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- 813I�so-oo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � Building Department
<br /> Date Received
<br /> I • ' ' Phone Contact for Permitting " �13 � - �.��
<br /> Owner's Nartie �/v �s,4 ��� Owner Phone Number , d��3� ' P�
<br /> Owner's.Ad�ress �P (. O 1� 1,:�^ Owrner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address �
<br /> JOB�4DDRESS �p ,3 v d LOT# �
<br /> SUBDIVISIO t)l ti/Pi-i �� PARCEL ID# Q -' cP"�/"(�d(pU'' dO�D(� ^'OOo��
<br /> � (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PRO OSED _ NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> e INSTALL 8 REPAIR
<br /> PROP.OSED SE _ Q SFR Q COMM' 0 OTRER
<br /> TYPE'OF COtdSTRUCTIOId Q BLOCK - Q FRAME 0 . STEEL Q .
<br /> - �
<br /> DESCI2IPTI N OF WORK .Z,t/3,Lr+i � l � J S�' 7.6��-, 3"r/�� �a?�'_o� � �,` '�, 51•a b
<br /> BUILDING'S ZE � � PY!�r SQ FOOTAGE I�P�?� .HEIGHT �I� -Iv �J(���0 S�c2-S
<br /> ILDING $ �r���, VALUATION�OF"TOTAL CONSi'RUCTION
<br /> d -
<br /> QEL Cl'RICAL , $ AMP SERVICE 'Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPL MBING $ � .��� �� �
<br /> _ v � � y��- ��.5
<br /> QM�CHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �
<br /> _ . � v�✓
<br /> QG,S Q ROOFING Q SPECIALTY Q OTHER �r""""
<br /> 3 i�
<br /> FINISHED F OOR ELEVATIONS FLOOD ZONE AREA QYES NO ��
<br /> BUILDER �D � COMPANY � /�rif/- �X�2�+ ,6 �G.-
<br /> SIGfdATURE �� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres � �� C��FR.!} (�, _ z� R�:IIr ��. 3 3S"�U License# ��^ l3((`�q /
<br /> , EL�Ci'RICI COMPA,IVY
<br /> _SIGM/ATURE '� REGISTERED Y/ PV FEE CURRE� Y/N
<br /> Addres L'icense.# `
<br /> PCUAABER:' COMPAPIY'
<br /> �SIGNATURE -REGISTERED `Y/ N. �FEE GURRE� Y/N
<br /> , Addres Llcense#'
<br /> MECHANIC COMPANY
<br /> SIGidATURE REGISTERED Y/.N F.EE CURRE� Y/N
<br /> Atld�es � - � License# —�
<br /> ,..;t��a, ..
<br /> _ OTHER« :-;�, .- COM1APANY '
<br /> 'SIGNA'T;URE";,- • , %- � REGISTERED Y/.N FEE CURRE� Y/N
<br /> ` '��:>-. �
<br /> Addres , • .•- '� - � ' ' License#
<br /> `.`RESIDENTI I ,.;' 'Attach:(2)"PIot�P_lans;(2):sets offBuildirig=Plans;�(1•)set of�Energy,Foims;�R=.O-W P.ermit for new.construction,
<br /> , -�ti;+��._;•,.Y� ;iNinimum�:ten;_(;1U)working;days after:`submittal�date. Requir'ed onsite;�Con`struction Plan"s,Stormwater Plans w/Silt Fence installed,
<br /> S'anitary;Facilities:&,.1,�dumpste,r:,Sife„W,ork�Permit for:subdivisions/large:projects_� " '
<br /> _. COMMERCI Attach`(2)�complefe'sets of'Builtling Plens plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permlt for new construction.
<br /> . Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles 8 1 dumpster,Site Work Permit fo�all new projects.All commercial requirements must meet compliance
<br /> ��SIGN'PERAAIT AttacFi�(2)sets�of:Engineer�dPlans.`'< < . � �
<br /> - - "'**FROPERTY SURVEY required for_aII.NEW construction.
<br /> � Directions: �.. . . � . _ .
<br /> � Ftll>out a plication completely.
<br /> Owner GonVactor sign back of application,notarized
<br /> If over$�500,a Notice of Commencement is required. (A/C upgrad�s over$7500)
<br /> '� Agent(fqr the�cont'ractor)�or Power of Pittomey(for tlie oiivner)would be someone with notarized letter from owner authorizing same
<br /> �...�OVER THE.C�OUNTER.PERMI'RItVG:=:.:.:�(capy,of�contract�:requireii), � '"i; �
<br /> � Reroofs if shii�gles Sewers � Seniice'Upgrad'es�`A%C Fences(PIoUSurvey/Footage)
<br /> ._�..._,... ._._._ ...�.... � �. .� i _ - U. .
<br /> Drlvew ys-Not over Counter if on public roadways..needs ROW� •
<br /> �� ::- �. .� � . ,,.� '._.,�r.- .�.--. .._, �
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