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813a�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
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<br /> Date Recelveii � Phone.ContacE'for Permitttn g l � �8 z _ 5�C �
<br /> Owner's Name ��/S �i 1� !�� Owner Phone Number O l�" O�`'`g��• I
<br /> Owner's Address �7�� 7 ! �}GRGe I�OSe ��3 Owner Phone Number �
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<br /> Fea Slmple Tltleholder Name � ` Owner Phone Number '
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<br /> Fee Simple Titleholder Address � � , �
<br /> JOB ADDRE�S � � / �� /l�/� f'�P LLs� LOT# � ,
<br /> SUBDIVISION {/�A'�/V�(iT C�'!"d d 1J�e �- PARCEL ID# �� � o�` �oC`� D���I� vL� �
<br /> WORK PROPaOSED , � �New CONSrR ADD/ALT �" SIG�V NED FR�OM.PROPERTY,T�rice)DEMOLISH
<br /> e, INSTALL �� REPAIR � • .
<br /> PROPOSED�l1SE Q SFR Q 'COMM - 'Q °OTHER
<br /> TYPE OF CONSTRUCTION - Q� " BLOCK " Q FRAf1AE � L] �STEEC Q
<br /> DESCRIPTION OF WORK �4 � 9e E �L�CG N�e�S�'-�2 011j�` O� �oZ- ��
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<br /> BUILDING SIZE � " " � �' SQ FOOTAGE�. . , „HEIGHT �..J
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<br /> QBUILDING $ .,,. . �.� � ` :. ' I
<br /> � , _ VALUATION OF TOTAC CONSTRUCTION �
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<br /> QELECTRIGAL - $ , - AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. i
<br /> Q PL�MBING :$ ' - - � ' -
<br /> QMECHANICAL $ �/���, �� VALUATIQN OF'MECHANICAL INSTALI:ATION
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<br /> QGAS Q ROOFWG �Q SPECIALTY.�] OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ;NO _
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<br /> BUILDER COMPI4NY' '
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� ' Y/N-
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<br /> Addre�s Cicense# � ' ;
<br /> ELECTRICIAPI _ _ � '`COMPAWY ° �
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURREk �Y/N ,
<br /> Address " �� " . License# .
<br /> PLUMBER `.,_. . COMP,ANY- - i
<br /> SIGtdATURE � � � � ,REGIS.TERED , Y.I.N.. � , :FEE CURREP� ' Y�/fV. . . '
<br /> �►ddre�s� ' � . , � Licepse,# r
<br /> MECHANICAL �,,,,,��,, p � . C.O�YIPANY �J�J'I�/ZS �}-NGC� � ��/�
<br /> ,G+W//t�c: ;�'�Y��LE'�..�. ,r: _
<br /> SICaNATURE � - `i REGI§TERED , Y./ N . ,, ,:' FeE cuw�En YJ�N�
<br /> Address�=" _ •'•��5�'/ i�/�6� � ' ° � . License# �Cl>�c�9T� '
<br /> OTHER '" -� � ,. . � ` � � ';COMPANY_ . , , � . .
<br /> SIGNATURE I�''= •+ � �` � •� `'� ` ' � ' "REGISTERED� ' ` Y/ Nt.: ` FEe CUR�� . Y/N
<br /> Address I - .` , . - . . _ ,� .�' - - � License#� .
<br /> �.,,.��t. . . , .�;..,,. �.. ..: ,F,,. .
<br /> RESIDEWTI���: �;AttacFi'(2):PIo.t1Plans;;:(2)sets;of BuIlding:Plan's;`(�1)set of�Energy�Forins;�,R=O-W�Perrtilt for new aonstrticUon, � .
<br /> �, '�j^:p i.:.Minimumsten°(:1,0);working;days,aRer,rsubriiittal`datei:Requireil onsite,:Con§trucdon�Plans;Stortnwrate��Plans w%Stlt'Fence installed,
<br /> ';' -Sanitary'FaGlltles;&1��dumpster,SIte�Work,Pertnit for subdivislons/large'projects: :.,.;;-. ` `
<br /> CONIMERCII4L Attach(3)�eomplete sets of Building`Plaris plus a�Life Safe{y�Page;(1)set of Energyi Forms.R-O-W Permit for new construction.
<br /> - ; Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides&1 dumpster.Site Work Permit for all new�proJects:All commercial requlrements.must meet compliance , _. �
<br /> . StGN PERMI�' Attaoh'(2)'sets of-Engineered:Plans.;:-�.�,�� � � �. ' ' ' �
<br /> � ""PROPERTY SURVEY reguired for all NEW�construction. , ' - , •
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<br /> Dlrectlona: � `r�:5�ta.=. - - - `
<br /> Ftll out applicatlon completely.
<br /> Owner 8�Contractor sign back of applicatlon,notarized
<br /> If over;2500,a Notice of Commencement la required. (AIC upgrades over ST500) - �
<br /> �, �:,:,�..,
<br /> " Agent(fo'r the cohtractor)`or Powe�ofAttomey(fo�tiie'owiner would,�be someone virith notarized letter from owner authorizing same
<br /> I 1�"..�i.K,� -ya:varxu!n:tiS�c�ss�nni�et�s�s.sx•:.t'r:�c:R�..�,-�a.r ,- ,
<br /> DVER THE.COUNTER:PE�MIT'LING;��r;;�-:(Front c�f Application Only)-�•_ � �" ,�.,�;..��•h���-�� ���r' I
<br /> Reroofs if shingtes Sewe�s t .,, Service;.Upgrades A/G�;=��F.e�oes(PlodSurvey/Footage) �;.�y q� ,�,r;�;?;r�= �,:;r°��,,,
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<br /> Drivewaya-Not over G3`,ounter.If;on;public,roadways..needs:R•O,,Vtif:-� � '+��s�e,�;4,;, ,:,,,�;_, jn;,,.3� �'�;' -,,,�V ti.��,4 �
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