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813:aao-ooz� City of Zephyrhills Permit Application Fax 813-TSO-0021 �
<br /> . Building Departrnent �
<br /> Date Recelv��tl .%� Phone�Contact�for Permtttin � — 3 �
<br /> Owner's Nar�e J 6/1� 1� W�R�1 EA� Owner Phone Number g�3'7$�'3 3a�
<br /> Owner's Add���� � I�3 2� � ��e Z �(,,'G ��3' y2 Owner Phone.Number
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<br /> Fee Simple TItleHolder Name ' � Owner Phone Number
<br /> i 1 .
<br /> Fee Simple Titleholder Addres� °
<br /> JOB ADDRE S �� � !?+!G �e .��,,�l� F�L 3 3 s�z. �oT# �
<br /> SUBDIVISIO PARCEL ID# 13 �Z� ' `z�-- �(�DO-Q(�l�O— �0! 1 "
<br /> - , - , (OBTNNED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED ,= NEW CONSTR ADD/ALT Q SIGN Q 'Q DEMOLISH
<br /> �B, INSTALL 8 - REPAIR � .
<br /> PROPOSED>USE � Q SFR [� 'COMM Q �OTHER "-
<br /> TYPE OF CO STRUCTION - Q� BLOCK " Q FRAME Q `STEEL Q _
<br /> DESCRIPTIO OF WORK' I 2Mb V� elG;f�;N M�T�n:a� �- e /�}c� �J tTp� n�'G IS
<br /> BUILDING SIZE ��� _x �: ,7, I SQ�FOOTAGE � S�a , . ;HEIGHT� �Z � �
<br /> QBU��LDING $ VALUATIONhOF-TOTAL CONSTRUCTION ^
<br /> 1 1� ��'�. �a.
<br /> QELECTRIGAL $ " AMP SERVICE - Q 'PROGRESS ENERGY [� W.R.E.C.
<br /> QPLUMBING ' $ -- ' f�f /,.�� Z 2 �
<br /> �� � ✓ � / ��
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<br /> QMECHANICAL $ - VALUATION OF:MECHANICAL INSTALLATION ` r �� �C�
<br /> i � J
<br /> QGAS � ROOFING Q SPECIALTY Q OTHER�
<br /> FINISHED FLIOOR ELEVATIONS FLOOD ZONE AREA QYES ;NO I
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<br /> �UILDER � �� . '�Z� COMPi4NY' �K JO�it�S /�v��'f1 �"JfIE'�'/i"`P�I .�ylG
<br /> SIGNATUItE REGISTERED Y/ N FEE CURRE� Y'/N
<br /> Address 33/�� /�uS���s �� ��_/lSvi`/�C �I✓yY��'� Ctcense# GCC'/3� �G�2
<br /> ELECTRIC . . .. ' :COMPANY� ' ' - -
<br /> SIGNATURE "' REGISTERED Y/ N FEE�CURRE��"� � 'Y 6 N"
<br /> Addre�s � . , � . _ , License.# . • °
<br /> PLUMBER � . A COINPANY� .. � �
<br /> SIGNATURE' � ' ` � ; �_ReG�S�REo. Y./�-N ,FEECURRE�- ' Y:/N -• '
<br /> Address � License,# � ^
<br /> MECHANICAL „ . • . ' ° - COAAPANY ` ' ... '
<br /> SIGNATURE�I � � � '� REGISTERED Y.,/ N . _ FEE CURRE� Y/N
<br /> Addres�lP:::. - � _ , . . ,. ,n _ ' , '. - ' .
<br /> , License#
<br /> OTHER ` ' , � . , , `� - ';COIIA�PANY _ . - . � . . .
<br /> . �F �
<br /> SIGNATURE -}:��.�'��� ""�: �%'` "`r; ' . ' " '` REGISTEREO ' , 'Y/ N�._ . ' • FEE CURRE�• Y/N
<br /> Addr�ss�l . •�.h _ , � - �' , � ' Cicense#• '
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<br /> RESIDENTIAL�.� .-.Attacfi;(2).PIotiP;lans;:(2)setsiof'Bullding'�Plans;(1)set of.Energy Foiiqs;R=O=W Permltfor new construction, " " `
<br /> � �;�Minfmum:tenr(:1;0)wor141ng days,aRer submlEtal date`.Requlred onslte,•:Constructlon Plans;-Stormwat'er Plans w/Slk Fence lnstalled,
<br /> Santtary Faclllfle.s;&;:1:�,dumpster,,-Slte°Worfc�,P.>ermit foc subtlivislons/large p'roJects,_: �;;`..,':: ' ` �� • - `� �- I
<br /> :• �::.,.� ,.._, _
<br /> COMMERCIF►L Attach(3)complete sets'of Bullding``Plans'plus a Llfe Safetji�Page;(1)set of Energy Forms.R-O-W Permlt for neW construoUon.'
<br /> Minlmum ten(10)woiicing days zfter submtttal date. Required o�site,Constructlon Plans,Stormwater Plans w/Silt Fence Installed,
<br /> Sanitary Facllltles 81 dumpster.Site Work,Permlt for�II neiiu�projects.All commerclafrequlrements.must meet compllence � '
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<br /> , QIGN PERMI I Altach"(2)sets�ofEnglneer.edfiPlans:;.,•:".�;- ... , ; � = � - :
<br /> -• � •"'PROPERTY SURVEY regulred for all_NEW cons.truction... � ��� � ��� �
<br /> Dlrectlons: I� .. .. . _- - ` . .., ,
<br /> FIII out applica8on completely:
<br /> Owner&IContractor slgn back of appl(catlon,notarized � � - , �
<br /> If over 5�500,a Notice of Commencement ls required., (A/C upgrades over 57500) �
<br /> �1:. .y:.,y;...
<br /> " Agent(foil th�e contractor)'or Powe�of"Attorrmey�(fo�the owner)would be someone with notarized letter from owner authorizing same .
<br /> DVER THE COUNTER.P..ERMI'RING-� --,-(Front of-Appllcation Only)
<br /> Reroofs If shingles Sewers,.,a.�._6:.Senrice_Upgradas.A/C,_._�Fences(Plot/Survey/Footage)_ _ _ ,
<br /> ...�... __ ._..-.:k,;_;: ..�. ,_.;, �-
<br /> Drlvewa lya-Not over CounterJf an,public roadways:.needs�ROW s� � , , . „ ,
<br /> ti�!'; .,_. . ,�,. , i , r; ' ' i• � �', � -,. , , , I
<br /> , .;� . ;'3 ':f? , ,, li".. �. .. ,� � , , . _ �
<br /> I `,,' ,�.j ` .,ji`I(;P -V 1„ �1�� . � , ' � ` •',i' _.'....4 ;h�lil!�i:�. - __ _. � ' .� +-,_ -
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