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813-780-0020 City of Zephyrhills Permit Application Fax-813-7$0-0021
<br /> • Building Department
<br /> Date Receive ' ��_ 2 Z— �0 1 6 phane Contact for Permitting G�3 �J G �
<br /> Owner's Nam , � � �31/�, '��. Owner Phone Number �� 3�( ^ ���
<br /> Owner's Addr ss .5�� I ' QGY !� GC�c�.� 0� L.�l<<CS 4wner Phone Number � �
<br /> Fee Simple Ti leholder Name Qwner Phone Number � �
<br /> Fee Simple Ti leholder Address
<br /> JOB ADDRES 3 83o'Z-S 5`�� i�J� y�;Jl �t. 3? �. LOT# ��
<br /> SUBDtVtS10N PARCEL ID#
<br /> , (OBTAINED FROM PROPERTY 7AX NOTICE)
<br /> WORK PROP SED e N TALLSTR 8 �PAIR � SIGN Q Q DEMOCCSH
<br /> PROP.QSED. SE Q SFR Q COMM � OTHER
<br /> TYPE OF CO STRUCTION Q BLOCK • Q FRAME L� STEEL Q
<br /> DEBCRIPTtO OF WORK �Q �a�-f.- �0 S�►-�vt- tlL� •
<br /> BUI�DlN�St E �_ SQ FOOTAGE C�.� HEIGHT ��
<br /> QBUI DING � Jr f jJ�. VALUATION'OF TOTAL Gt�NSTRUCTtON
<br /> QEI. CTF2ICAL �a`—� AMP SERVECE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> QPI. MBING $ �
<br /> �,._„_—�
<br /> QME HANIGAL $ VALUATION OF MECHANtCAL INSTALEATION ��
<br /> QGA � . ROOFING ��
<br /> Q SPEGIALTY �� QTHER
<br /> FINISHED FL OR ELEVATIONS � � FLOOD ZONE AREA QYES NO
<br /> SUI�DER COMFAhtY �'�3i�`'. �C�.. ��r ,t�, +IUG 6 ��tJl✓'
<br /> SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �- �
<br /> E�ECTRICI CGIMPANY
<br /> SIGNATURE REGISTERED Y/ N � FEE CURRE� Y/N
<br /> ', Address Cicense# �— � ' ��
<br /> P�UNISER COMPAi�lY
<br /> SIGNATURE ftEGISTERED Y�/`N FEE CURRE� ` Y/N
<br /> , Address " License# � �
<br /> � MECHl4NIC , COMPANY
<br /> SIGNATURB � REGISTEREd ,; Y/.N FEE CURRE� Y/N
<br /> Add�ess ' ' ' � ,. Licens,e#..�i �
<br /> OTHE[2 "" CC1MFAt�1Y
<br /> SIGNATURE� '. , REGISTERED ,•YJ.N.. FEE CURREk Y./N
<br /> Address � •� .. • •- License# �` �
<br /> .' RESEDENTI y Attach.(2)'_Plot Plans;'"(2).se#sof BuildEng-Plans;(9)`set'of�Ertergy'Foims;R-O-W Pemii#far new.consh'qction,
<br /> . , .Minimum.ten,(10)working:8ays aftec°subrriittal=date. Required�onsite;Constriietion Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanita,ry;Facilities.&�.1��.dumpster Site.Work Permit for subdivisionsflarge projects �
<br /> GOMMERCIi4 Attach`{2}''corriptete se#s of BuEliiing�Pians ptus a l.ife Safety Page;{1)se#of Energy Farms.R-O-W Permit for new constructian.
<br /> Minimum ten(10)working days after submittal date. Required ansite,Construction Plans,Stormwater Plans w%Silt Fence installed,
<br /> Senitary Facilities&1 dumpster,Site Work Permit for ail new projects.Ait commercial requirements must meet comptlance
<br /> ' SIGN"PER�AIT At#aeh{2}se#s of-E�gineered Plans:'°
<br /> � """PROPERTY$URVEY required for aII.NEW construction. �
<br /> � U1C8G��OFIS: r.. - .
<br /> Fill out a plication completely.
<br /> Owner& ntractor sign,back af application,notarized
<br /> if over$�500,a Notice of Commencement is required. (NG upgrades over$7500)
<br /> "'. pgent(fb 'th'e contractor)�or Power of Attomey(for the owner)wauld be someone with notarized letter from owner authorizing same_
<br /> OVER THE C,�.EINTER'P.ERMIiTiNG �{copy of contract required}
<br /> Reroofs if shin les Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drivewa s-Not aver Counter if bn'�pubiic`�oad'`w'ay"s`:neei�stRONV � ����"� � ��.�,-..,V=<..��;.,,.v;�.,,�r,„�:...�,rw r=.._
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