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<br /> s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021 ,
<br /> i • Building Department i
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<br /> Date Receivod '
<br /> ,i Phone Contact for Permitting � — !
<br /> Owner's Name Jo h�..1 ;f Owner Phone Number ,
<br /> Owner's Address � � � 3 l_- rG S S ,..�t Owner Phone Number
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<br /> Fee Simple itleholder Name Owner Phone Number
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<br /> Fee Simple Yitleholder Address
<br /> JOB ADDRESS 1 ,3 C r��S Sfi � � y Li• I S i� I LOT# �
<br /> susoivisio PARCEL ID# l 2-Z fv- Z I - D Z- �� -o//o �J� 6�73�
<br /> I WORK PROPOSED NEw CONSTR ADD/ALT � SIGN NED FR�OM PROPERTYT�rice)DEMOLISH
<br /> e INSTALL� e REPAIR
<br /> PROPOSEDIUSE Q SFR Q COMM 0 OTHER
<br />��'I TYPE'OF CONSTRUCTION Q BLOCK • Q FRAME � STEEL Q
<br /> DESCRIPTIOM OF WORK ��'`�a C' �
<br /> BUILDING S ZE SQ FOOTAGE ,� o� � HEIGHT
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<br /> �BUIILDING $ /� �����J� VALUATION OF TOTAL CONSTRUCTION
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<br /> QEL CTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. �
<br /> OPL�MBING $
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<br /> QM CHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �(,� t2
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<br /> OGAS ' ROOFING Q SPECIALTY. O OTHER �
<br /> FINISHED F IOOR ELEVATIONS FLOOD ZONE AREA �YES NO
<br /> BUILDER COMPANY -
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N ,
<br />' Addres License#
<br /> ELECTRICI_ COMPANY
<br /> SIGNATURE - REGISTERED Y/ N FEE CURRE� Y/N .
<br /> , Addresa Cicense# � �
<br /> PLUMBER. COMPANY �
<br /> I SIGNATURE REGISTERED Y/ N ' FEE CURRE� ' Y/N '
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<br /> , Addres� Licen'se#_ -
<br /> MECHi4NICA� ` , - ,. COMPANY
<br /> SIGNATURE � REGISTERED - Y L N FEE CURRE� 'Y/N
<br /> Address ' ' ' _ Licens.e.#:
<br /> O'iHER`^ �..• , /%�✓��,� COMPANY ,�Go �f- f�4 c �w 6i.. I�u�r�- �L�-c
<br /> SIGNATURE . ,:= � �G> REGISTERED ,�Y/N. . �FEE CURREk ,, Y./N
<br /> � Addres .3��, � � S)?,.•S,2,,.,f�� l�h.�a�..�o. .F( 3> . . . . • License# C' C�[7 S 7���
<br /> � RESIDENTIAIL', Attach:.(2)`Plot-Flans;'(2)`sets of-Buil'ding=Plans;(1�)'set of'Energy;Forms;R=0-VV Perrriit,for new.construction,
<br /> 1 �� . �Minimum;,ten.(•10)working'days after'submittal°date. Requir`ed onsite;'Constnlction Plans,Stor'mwater Plans w/Silt Fence installed,
<br /> �.� Sanita,ry.Facilities.&:1�<dumpster;Site Work Permit for�§ubdivisions/large projects � -
<br /> :;COMMERCI� Attach.(2)complete sets'of Building P_lans plus a Life.Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcdon.. _ _ _.
<br /> i Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> ' ' Sanitary Facilities&1,dumpster,Site Work Permit fo�all new projects.All commercial requirements must meet compliance
<br /> ~ ,SIGN PERMI II Attach"�(2)`sets of;Engineered Plans.�� "
<br /> """"RROPER'fY SURVEY,requiced for aII.NEW.construction.
<br /> Directions: ,4,.;__ - ,
<br /> Fiil.out alpplication completely.
<br /> `Owner&IlContractor sign.backof application,notarized
<br /> If over$2500;a Notice of Commencement is required. (AIC upgrades over$7500)
<br /> , "' Agent(fii�tfi'e co`nt�actor)�or-Power of Attomey(for the ovuner)would be someone with notarized letter from owner authoNzing same
<br /> - OVER THE COUNTER:PERMITTING (copy of cantract required) �
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<br /> Reroofs if shin,gles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drivewal�ys-Not over Counter if on public roadways..needs ROW
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