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<br /> - sja- aa-oa2o City of Zephyrhills Permit Appficatian Fax-813-780-0021 ;
<br /> Building Department f �� f �
<br /> �+S/o.'�"'t�e`��`?G Jl�f���`'�CJ�f2r C`t3/YT
<br /> Date Receive� . Phone Contact for Permittin �,�
<br /> �r-r�'r�r-�rT
<br /> Owner's Nam�e � �a �, ,r.� � Qwner Phone Number ,��(�j', �. �i lo�
<br /> Owner's Add�ess ���^�a���� '�a �'"' �✓` ��-/►�r'J�.3� 3�pWner Phone Number �� �
<br /> Fee Simple T tleholder Name �",j C.,r� � � Owner Phone Number �
<br /> �
<br /> Fee Simpie T tleholder Address ��'`/7�t I
<br /> JOB ADdRE �S i � � � � /� fc)
<br /> I � �.l' � �..' Cr"t LOT# �I
<br /> � C��I' �' 1
<br /> su�otvisia ���, t-a'�et"� �ca � PARCEL(D# � '�' >Ga�`��— �f�°C�v 4�'/��
<br /> (OBTAINED FROM PRpPERTY TAX NOTICE) I
<br /> WORK PROP� SED NEW CONSTR AQDJAl.T 0 Sifi�N Q � DEMOLISH
<br /> �INSTALL 8 REPAIR
<br /> FROPOSED tISE �� SFR Q GOMM � OTNER
<br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � Sl'EEL Q ,
<br /> i
<br /> DESCRiPTION OF WORK ��� ��'�'�����r�-j�, �`�'j�C.�t/+C+G ��� bex.'�-� -��o�>~ I
<br /> BUt�D1t3G St�E � � Sp FQOTAGE I�'""�� HEIGHT . �
<br /> �BU� DENG $��r ���. VAL.UATION OF TOTAL CONSTflUCTION
<br /> OE� CTRICA� $ ��� �� AN(P SERVtCE � PROGFiESS EtVERGY � W.R.E.G.
<br /> P� MB1NG �, ;
<br /> o � ���� 9 ,
<br /> OME�HANtCAL $ VA�UATION OF MECHANICA�ENSTA�IATION �` ���
<br /> � �
<br /> �GA� ��F�QOFIt�2G Q SPECIRLTY � OTHER
<br /> FINISHED FL�OR ELEVATIONS ,,,�^��' ��' FLOOD ZONE AREA �YES NO
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<br /> �-1--i-H�-- f-i•-FI-1-i-1--i�-1-1-�•-i-1--1-1••1�-1--�-1-1--4-M•�i�l-1•�1-•1�-1-�1-4-1-f-1--1�-1�-1--1-6••• • • • • • • • • • • • f-,E,,,1-4-1- �
<br /> BUI�DER � `���+��„���(�i� COMPANY ��� - ���"�`'^� ��e '
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address; 1���+��'�--`��'Cc��7 /�P"' I�'' '�- License# ������'Q f= +� I
<br /> ELEC7FtICIA `�`� „��.�' COMPAI�Y �� d'pG�t'b S�I/t �.!E''�G:._�t'i C:- i
<br /> SIGNATURE r" ""� REGISTERED Y/ N FEE CURREA Y/N.
<br /> Address� 1 �� �' ��� 1���' Y s�'��ry" '�' License# ����j��� C5� � , I
<br /> � j �r � I
<br /> ' PLUMBER ' � � ��,��_T CQMPANY t.,�6/"rI"1 �r''��'Ta n'E.-/ Q""�� '
<br /> �IGNATURE I ��"� "`�� REGISTEREp Y/ N FEE CURRE� Y/N
<br /> , Address`, �7 �P G^� �� � � �✓f� �GL License# ��C ��� �► %d� � `
<br /> MECHANICA I
<br /> ��..�',�,� COMPANY �Y`C'� (��.'S� 1 l�� ��f`J�j/ �"I`�.`r°� ,�
<br /> SIGNATURE ' REGISTEFiED Y/ N FEE CURRE� Y/N
<br /> Address' S�j L3� �S'�j�,i�f. �G�^a-r'��t:.1+� License# I�.°r-�(�t✓�� �IB� �
<br /> OTHER + � C",,.y�--- COMPANY � 1 ��C1►/'''� �t3�� �
<br /> SIGNATURE I REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�s'� l��°i ,� � ���s .�;�' �e^rri �' License# �� �•.�� � {� (� ' �
<br /> IIIIIIIIM1I11I1111 `111111111l111111111111111lItlilillililltltliit [ 11
<br /> RESIDENTIA Attach{2}Plot i'lans;(2}sets of Buiiding Plans;{1)set of�nergy Farms;R-O-W Permit for new construction,
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,8tormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
<br /> COMMERClA Attaoh(2}comptete set5 of Buitding P(ans plus a Life 8afety Page;(i)set of Energy Forms. R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, ,
<br /> Sanitary Facilities&1 dumpster.Sits Wark Permit far al!new projects.A!1 commerciai requirements must meet compliance
<br /> � ° SlGN PERMtT Attach(2}sets of Engineered Plans. `
<br /> ****PRdPERTY SURVEY required for all NEW constrUction.
<br /> . .-..�.'..�-.:-}.�i..���i-.i..1-i..I-.I..N�..�. . . . . . . . . _. . j„{.,b,.•.�:--:�'.�:.�F.i��-.1..i�i�I--i..i�. .,�,■,�_. . . . . . . . . I-i-�L.i�
<br /> Directions:
<br /> Fill out aqplication completely. . ,
<br /> Qwner&Contractor sign back of appiication,natarized � , �
<br /> If over$^500,a Notiae of Commen¢ement is required. (A/C upgrades over$T500)
<br /> ** Agent(fo�the cantractor)or Power of Attomey(for the owner)wouid be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (copy of contract required)
<br /> Reroofs if shin�les Sewers Service Upgrades A/C Fences{Plot/Survey(Footage) �
<br /> Driveways-Not over Counter if on public rbadways..needs ROW ' , � ,
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