -Not over Counter if an publlc roadway`s.:needs`.ROW ��1; ,
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