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�;, � 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � Building Department
<br /> Date Received �////a.D/� .Phone Contact for Permitting � —
<br /> Owner's Name �b pG Owner Phone Number / j �—
<br /> Owner's Address J ��'`}'�/► Owner Phone Number
<br /> Fee Simple Titleholder Name � ,� d'G'�"1('/ -n Owner Phone Number '
<br /> �I '� p /� ,, �
<br /> Fee Simple Titleholder Address � � � �I�l�� 7� S� `�,i1 ��s�4`'� �
<br /> JOBADDREI S �•SC'� �CS' ;�/� LOT# '
<br /> SUBDIVISIOII PARCEL ID# �� 'Z,�D Z I ' �E1 I Cl'" d�t� - �"JS '
<br /> II (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PRO IIOSED e .. NEW CONSTR'8 ADD/ALT � SIGN Q � Q DEMOLISH
<br /> INSTALL 'REPAIR
<br /> PROP,.OSED USE Q SFR Q COMM Q OTHER ,
<br /> TYPE`"OF CONSTRUCTION Q BLOCK •• Q. FRAME � STEEL Q
<br /> DESCRIPTIOId OF WORK � � a� (_7�- O"(�
<br /> �I
<br /> BUIL"DING SIZE SQ FOOTAGE HEIGHT •
<br /> �UI�LDING $ '��` � VALUATION"OF TOTAL CONSTROCTION
<br /> �
<br /> QELECI'RICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> �' � /�c�, S.�
<br /> QPLUMBING $
<br /> QME IHANICAL $ VALUATION OF MECHANICAL INSTALLATION CJ�
<br /> � . � (�0
<br /> OGASI Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOi R ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> I
<br /> i r �
<br /> BUILDER � 'o COMPANY � �ty C7Q'�S' 2 �d�
<br /> SIGNATURE i REGISTERED Y'/ N FEE CURRE� Y 7
<br /> Address I �) 1 ��{' � (,v� ��
<br /> I License# .�� " Q"
<br /> "ELECTRI,C,IAN i . COMPANY
<br /> �. SIGNi4TURE ; REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �I - License# �
<br /> �:k ti
<br /> PCUMBER:, , - COMPANY-
<br /> SIGNATURE -�cisrEREo Y•/•N FEe CUw�en - � Y/N
<br /> i - ..
<br /> Address ! License#� :
<br /> ; ,
<br /> _MECHANICAL' � COMPAWY
<br /> SIGNATURE" '� REGISTERED , Y,/ N FEE CURRE� . Y/N.
<br /> .. I ;,_
<br /> Address�•" � ' � � ' License.# -
<br /> ��.�;r-:.. •� I. .. . ,
<br /> OTHER=� _. ��I � COMPANY
<br /> � $IGNATURE;r,, :�, r•' - `� �� REGISTERED Y/.N. FEE CURREK Y/N
<br /> .�._ , � .
<br /> _ Ada�e$s�,, � - - - • License#
<br /> .. i:
<br /> 3'`.RESIDENTIAL>,�r;�',At#acFi;;(2)�PIot�Plans�;(2):`sets�of`Building�Plans;(1)�sefof=Energy'Forms;R';O=W.Fermitfornew.construction, �
<br /> � ;�.Minimum,ten,(10)w g y q �"`
<br /> _ , ,.�;;x��,.,. ,. ., ,,, , _, ,_ . ,_.,orkin �iJa's`:aftersutiinittal:date.vRe uiied'orisite;�Con'struction Plans;Stormvirater Plans w/Silt Fence installed,
<br />- -r--- - ?�� ! Sanita.ry,.Facilities,;&;lydumpster;,Site;;Work Rermit.fo�;subdivisions/large;projecfs � '
<br /> ��'COMMERCIAL Attach�(2)�complete`sets'of'Bu(liiing Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new consUvcUon.
<br /> � - - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> ``�` Sanitary Facilities 8-1-dumpster:_,Site,Work Permit"fo�'all-new�projects.All commercia6requfrements must meet compliance
<br /> �t.--.
<br /> ;r:SIGN:PERMIT "AttacFi(2)sets:.of;Engineered;Plans:��� . ; .: . •
<br /> , �:
<br /> �:����- " "'**PROPERTY SURVEY required for.all,NE .W.construction:.
<br /> :� _ ...�.. .�, - -
<br /> ;-Di�eotions: . ': �.,� �
<br /> . '`� �Fill.outapplication completely.
<br /> ;Ouvner'&Con�tractor sign back of appiication,notarized
<br /> �'If over$2600;�a Notice:of:Commencement is required. (E4/C upgrades over$7500) _
<br /> Li.,..�in...:->.�'1
<br /> _�`�"'= ,Agent(for'th'e;'i onfra"ctof)�or�Power�ofAttomey(for tlie owner)wauld be someone with notarized letter from owner authorizing same
<br /> �:",OVER`.THE�COUNTER:_P.,ERMIITING_ _..-. (copy of contract required) �'
<br /> `::;;Re�oofs if shingles� Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> " Drlveways-Not over Counter if on�publi�fio'aidwd'ys:"ne�ds':RC'�fN"" "�'� �
<br /> , '�, .;i:»:1'.;5:�:: �_.„i; -;t. ,. ' ,
<br /> � ��`y�L�i)rrcl u{;.._.:��tii(T .�
<br /> � �i:`f,C r-Y3(;f�r:��dGi�o:"�I: � �.,. ,
<br /> .��c.,Fa.n�. ��,p� �+�;F
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