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81�780-002� City of Zephyrhills Permit Application Fax 813-780-0021
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<br /> . Building Department
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<br /> Date Recelved � Phone�Contact forPerm(ttln �/�1 %��- – �d/�
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<br /> Owner's Pla i e @�""' � d� //.C/U� � ner hone Number O��' � = � ��Q
<br /> Owner's Address /��� /'e/l�� f"1�� •Owner Phone.Number •
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<br /> Fee Simple TI tleholder Name Owner Phone Number
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<br /> Fee Stmple Tltlehold�r,.Addres� _ �
<br /> JOBADDRE�S �75�� �Qy'e/�}f�. �UL LOT# �
<br /> SUBDIVISION ��N 3� (�j"��d7� . PARCEL�ID# J �� o�1� �d�� �dD�O !���
<br /> , (08TAINED.FR�OM PROPERTYT�rcE)DEMOLISH �
<br /> WORK PROiOSED , -;NEW CONSTR � ' ADD/ALT Q� SIGN
<br /> B; INSTALL B �REPAIR ��
<br /> PROPOSED�USE Q SFR Q COMM 'Q OTHER
<br /> TYPE OF CO STRUCTION � Q BLOCK " Q FRAME [� 'STEEL Q _
<br /> DESCRIPTIO�OF WORK' -� �Si �� �/�/9`/� L'"�}d�� J� ��-7l� l�/1�L��}"�'"'
<br /> BUILDING SIZE ' � SQ FOOTAGE � � HEIGH ��..
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<br />', OBUILDING $ VALUATION�O`F'TOTAL"CONSTRUCTION
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<br /> QELECTRICAL . $ ." AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br />, QPI:UMBING � ' ' �
<br /> OMECHANICAL ' $ rf VACUATIqN OF'MECHANICAL INSTALWTION
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<br /> QGAS Q �ROOFING .Q SPECIALl'Y .Q OTHER -
<br /> FINISHED FLIOOR ELEVATIONS FLOOD ZONE AREA QYES NO �
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<br /> BUILDER I , �
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<br /> SIGNAYURE � REGISTERED Y/ N FE6 Cl1RRE� -
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<br /> Address� • � Ucense# '
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<br /> ELECTRICIA�N; ' =C'OMPAWY' �
<br /> SIGNATURE f � REGISTERED Y/ N FEE CURRE�; 'Y/•N
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<br />' Address� ` " � �_ License.# �
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<br /> PLUMBER ' I COMPANY - �
<br /> SIGNATURE`I� � �� ,._REGISTERED- Y/:'N., '. FEE CURRE�' , Y./N. -
<br /> Addres� ' License.# •
<br /> MECHANICAL ~
<br /> SIGNATURE � - ' ,li�l��G���7����h– �; . COMPANY �� S D .�II1�e �`J * �L�
<br />� I REGI$TERED Y./ N . FEE CURRE� Y/�N
<br /> �I>'' '[�.'r7�I ���1� /� � �=/��LCS �.L ' ,License# L�/�GD� 3� '��.
<br /> Addres�'�' :s.' f
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<br /> i OTHER '� . , . - ` ' 'COMPANY � � ' ,
<br /> SIGNATURE' -�- � � -� •• � ` '' "REGISTERED�� ' Y/ N,... �'FEE CURRE� Y L N
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<br /> Address�� _ ��• � -j . - L'lceiise#
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<br /> RESIDENTIAL��� •Attach"(2);P>lof P,lans;;;(2)setsiof;Bullding Plans;(1)sef of-Enercjy�Fortns';'�R�O=W'Perinit for new constfuction, �
<br /> - �;����_.r_Minimumyten,.(1A)�wo,rl4tng;days;after,�subrtilftal date.�•Requlred on§ite„ConstiuoBon:Pl�ens;StorrnwateYPlans w/S(It Fence installed,
<br /> S__ry Facfltti�es=&,1.,dumpsterTSite�.W.ork;.P..ermit for subdivislonsAarge_p_r,oJects___�;a,_ " ,_ _ '
<br /> _ p� antta ' :_ ;, : �
<br /> COMAAERCI�L Attach(3)`aomplete seCs�of Building Plans;plus a Life Safety Page;(1)set of Energy�orms.R=O-VY-Permit for new construction.— ��
<br /> Mintmum ten(10)working days after submittal date. Required onsite,ConstrucNon Plans,Stormwater Plans w/SEIt Fence installed,
<br /> � Sanitary FaciliBes&1 dumpster.Site Work Permlt for all new:projects:,All commercial resaulremen4s,must meet compliance' •
<br /> , SIGN PERMI I AttacFi'(2)'sets ofEngineered;Plans:: ���� .. x �. �� � ` �
<br /> i ""PROPERTY SURVEY reguired for all NEW c�nsWction. , . ._ � •
<br /> Dlrectlons: I� �.-��°_;-•�: � -'
<br /> Ffll aut application wmpletely.
<br /> Owner&��Contractor sign back of applicatlon,notarized
<br /> If over S;t500,a Notice of Commencerr�ent i�required. (A/C upgrades over 57500) ,
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<br /> Agent(fo�the contracto�)`or Pow,eP,�,af',Atto�a„��Qc;t�ie;o�};vKould°be someone with notarize letter from owner authorizing same
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<br /> DVERTHECAUNTER.P��tMITY1NG�y'"'-%•(FrontofiAp�plication:Qnly) �'� s;:lkir,A,tt�;� .a .�,d.;'!2 ����o•.,,
<br /> Reroofsifshingies Seinrers�� �����Service�Upgrade� A/ ��;ti' Fenc�s PIoUSurve /Foota e) �, �^'�;="°�'• �
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