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<br /> 813-780-0020
<br /> City of Zephyrhills Permit Applicatian F�x-813-780-0021
<br /> BuildingDepartment �s j�����i���������` ���
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<br /> D'ate Received '
<br /> �_ I Phone Contact for Permittin --
<br /> Owner's N�� � a e^, � � Owner Phone Number ��(��, �. ���
<br /> Owner's Arldress ���'da���'° '�-� �""" �✓' ��-+'r•�✓J�33 3�qWner Phohe Number �� �
<br /> Fee Simpl' Titleholder Name �,;,}'G,,rw � � Owner Phone Number �� � �
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<br /> Fee Simpl Titleholder Address �'�`f-
<br /> �oa aaoRi�ss v1�1 y� ��'-r� �.�-r �i _ � ��� ��
<br /> �tC' LOT# `�_'
<br /> SUHDIVtSJQ N ��1 ( 1-a'G("'� c�ca PARCEL ID# �f��f'r�/
<br /> I (OBTAINED FROM PflOPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADQ/ALT 0 SIGN Q � dEMOLISH
<br /> I �INSTAL.L e REPAIR
<br />� PROPOSED USE � SFR Q GOM�If � OTHER
<br />� TYPE OF C�QNSTRUCTION � BLOCK Q FRAME 0 STEEL 0
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<br /> DESCRIPT�ON OF WORK ��� ��°�jr1�7�n-�-�� I'�'T�c���"� �rt�� bex-'�-� -f;�o�
<br /> BU1LDtNG S1ZE � Sa FOOTAGE Br 7�i� HEIGHT
<br /> M �������N� � ,l�S, ��'f� VALUATION OF T(7TAL CONSTRUCTION
<br /> OE EGTRICAL $, ��� �� AMP SERVICE O PROGfiiESS ENERGY 0 W.R.E.C.
<br /> QP UNiBiN� $
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<br /> � � ���'a
<br /> �MECHANICAL $ /'��� � VA�UATIOIV dF MEGF{ANIGA�INSTAI.EATI4N
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<br /> �Gf�S ��FtQOF1NG Q SPECIALT'f � OTFiEA
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<br /> FINISHED LOOR ELEVATIONS /��/ �� FLOOD ZONE AREA �YES NO
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<br /> -1-1- t-1�-1-1-�1•�4-1-1-1-�--1-•1-1--1�-1-1-�t-4-1-F-�--1-ift-b-1-1-1-�-1-1-1-1-i-1-t-4-6-• • • • • • • • • • • • 1-1��-1-
<br /> SIGNATURE � r���-�'y '�� �OMPANY �4� - �'I��"'�^+ �J`4 e
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre s l���r���C �CCo f+'I /��"' �� '"� License# ��C.C���Ca G� � �
<br /> ELECTRICi�t�t � GdMPANY ��Y J`�Cir��p� ��'�'�-=��' � �
<br /> SIGNATURE �"" �""��~� � REOISTERED Y/ N FEE CURRE� Y/N I
<br /> Addre s i �l" �G ��- I
<br /> �� �` �� i� ,�1c� rr' License# �����':► � C3� �
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<br /> P�UMBER � ,,,,�� CQMPANY t.,.�d/""�'1 Lv!"-�'7� �!'e--/ O""`a��
<br /> �IGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�s � �,�rp �.(,Q �� License# �� � �7 %�«�- �
<br /> ,, �- /��,t L�L Fc u
<br /> MECHANIC�L ��.�_�,� COMPANY �I"L� (`�,'"S} 1 t��. CK�!"'St� $'��.� f'
<br /> , SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�s 5�j f�� E,rj"h�/��f, �G�-r��cr��e License# VJ``T��J3 4�1(�� �
<br /> QTHER I ������--,�,,,_ COMPANY � 1 b�f'r/''r:� �UQ�n
<br /> SIGNATUR� REGISTERED Y/ N FEE CURRE� Y/N i
<br /> Addres ��� � �`'-�'�' .�'l� �e�:n +�" License# �� �'..�� � {r� � � '
<br /> 11111 11111111111111111111111111111l / 11111111lIlliliili ! ! ! ! lillttll
<br /> RESIAENTIA� Attach(2)Plot P(ans;(2)sets of Buitding Alans,{i)set of Energy Farrns;R-O-W Permit for new construction,
<br /> Minimum ten (1 Q)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> 8anitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
<br /> COMMERCt�L Attach{2}complete sets of Bui(ding Pians plus a Life Safety Page;(i)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Fiequired onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied, �
<br /> Sanitary Facllitles&1 dumpster.Site Wark Permit for a11 new projscts.AIt commercial requirements must meet compiiance
<br /> SiGN PERM�T Attacfi{2j sets of Engineered Plans. '
<br /> **'t*PROPERTY SURVEY required for all NEW construction.
<br /> , � ._,,,,�,,,�;,�;,.t�l--i�■ . . . . . . .. . ��■ . . . , . . . . f.-i...i..i-i--L-l-i�...l-I..i-�i�I-l..i-i-1--i..i-i--i..�..` ',--.:�:.�.�.p.��{-i-�i..i-.
<br /> Directions: � _ ,
<br /> Fill out applicatlon completely � •
<br /> Owner&Gontraotor sign back af appticatian,•notarized
<br /> If over$2500,a Notice of Commencement is required. (,A/C upgrades over$7500)
<br /> ** Ageht(f�r the contractor}or Ppwer of Attorney{for the owner)would be someone with notarized letter from owner authorrzfig same
<br /> OVER THE COUNTER PERMITTING (copy of contract required)
<br /> Reroafs if shij�gles Sewers Service Upgrades AJC_, Fences{PlotJSurvey/Footage)
<br /> privewiys-No#over Counter if on public roaiiways:.needs:RO.W � � ,.
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