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������°-0°2° City of Zephyrhills Permit Application Fax-813-760-0021
<br /> , Building Department �,,p /_ 1
<br /> L�/SYi.'�'lQ�C�G:a�t��/`�3��fL C"t3/r�
<br /> Date Receiv d
<br /> �._�_. Phone Cantact far Permitting --
<br /> Owner's Na e � ���} ,�, � � Owner Phone Number � ���(�j', �, �`,t(r��
<br /> Owner's Ad ress �a�,oa���� �a P�^ �✓' �,�,,,.y.�c,3�' 3�';�Wner Phone Number �� �
<br /> Fee Simple itlehalder Name ��C.,-r�. �, y� Glwner Phone Number �� �
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<br /> Fee$imple�itleholder Address ��-�-
<br /> J08 ADDRESS (Q f�� ` /�j� _ � LOT# ��// �
<br /> SUSDNlSlQN •,J 1�� L.��("� e�Ca PARCEL tD# ��'r��'�1 "t���+����iff.��J'•'f�/r��
<br /> ..--,,��,,��--~~�� (OBTAINED FROM PflOPERTY 7AX NOTICEj
<br /> WC1F3K PROPOSED �NEW CONSTR 8 ADD/ALT � SiGN � � DEMOLISH
<br /> INSTALL REPAIR
<br /> RRQPOSEC} SE �". SFR Q GOMM � {}T}-IER
<br /> TYPE OF CO STRUCTION � BLOCK Q FRAME � STEEL Q
<br /> DESCRIPTIQN OF WORK ��� ���/�te-t'crr�-j�, �=c°`S�c,�G�+�G ��e�Q be�.'�-� -�;�a�.4
<br /> BUtL,DiNG S1ZE � � S�FOOTAGE ,,,�� HEIGHT
<br /> �g�C���G ������j'�� VALUATION OF TOTAL CONSTRUCTION
<br /> �ELECTRICAL r; „ �� AMP SERV(CE 0 PROGRESS ENERGY � W.R.E.C. �
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<br /> OP�i MBING $ ���� ���../
<br /> �(VIECHANICAL $ VAI.UAT(C1N OF MEGHANIGA�INSTAL.CATION � �
<br /> � ����
<br /> �GAI [�F�OOFIN� � SPECIALTY � OTHEFt
<br /> FINISHED FLOOR ELEVATIONS ��s ja �� FLOOD ZONE AREA DYES NO
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<br /> BUtLDER � ���+� �(,�_ COMPANY ��� - ���`'�'^* ��G
<br /> SIGNATURE REGISTERED Y/ N FEE CURFE� Y/N �
<br /> Address 1c��'G7n��''C��"CO/y'� /�I"' IG-/Yi "y ��`'+��.C�J�a �v � � i
<br /> License#
<br /> ELECTR(CIAN �`� ��_,�_ COMPANY ��✓'� brY}C��S�� ��'�'-'�=-"Cr'' L
<br /> SIGNATURE "�� flEGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address 1 � J � ��� ���" �s���� '� License t� ���t���� C,3 b I
<br /> PLUMBER � � ��,,���_�� COMPANY 1,.�6�J"i t�t'° `-j'-`7rd rt 'E".--�!J`"a��
<br /> SIGNATURE ��� ""�� REGISTEREp Y/ N FEE CURRE� Y/N
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<br /> Address ��� ��,e �(,� e �v� �GL License# r��C ��2�d� �
<br /> MECHANICAL ���,�,,,�,� COMPANY t I"�G�U��"Sc� 1 t�'f'-- t'i'�("�� �"�'� f
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� •Y/N i
<br /> Address ��j 0`} c=$'i7c/^f't, �C,r�-r�f G.�� License# ���C.�33 �(�� �
<br /> OTHER ��,.,y�,,,� COMPANY �I 1 t��GP'r:� J°CG7� i"1�
<br /> SIGNATURE � �^_C�� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addressi �p�i� � �`��' J�f'" �e�:n � L.icense# �r� �J � � {�+ � �
<br /> 111111 1lIIIIIIIIIIllll1l111 / 11t1111l111lIt ! litltll111ItI3111I1tIlI
<br /> RESIDENTiA� Attach(2}Piot Plans;(2}sets of Building Plans;{i}set of Energy Farms;R-O-W Permit for new construction,
<br /> Minimum ten(1 q)working days after submittal date. Required onsite,Construction Plans,8tormwater Plans w/Siit Fence installed,
<br /> Sanitary Faciiities&1 dumpster;Site Work Permit for subdivisionsliarge proJects
<br /> COMMERCIA Attach(2}complete sets of Building Plans p(us a Life Safety Page; (1}set of Energy Forms,fl-O-W Permit for new construction.
<br /> Minimum ten (10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facliitfes&1 dumpster Site Work F'e�mit far aIl new pro�ects.A11 cammercial requirements must mest compliance
<br /> SiGN PERMt , Attach(2j sets of Engineered Plans.
<br /> ' '�*"*PRQPERTY SURVEY required far all NEW construction.
<br /> .� f • . • • e . ����.���..�...�+��� ■ ■ ■ ■ ■ ■ ■ � j„j..�,+��.���{..li..i�ri��� ����� e � ■ � ■ ■ e � ■ � � ���{�.�
<br /> Directions:
<br /> Fill out ap�plication completely
<br /> Owner&Contractor sign back af applica#ian,notarized , -
<br /> If over$�500,a Notice of Commencement is required. (AJC upgrades over$7500)
<br /> ** Agent(fo�the contractor)or Power of Attomey(for the owner}would be someone wiih no#arized lettar from owner authorizing same
<br /> OVEfl THE COUNTER PEFIMITTING (copy of contract required)
<br /> Reroafs if shin�les Sewers Service Upgrades A!C Fences{PloUSurvey/Footage}
<br /> Drivewa�s-Not over Counter if on public roadways.,needs RO.W ` � ' ,
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