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813 so-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> I Building Deparfinent
<br /> Dat�Receive �
<br /> � - P.hone{ContacE,for:Perrrilttin � !3/3 - �6.5� _ �7 Z �5�
<br /> Owner's Na e %/��!� ��l%� Owner Phone Number ����7�0— /'ro ✓�
<br /> Owner's Add eas �a �� � ��s-f f� Owner Phone"Number �
<br /> Fee Simple T tleholder Name ��G�� °���� Owner Phone Number
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<br /> Fe�Simple T tleholder Address �'P��� /��7 2 �D��� �- °/'� ¢ �G 33(Z�
<br /> �� �JOB ADDRE S J �� � �� LOT#
<br /> SUBDIVISIO � PARCEL ID#
<br /> , , . (OBTAINED FROM PROPERTX TAX NOTICE)
<br /> WORK PROP SED w NEW CONSTR ADD/ALT Q` SIGN Q Q DEMOLISH
<br /> � B. INSTALL B > .REPAIR � '
<br /> PROPOSED. SE Q SFR [� �COMM Q �OTHER
<br /> TYPE OF CO STRUCTION' - Qe` � BLOCK " `Q FRAME � STEEC Q
<br /> DESCRIPTIO OF WORK � ��v,� �/�i���e p v�
<br /> �UILDING'SI E ' � SQ FOOTAGE�, , :HEIGHT . _. ,
<br />� OBU LDING $ VALUATION�`O��TOTAL CONSTRUCTION
<br /> QEL CTRICAL „ $ " AMP SERVICE. Q PROGRESS ENERGY Q W.R.E.C.
<br /> � - - . , , - � -
<br /> QPL�MBING $
<br /> �ME HANICAL $ VACUATIqN OF;MECHANICAL INSTALLATION '� l�� � �
<br /> - �3 9oa.� . . . ,
<br /> QGA Q ROOFING Q SPECIAL:TY Q OTHER � -
<br /> FINISHED FL OR ELEVATIONS FLOOD ZONE AREA QY�S NO
<br /> BUILDER COMPANY' �
<br /> SIGNp►TURE REGISTERED Y/ fV 'PEE'CURRE� Y/N
<br /> Addre�s L'icense# � '
<br /> w ,. �,. - "
<br /> ELECTRICIANI.: � COMPANY� ' `
<br /> SIGNATURE ' REGISTERED Y/ N FEE'CURRE�� ' 1 Y/N
<br /> Addre�s � � , ,� , Ucense#. � '
<br /> PLUMBER C,OMP.ANY � ; - �
<br /> SIGNATURE` , ,REGISTERED Y./.N.: ., � =FEE CURREN Y/N '
<br /> Address � .License„# ' ,
<br /> MECHANIC' � ' `. ` � COMPANY. :!'1%'���/ �O?"�'�
<br /> SIGNATURE• - � � � REGISTERED , Y,/ N � FEE CURRE�- Y/�N
<br /> _ :" ' ef. . — �
<br /> Addres's�. . , , ;. _ �. , , - . - ,. , .. , �
<br /> License#�
<br /> OTHER �'` , , � , ` ';COMPANY. ,
<br /> SIGNATURE-. T,- �i� - " -`�R � � • ' ` U `REGISTERED � Y/ fV.._, � FEE CURRE�• Y/N .
<br /> Addr�ss _ ,t _� a;�k,: . � , " L'icense#�
<br /> RESIDENTI, �� Attacti"(2)„PIo.FPIaFis;,(2)'seEsiof:Building`Plans;(1)set of�Eneigy Fortns;'R-O=W'Perir%lt for new oo,n§truction,
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<br /> � �,.,;.)=....�4,.9:.. Y,g.. _ .. � . . , -. _,..-. ,=...:�- .. . ,. , �
<br /> � :-:Minimumaten� 1,0 wo tn da aRer,;submiftal"date�•R"ulred onsite,:'Construcdon Plans;�StormwateYPlans wI Silt Fence installed,
<br /> _ ,,..:,....� ..
<br /> f��SanitaryFacfllUes;&Rtl;ydumpster;Sit@°Worlc�Permitforsubdiyislons/la�ge'pro)ects;;y^_�:;' ' -' ' � - '
<br /> COMMERCI AttecFi(3)complete sets'of Buitding'Pians plus a Life S'afety Page;(1)set of Energy Fortns.R-O-W Permit for new construction.-
<br /> Minimum ten(10)working days after submltNal date. R�qutrad onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides 8 1 dumpster.Site Work Permit for all new;projects.All commercial requlrements,must meet compliance '
<br /> SIGN PERMI Attaoh'(2)'sets of"Englneeied;Plans.; ;�t:�.:��-• ... ;.. • .� . ` ' `` � ' - -
<br /> ""PROPERTY SUR1/EY requirerJ for,all_NEW ponsWctlon.:. -
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<br /> Dlrectlons: I ..- ._ . .. .
<br /> Fill out ar�plicatlon completely. +�
<br /> Owner&Contractar sign back of applfcaHon,notarized
<br /> If over S 500,a Notice.of Commencement la requlred. (AIC upgrades over�,7500) . :
<br /> .. � .�,,:•;;F�,.
<br /> Agent(fo tFie�contractoc)"or Powe�:of;Attomey(for'tFie�owne�)'would`be someone with�notarized letter from owner authorizing same
<br /> DV�R:THE C UNTER:P-,ERMITTING --,.(Front�of-AppllcatiomOnly)-���� �
<br /> Reroofs if shingles Sewers � Service;Upgradas A/C�, ^ Fences(Plot/Survey/Footage) _
<br /> Driv�wa I -Not over Counter if on public roadways needs ROW� = LJ•� �'
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