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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department _
<br /> Date RecPived �� ��� _ �O`� �
<br /> Phone Contact for Permitting •
<br /> Owner's Name e l�/� (�/� �' Owner Phone Number ��— ���` 6�A� �
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<br /> Owner's Address 3��� �dl�$/�Q. /'7'U� Owner Phone Number
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<br /> Fee Simple Titleholder ldame Owner Phone Number �
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<br /> Fee Simple Titleholder Address �
<br /> JOB ADDRES � : � � �e LOT# � �
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<br /> SUBDIVISION (�/� � /% Z Dl�j PARCEL ID# 3� as �/ �9D ��D� L �� I
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROP SED NSTALLSTR REPAIR � SIGN Q Q DEMOLISH I
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<br /> PROPOSED USIE Q SFR Q COMM 0 OTHER . .
<br /> TYPE'.OF CON,5TRUCTION Q BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK �C—S /r✓ L� Gf�N e pG[� / C07�7. �Je�f� ..7� � �b7� /�J�
<br /> BUICDING SIZ� SQ FOOTAGE� HEIGHT
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<br /> �BUI �'DING $ VALUATION'OFTOTALCONSTRUCTION
<br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W:R.E.C.
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<br /> OPLU BING $ ;
<br /> QMECHANICAL $ � ��� �D VALUATION OF MECHANICAL INSTALLATION �
<br /> �GA i Q ROOFING Q SPECIALTY � OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> - BUILDER COflAPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �
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<br /> ELECTRI,CI COMPANY i
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address I License# 9 !
<br /> PLUMBER.; � COMPANY .
<br /> SIGNATURE I - REGISTERED Y�/ N FEE CURRE� � Y/N
<br /> Address l - License# � �
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<br /> ; MECHANICAL, � ' � ��n///III��� , COMPANY ��/QS !'O- gI1I� �����11�G� �
<br /> SIGNATURE ��. � REGISTERED Y! N FEE CURRE� Y/N i
<br /> Address� '� � � �//eN�/ �� � ` L:icense# l�f���.3��� I
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<br /> OTHER� ' COMPANY �
<br /> SIGNATURE.� :� - REGISTERED Y/.N FEE CURRE� 1 Y/N '
<br /> Address. � License# �
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<br /> �RESIDENTIAI�',. Attach(2);Plot Rlans;(2)_s`ets of Building�Plans;(1)'set of Energy Forms;R-O-W Permit for new.construction, �
<br /> � � , Minimum.:ten..(,10)working:days aftersubmittal�date. Required onsite,Constniction Plans,Stormwater Plans w/Silt Fence installed, �
<br /> Sanita.ry Facilities�&��1.,dumpster;Site:W.ork Permit for:.sutid'ivisions/large projects
<br /> �_- COMMERCI Attach'(2)complete sets"of Building Plans plus a Life 8afety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> � ., Minimum ten(10)uvorking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilit(es&1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance
<br /> ��SIGN�PERMIT Attach�(2)sets of:Engineered Flans.-. ' �
<br /> " � '*"*PROPERTY SURVEY required foc aII.NEW.construction. �
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<br /> Directions: II �.- �:.
<br /> Fill out application completely. '
<br /> Owner&IContractor sign back of application,notarized "' •
<br /> ` If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) ' ;
<br /> `" Agent(for4h'e-cont���to[.�or,.Po.�we��o,fi4tto n�ev,(f r the owner)would be someone with notarized letter from owner authoriziqg same 4�
<br /> �.�3,�..3'x�r�,wids..Y
<br /> OVER'THE C�UNTER P�}�`-RMITTIf�G"^4�' x(Co'�ijF.'of contraet�requi[ed)�y �`�°�'.��*�^�"���r�x� �
<br /> Reroofs if shingles Sew�'rs'�'t""��Service'•Upgrades A/A�'��<Fengcyes(PIoUSurvey/Footage) ';`�'�'"'' �t`���'y`' �,v�`•"';�•.
<br /> �:,rOC ;•�" ���i_ 'ti;j'r.�' :ST::i.i t��i �•qA � ��� �F° q %;Tt�01't �t;n�.;iC 71iCi1lG� � ;ifd'ya ':a�,-:.:,�'•.
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<br /> Drivewa s-Not ove��CouriteFlf�on publia:roadw8ys..ne�ds��EtO.VN• �� _ � '.t9 r� .f s
<br /> �hc:.i'p�E'nv};$i',0'fit�i1?�'J i'S li C',�i�^.�: •':�^ri±.'�1`)�.,�` � .;..-,f+��3'1 � ��i��;.T.E!'.{icj �i,�.��.�E�•iU: ,
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