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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ; Building Departrnent
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<br /> Date Receivid �1' �- �i � ("t �Z •
<br /> y �- - Phone�Contact•for+Pernilttin
<br /> Owner's Name ,1 C(, Owner Phone Number
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<br /> Owner's Address Ze {"� Owner Pfione Number
<br /> I�� - � � '
<br /> Fse Simple�Itleholder Name � - Owner Phone Number �
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<br /> Fee Stmple Titlehotder Addrass °
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<br /> JOB ADDRESS LOT# �
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<br /> SUBDIVISIO�N PARCEL ID# � � " Z lt� ' 2 — ����� 197Dv - al2d
<br /> � , (OBTAINED F,ROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � NEW CONSTR ADD/ALT Q� SIGN -0 , Q DEMOLISH
<br /> '� �-8. INSTALL 8 �.,REPAIR � -
<br /> PROPOSED�USE Q SFR. Q COMM 'Q -OTHER ' �
<br /> TYPE OF C�NSTRUCTION Q � BLOCK ' Q FRAME � [,� STEEL Q
<br /> DESCRIPTION OF WORK C Gi.r �� � l DI,J 3� l ��I l,� CLC''` i`�i],� 5�a vtq` �j�!`�jql�
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<br /> �UILDING SIZE � � SQ FOOTAGE� - _ HEI,GHT .
<br /> QBUILDING $ VALUATION�OF TOTAL CONSTRUCTION �
<br /> QEL�CTRIGAL , $ " AMP SERVICE
<br /> � Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ � �
<br /> M �C ' 'v ��
<br /> Q E HANICAL $ V/1CUATION OF MECHANICAL INSTALLATION � �'
<br /> � 5�s5� ,�� � �
<br /> QG14S Q ROOFING ;Q SPECIALTY �._ OTHER�
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<br /> FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA QY�S NO
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<br /> BUILDER COMPi4NY�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N ,
<br /> Addre�a Cicense# �
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<br /> ELECTRICIAN: . COMPANY � � �
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURRE►�' �Y/N
<br /> Address , , , License#. � `
<br /> PLUMBER " `COMP.,,ANY � � -
<br /> SIGNATURE _ ; �REGI&TERED Y./ N,. .''-FEE CURRE�- ' ' Y.�/N °
<br /> Addre� License,# , �
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<br /> MECHANICAI: , C.OMPANY
<br /> SIGNATURE " � REGISTERED Y.,/ N , ._, FEE CURREA Y/rN ,
<br /> Address�'' _ � �� ' License#
<br /> OTHER (:- _ , . ' ' � ��C� , �
<br /> � ,COM,PANY ' _ �D �✓t C.d yj j J' ,`O v�
<br /> SIGNATURE, '." ' - - '' � � � " -REGISTEREO ` ' Y/ N.. FE R�n Y/N
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<br /> Address� �f~; �., .d ��,: 0. t� � � � License#' CC
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<br /> RESIDENTIAL:., ;-Attacfi'(2),;Plo.f Plans;;,(2-)§ets;of Building�Plans;`(1)`set of-Energy�Fo"rms;'�R-O=W Permif for new constructton, "
<br /> � •�: Minimum;tenr(:1,0)�worktng}days;after:`submitital-date._:Requiredonsite;�:ConstrticBon�Pl�ans;Stortnwater'Plansw/SfltFence�installed
<br /> ���� �SanitaryFaGUUes,&;1,;dumpster,,Slte�Work;Perinitforsubdivislons�arge;pro)ects.-N.." °- _-- '�� '� — — '
<br /> COMMERCI�L Attach(3)�oomplefe sets"of Builtlfng Plans plus alife Sefety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> ; Minfmum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> i Sanitary FaciliUes&1 dumpster.Site Work Pertnit for all new:projects.All commerGal requlrements.,must meet compllance �
<br /> . SIGN PERMI� AttacFi(2)"sets of Engineer.ed:Plans.;:�, ° � . .. � .:- �
<br /> ;i ""PROPERTY SURVEY required_for all NEW construcUon._
<br /> Dlrectlon�: - .. .,. �
<br /> F(Il out applicaUon wmpletely.
<br /> Owner&;�Contractor sign back of appl(catlon,notarized
<br /> If over�2500,a Notice of Commencement is requlred. (AIC upgrades over E7500) _ �
<br /> " Agent(for the contrector)or Powe�of Attomey(for the owner)would be someone uvith notarized letter from owner authorizing same
<br /> DVERTHECOUNTER.PERMITTING-- --(Frontof-ApplicaUonOnly)— "
<br /> Reroofs if shingies Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drivewaya-Not over Counter if on public roadways..needs ROW �
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