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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax 813-T80-ooz�
<br /> ' , � Buiiding Department
<br /> Date Recelved � � P.,hone�Contact�for°Permlttln 1� — l�l
<br /> Owner's Wame L' a Owner Phone Number � / �
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<br /> Owner's Address o`� Owner Phone Number
<br /> Fee Simple Tltleholder Name � � Owner Phone Number '
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<br /> Fee 3lmple Titleholder Address -
<br /> JOBADDRESI �aan �L,PL]�.��EiOM �VP_• l--O'�' � ��3 LOT# � �"l3
<br /> SUBDIVISION �Zd�'1 - PARCEL ID# �3 — ^ 1"' « —
<br /> ,. (OBTAINED FROM PROPERTY,TAX NOTICE)
<br /> WORK PROPOSED , _� - NS �LSTR e REPAIR � SIGN Q � Q DEMOLISH �
<br /> PROPOSEDrU$E �J SFR. � 'COMM Q •OTHER
<br /> TYPE OF CONSTRUCTION Q� � BLOCK '' Q FRAME . Q STEEL Q MD f
<br /> ..- Y
<br /> DESCRIPTIO�OF WORK �Q1fY1 c� '
<br /> BUILDING SIZE' � C�o�� �` SQ FOOTAGE �q I o2 S HEIGHT ..
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<br /> QBUIILDING $s'Q� .O� VALUATION;OF`TOTAL CONSTRUCTION �
<br /> Q ELECTRICAL $ �/op0 �� AMP SERVICE •[� PROGRESS ENERGY [� W.R.E.C.
<br /> QPLUMBING $ �QO fv� - � ��C
<br /> '�P
<br /> OMECHANICAL $ VALUATION OF;MECHANICAL INSTALLATION. ,,�yo,Q(J��n �
<br /> /,d�a0.p c� • (,yy�'���,
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<br /> QGAII Q ROOFING Q SPECIALTY � OTHER• ��
<br /> FINISHED FLOOR ELEVATIONS FLOOD d��
<br /> I �� ZONE AREA QY�S NO .� l�
<br /> mi�I 1$
<br /> BUILDER C/��� COMPAIVY` � '�� ..
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� ,Y/N �
<br /> Addresa �' . 1 4., Il�� � Gcense# ��{!�Q a'33 7�
<br /> ELECTRICIAN: �,,�M. �'COMPI4NY �l �G �
<br /> SIGNATURE Ci�� � REGISTERED Y/ N FEE'CURRE�°' Y/N �
<br /> Address � S�'(� � : 3 , . License# � QD
<br /> PLUMBER ', _ �J��y CONIP,.ANY � l��T- ,� ,
<br /> SIGNATURE'ii �`�•� REGI3TERED Y./.N FEe cuR�n ' Y•/N -
<br /> Address� —l� b l�'`A, . Z. �yy :License.# ,
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<br /> MECHANICAL' � ' C�OMPANY �O�r1S �C
<br /> SIGNATURE '` � '
<br /> REGISTERED Y,/ N FEE CURREP Y/•N
<br /> Address ' � h c�V e.'� Licens,e# G I�I 0`15
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<br /> OTHER ' - � ;COMP/WY �
<br /> SIGNATURE - �- • ' ' ' '' REGISTERE� ' Y/ N.. FEE CURREh Y/N
<br /> Address ;. , . ' , . - . - ' � Llcense#
<br /> RESIDENTIAL.;;-, :AttacfiY(2)„PIot�P,lans;;(2)sets=of�Bullding:Pl�ans;'(.1)sef of Energy>Foims;`�R=O=W Perrnit for new construcUon,;
<br /> •�:..Minimumrten•(,1.0);working;:days"aftec;submlftalilate.�R'equlrcd onslte,:Constiucdon-Rlans;�Stortnwater'Plans w/Sllt Fence installed,
<br />___ --- __�.i_�; San(f�ry Faclllties 8�,1 dum�ster.Sltt�_WorkPemldtlor suhdiVislons/large pro]ects_. -� ' ' __ ___
<br /> CORAMERCIAL Attach(3)�complete sets of�Bullding Plans plus a Llfe Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> i� Minlmum ten(10)working days after submlttal date. Required onsite,Constructlon Plans,S4ormwater Plans w/Sflt Fence Installed,
<br /> � Sanitary Factli8es&1 dumpster.Slte Work Permlt for all nauv proJects..All commerctal requlrements,must meet compllance
<br /> SIGN PERMIT Attacti(2)sets'of Englneered=Plans.. � -=� � �..
<br /> ""PROPERTY,SURVEY regui�ed,for all NEW construction.. �_ _ a. � _ ' - . ..
<br /> Dlrectlons: �I . -{�:��•. -
<br /> FIII out aQplicadon completely.
<br /> Owner 8�Contractor slgn back of applfcatlon,notarized
<br /> If over 52500,a Notice of Commencement la requlred:. (AIC upgrades over 57500) � ' '_ ,
<br /> " Agent(for the contractor)or Power of Atfomey;(fo��ttie owner)would be someone with notarized letter from owner authorizing same
<br /> �VER'THE�OUNTERPERMIT7ING-. �• --{Frontof�Appllcation-Only)•- - - - ' �
<br /> ReroofsJ.f_sh�ngles__,.._.Sewers.....�__Servlce Upgrades A/C Fences(Plot/Survey/Footage)
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