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<br /> 813-780.0U20 City of Zephyrhills Permit Application Fax-813-780-0021 ,
<br /> • • Building Departrnent
<br /> Date Received ' . ::= phone3Cont�cYfor�Permlttin •' ' �
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<br /> Owner's Name �`�Olti ��'Yl i Owrrer Phone Number � ��- f -�� �
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<br /> S5D . °. $ . ' , ,
<br /> Owner's Address � �Oweer Phone.Numb�r' ;
<br /> Fee Simple Tit eHolderName • � • Ov+rner Phone Number ,
<br /> Fee Simple TI�eholder Addresa � - I
<br /> JOB ADDRESS LOT# � ,
<br /> SUBDIVISIOPI� • PARCEL ID# : � I
<br /> • (OBTAINED FROM PROPERTY,TAX NOTICE) � '
<br /> WORK PROP ISED .�:;NEW CONSTR' . ADD/ALT Q� SIGN' 'Q �- Q DEMOLISH j I
<br /> ,... �:,e� INSTALL � .r: REPAIR
<br /> PROPOSED=U$E _ . -• :Q SFR� �] COMM . �OTHER'" �
<br /> - �
<br /> TYPE OF CONI TRUCTION''<� Q" x•�BLOCK � � FRAAAE ° :Q STEEL' "Q ,
<br /> : :�.. ,�.� /
<br /> DE3CRIPTIO 'OF WORK' l�`f � �/x'e� .� C�O-� ,.r� �
<br /> BUI 1 � • ' - .
<br /> LD NG':SIZ�� . � �'SQ FOOTAGE.�, HEIGHT�.� ;
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<br /> OBUI DING $ yALUATION�OF.'70TAL.CONSTRUCTION = '
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<br /> Q ELECTRICAL $ " AMP SERVICE. '� �.Q '�PROGRESS ENERGY [� W.R.E.C.
<br /> QPLU BING - :$ �- ' � ,
<br /> ; - ,, � � '
<br /> QME HANIGAL � $- Vi4LUATION OF;MECHANICAL INSTAL`LATION. �"` '
<br /> ,SS�� 7�: . . . , . ....J. .. . , c6
<br /> ��5 [� ROOFING ,� SPEGIAL7Y �: +OTHER, \ '
<br /> �. _.�I , « ,,.. , :
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA, � ,QY�S. NO
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<br /> BUILDER COMPANY�,:. . . :,�;.�,;_, •<F� , . , . , , �
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<br /> SIGNATURE REGISTERED Y/ N .'`�'�'�FEE CURREK•�--'' ` Y/'N'= �� . �
<br /> . .' ",VA s;. °6r , ;:S':' :'��% ..,. � , — ._ ., _. , i
<br /> AddfeSS �.: , , "t i ., .. �l:icenSB;#; -
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<br /> ELECTRICIAN a , . • � �?C.OMP,ANY _ --- ;':��,.;;-;__�:-: ,. , .. - _ � . . . .
<br /> SIGNATURE ' 7 REGISTERED 9Y/ N FEE GURRE��'� �`��Y/�:N- `� ' �
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<br /> Addreu' . . . , - � �x...:�-Ligenses#: •' I
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<br /> PLUMBER ' , , . . . " .COAAPAWY - ~ - r�. '_ � :�.� - ' �.
<br /> SIGNATURE°�` _ c,` . � � . -�REGISTEREO _ -.Y./,,N:.s f;;FEE�CURrte��� Y�/N,-,:� _ _ _ �
<br /> Address ` ' ' � � ' � � `�Li,censeu#f ' _� . . , . ', . , �
<br /> _ _ . � , .. . At.. 15, �.�
<br /> MECHANICAI: • - , „ � , ' . 'COMPANY `1 /J.S, �;�-�, .� '
<br /> SI(3NATURE�, �•� >> _ t;` - � .-
<br /> tiE�iS7EtiEo_ Y/,N FEEyC,URFtEA.. Y./rN .
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<br /> Addresa��' - - ,. _ . - ;:r-- -_ . �x , . .. : _ :, ... . - ' License#.� _ .�o, .� �
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<br /> OTHER J�" :., - .. , , •_ . , : � .__,, , :•� . , , ..., ._ _ , • . , ' ;
<br /> ,COMPANY _ .. , ' � � ,
<br /> SIGNATURE•<�.��� - - - << .. .��'1, :-, ,��- , ,. . .,, .,..r � f., �4:: ,., , , . �
<br /> REGISTERED!� Y/ N..... aFEE CURRE�'' `Y'/N
<br /> ���� „ - .. .��: „ _.. . . _, , . _ _ � _. ._ . - .. - � . :. = •
<br /> Addre� __„�r,,N< - :,s��a�:�:; - ;Y� -�a� „�;,.4 -���: - . : ;.License#�j: • ' , , , - ,
<br /> RESIDENTIAL,�; =�Altach�2 P1otiPla�is` 2� s'ets.'of " ' "`�; •� ""-r,'`.��. ._ '`"°:"°�""`' F � '�i�' `J.,,' �°-•," ..: ::, . , ,. . , ,
<br /> _ . ,( );� ,-( ) 'Ba(Idfng�.Plan"s;(1�)sef'of<Energy`�ortns;�R"-aVll•Permif for new construction,.
<br /> .,..: S .�-�. ���-�•:, .; � Tr ,. .. , . .. ._
<br /> -u �;��Minimumi,t�en,(10)�,worl4ing;d�ys aiter�submlttal�date t:;R,equlred onsite;`ConstFuctlon=P,lans,�§to"miwater=Flans w/SilYFence instelled,
<br /> Sanitary"Fadlides�8��1�duri�pster�:Site Work Pertnit;tor subif(v(slons/lerge:pro)ects;�.w��:,;; ;,� �;-::,..,;� , , ;:�'� . , •.��a
<br /> COMMEItCl�411 Attec�(3)-c:omplefe�sets"of'Bu�ldfng Plans"plus a Llfe Sefety Page;(1)set of Energy Fomis.R 0=1N Perm(t for new'construotlon. �
<br /> Minimum ten(10)wrorking days after submittal date. Requtred onsite,Conswctlon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> . Sanitary Fadlttles 81 dumpster.Site Wark Permit for all newaprcjects:::All commercial requlrements_must meet compllence' � � ' �
<br /> _,. _...�_. _.e..�: .._....�....._. ,�_.,....._.
<br /> _SIGNPERMIT AftaCF1(2)SetSofEr1y11ieflf.BdsP,,leps:i.;,y:t;;°,•a�:,-; _•v.; .:;=.;._. . . -_. ,. --: - . �,�
<br /> "••PROPERTY SURVEY r ,uired for all_NEW coostrucUon._ . . - �
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<br /> ,Direc�lon�: I :-�-.�r�,,�.::,:� .. ,. ._ .' `
<br /> FIII out applicatlon completely. ' �
<br /> Owner 8 Contractor sign back of appllcatlon,notarized , �
<br /> If over�500,a Notice of:CommencemenQ ts required. (WC upgeades over 57500)
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<br /> " Agent(fo i the contraictor}or Powe�of%lttortiey(for the ownerj would�be someone with notarized letter from owner authorizing same
<br /> DVER THE C�UNTER_PERMITTING�••-�:•-(Front•of-AppllceUon•Only) -�-- ' - v `
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
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<br /> Drivewa�va-Not over Counter if an publlc°rbadmiayst:fii��ds'ROiM'"`"" "'`;;"�`""`E+ �,�,U,�„,,,,,,
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