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813-7so-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � Building Department
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<br /> Date Received � /�� �� � Phone Contact for Permittin r
<br /> Owrner's Idame �Q r�a( �[- t, Owner Phone Number , � � � ���� I
<br /> Owner's Address ��7s i�/' / L,, Owner Phone Idumber I
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<br /> Fee Simple Yitleholder Name Owner Phone Idumber
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<br /> Fee Simple Tigleholder Address
<br /> JOB�4DDRESS 7��5 r� o/T /�-4� LOT# �
<br /> sua�ivisio�, � PARCEL ID# � 3- ZCo• 2 / - (�p - OD Do-C7�yb
<br /> (OBTAINED FROAA PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEw CONSTR ADD LT �] SIGN � Q DEMOLISH
<br /> ; � INSTALL � PAIR
<br /> PROPOSED USE 0 SFR Q COMM 0 OTHER
<br /> 'rl'PE'OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q / ' vi,.i
<br /> DESCRIPTIORI"OF WORK �G�CeQ/V '�d O/��
<br /> �UICDING SIZE l�O N S� SQ FOOTAGE S7 ,FIEIGHT ID �
<br /> QBUILDING $ �� C� � VALUATION'OFTOTALCONSI'RUCTION
<br /> o� 7
<br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ ���L�nfY�.c� ✓
<br /> I � � �V D G. �/
<br /> QMEi HANICAL $ VALUATION OF MECHANICAL INSTALLATION j�C�,�_ �
<br /> OGAi Q ROOFING Q SPECIALTY 0 OTHER ���"W��G S � ;
<br /> /C�� r/
<br /> FIiVISHED.FLOOR ELEVATIOIVS FLOOD ZONE AREA �YES NO �
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<br /> �UILDER I '. O k� �v� COIN,PAPJY i!� . L.L C.►.
<br /> SIGPli4TUi2E G`"�� `�`'�`
<br /> REGISTERED Y/ N FEE CURRE� /N
<br /> Addres I 7zU � CTti�� ��� '` ��yZ License# (r z� T
<br /> ELECTRICIAFf � �d ��F,CORfiPARJY � � ( � ��J � �C
<br /> SIGfVATURE ���?'�-� " REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � � e�,,d'- r License# �d a Z.'�J'_�Q
<br /> PLUM�ER, COMP�4P1Y
<br /> SICsN�TURE �REGISTERED Y�/ N FEE CURRE� � Y/N
<br /> Address License#
<br /> MECH,APIICAL COMP�►IdY
<br /> SIGPIATURE� REGISTERED Y J N F.EE CURRE� Y/N
<br /> �idiires� - � License#
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<br /> O'THER� � � , COAAPANY
<br /> SIGWA7iURE�'; REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address. _ •- � License#
<br /> _ RESIDEPlTIAL ' Attacfi.(2);Plot°Plans;>(2)sefs of 6uilding=Plans;(1)�set ofEnergy Fo�ms;R-O-W Permit,fot new.construction,
<br /> , -, , �r•>Minimum ten�.(;10)working,days afte�:§u6mittai-date. 'Required'onsite;�Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary;Facilities.&;lvdumpster,Site;Work Permit for.subdivlsions/large:projects �
<br /> CORNNiERCI,�L Attach`(2)cortiplete sets of Builiiing�Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Pians w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit fo��all new projects.All commercial requirements must meet compliance
<br /> SIGN PERMPT Attach+(2)�sets of,Engineer�d Rlans. ;
<br /> "'",PROPERTY SURVEY required for_all NEW construction.
<br /> Direc4ions: .. ,. -. , ,
<br /> Fill:out application completely. '
<br /> Ovimer&Contractor sign back of application,notarized
<br /> If over$2500,a Idotice of Commencement is requireo1. (A/C upgrades over$7500)
<br /> °* Agent.(forth�eeoF1'tFaotoF)•or-�Rower:of AEtorRey�(for;tfieorivner)would be someone with notarized letter from owner authorizing same
<br /> 7HE COU�Trihr,S��a'��tyr,.,T••�ii rra:Y 'x=�'0`+: � � ... _._.. . _..,....-..__... ..». ...._.._.«._ e
<br /> OVER: ER PERMIT'PIPIC . (copy-.gf;'codt��ct-�equired) � "+ � � � - ��'�..
<br /> Reroofs f #�%�*nr�ewers`-''�f'"S$"hiic'e'lf ' � ,.,, ,. ,v a .. � .: ��-, , � }
<br /> i shingle� pgrad�s.,i4/O Fences(PlobSurvey/Footage) _ r=. . _i
<br /> I i S�7:Sk r,^: :.w9 A�aazt+£,r; .n�,�-�,� t �;�, , .. , , ��, r�r:i,, , i_:
<br /> Drlveweys-Not�over�Co�nte`1f�n�putYlic roadways needs ROW � � . .,, .�� � '-3''�' � � • .''�,` 'i
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