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<br /> a�saeo-oo20 �\
<br /> City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � � Building Department
<br />� ,. ' �Gl V�►=
<br /> Date Received � . � Phone-Contact for Permlttln 1,� �.G_ - �-/�� �
<br /> Owner's Name cz�c�-c..� �\ � ,� Owner Phone Number g�� � g� Z ��
<br /> Owner's Address � D� � ,!� . � Owner Phone Number� �^�!��� ,V�� �i�-� !� '
<br /> � , �a
<br /> Fee Simple Tltle6older Name Owner Phone Number ��
<br /> ,r.;� _ . , ' ' �
<br /> Fee Simple Titl holder Address �
<br /> JOB ADDRESS �v��-/�'I n;n � Z . �J � ( , LOT#
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<br /> SUBDYVISION - PARCEL ID# � � :, `
<br /> . , , �r (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPO�ED- NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> B:' a INSTALL 8� REPAIR �
<br /> PROPOSED�USE, Q SFR Q COMM '- -` OTHER �G �
<br /> TYPE OF CON I TRUCTION � �Q ' BLOCK ' Q FRAME �Q STEEC 'Q
<br /> DESCRIPTI�N OF WORK ,� ' '
<br /> , � �, �.� -. � _ �
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<br /> BUILDING'SIZ � �SQ�FOOTAGEC�� � ...HEIGHT ?�
<br /> � t � �
<br /> QBUIL ING $ '� ��� VALUATION:OF`;tOTAL CONSTRI'ICTION ' � .
<br /> , � ' , (V:
<br /> QELECTRICAL $ - AMP SERVICE, Q PROGRESS ENERGY Q W.R.E.C. `�
<br /> QPLU BING $ ' � � -
<br /> � 1
<br /> QMEC ANICAL $ ' VALUATION��F:MECHANICAL INSTALLATION � L(„_��,��Yl.� -"-
<br /> ` /� ��cir
<br /> .. ��
<br /> QGAS Q ROOFING ,Q SPECINLTY � OTHER� - l� --
<br /> FINISHED FLOOR ELEVATIONS FLOOU:ZONE AREA QYES NO
<br /> BUILDER -` - - - - - � �OMPi4NY� --- - - --- --- - - -
<br /> SIGNATURE �� R�GISTERED Y/ N FEE CURRE� ' Y/N .
<br /> Address - - � � Gcense#'
<br /> ELECTRICII'.!d_ . �COMPANY� � �- � '
<br /> SIGNATIDftE � REGISTERED Y/ N FEE'6URRE�' ' Y/N -
<br /> , :�.,. �. � , ,
<br /> Address � ' ,i ' .. License#� �
<br /> . � , , � .
<br /> PLUMBER ' , � . � . COMPANY . , � ' � �
<br /> SIG�ATURE` ' � `; ' _REGiS.7EREo X./ N .F.EE Ci1RRE� " Y.-/N '
<br /> Address License,# - ;
<br /> MECHANICAL` , �` � l` COMPANY e
<br /> SIGNATURE� � ' � � � `��, . REGISTERED Y,/ N FEE CURREt� Y/�N
<br /> ' • . �_ •
<br /> Addreas� = � ' �� ° � ' Lfoense#
<br /> . ;N;.
<br /> OTHER „ ./�. . , :�,�--• �'COM,PANY. - ��+`���-�.. Co� � ��:',lc►��-f.
<br /> SIGNF�TURE `1 �/ s- ` - ' `REGISTEFtED ' `, u ` Y/ N... FEE CURRE�• Y/N �
<br /> �'•
<br /> Address l ':�f�� '::�.�t. . ,Lo a S'; L.'t �'C�'f - � Llcense#� � "
<br /> RESIDENTIAL:;;":�Attacfi'(2),P..lo.t%P,laris;,.(2)setsFof:Bullding�Plans;'(1)set'of=Energy�Foirns;R=�O=VV`Pennit for'new construction, =�
<br /> -� ,.�, � Minlmum;�ten°�10;workln �da - . .. . . ` ` , . . '� , - ` , .
<br /> „_„,,_(„_) ., , „g' _grs:after.;submlftafdat�::Requlred on`slte,_ConsUucdon-Plans;Stormwater Plans�w/SIIt Fence lnstalled,
<br /> �� ���Sanita''ry FacI�llUes-&-1�dumpsterQSlte Wo�lc,Permit#or_subdiylslons/large;projects._ • ' '�
<br /> COMMERCIAL Attach(3j complete�sefs'of Building'Pla.ns plus a Ufe Sefety Pege;�(1)set of Energy Forms:RA W Permit for new consUuctlon.
<br /> Minimum ten,(10)worktng days after submlttal date. Requlred onslte,Constructlon Plans,S4ortnwater Plans w/Silt Fence fnstalled, �
<br /> Sanitary Facflitles 8 1 dumpster.Slte Work Permlt for all neuv projecfs.All commerclal requlrements.must meet compllance
<br /> SIGN PERMIT Attach"(2)"sets"�of�Eng,i'neered�Plans.::� ��- - � - �.- -
<br /> ••"•PROPERTY SURVEY required for_all_NEW constructlon.. _
<br /> Dlrectlons: � �. - '
<br /> FIII out applicaUon completely.
<br /> Owner&Co�tractor slgn back of applfcaUon,notarized
<br /> If over S25 0,a Notice of Commencement Is req�alred.� (AIC upgrades over;T500) , -
<br /> ' ��"a;.:«.::'; '
<br /> " Agent(for e contraotoc)or Power of Attomey(for the ovmer)would be�someone with notarized letter from owner authorizing same
<br /> �VER THE COU TER PERMITTING --�---(Front of-Appllcation Only)- � . ,
<br /> Reroofs If shingl s Sewers Servlce Upgrades A/C Fences(Pl�dSurvey/Footage) ' ` ,
<br /> Drlveways- ot-overCounterif�ts�"pnbllc"rti8tlupays..needs ROW� �-...-.�-------•-----.__.....,.._,___�_.._w.__�.�--_...,._. �_ ; ..
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