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<br /> 813-780-0020 City of Zephyrhills Permit Application FaX-$13-780-002�
<br /> Bullding Department
<br /> Date Recelved
<br /> � � Phone Confacfifar•PermittEn �
<br /> Owner's Nama �� Ow»er Phone Number � —3 ��3 �
<br /> Owner's Address ��'U � '1 � �-� ,,o e2 � - •Ow�ner Phone Number �� ���
<br /> Fee Slmple Tikleholder Nama � � Owner Phane Number �_ —�
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRESS ��3 �r n�. I�.,�/G � 2-2. ,' � ��S � � LOT# [��
<br /> SUBDIYiS10N ��3�"� S W-1-(�-� PARCEL ID# --,�.�--� 1- G oo �G�Ob --OaC��
<br /> (08TAIMED FROM PROPERTY,TAX NOTtCE)
<br /> WORK PROPOSED _NEW CONSTR ADDJAI.T � StGN" 'Q Q DEMOGISH
<br /> �•e; INSTALL 8 REPAIR ^
<br /> PROPOSEDiU$E Q SFR � GOMNt Q OTHER �
<br /> TYPE OF CONSTRUC'170N Q ` 'BLOCK ' '[� FRAME [� STEEL Q
<br /> pESCRIPTION OF WORK' C' �r� ;�a d,�1'k` `
<br /> BUILDtNG SIZE �`_�� SQ';FOOTAGE� . MEIGHT����.�
<br /> QBtl11.D1NC' � � VALUA7iON�1F TOTAL CONSTRUCTION �
<br /> QECECTRICA�. - $ " � AMP SERViCE ��] PROGRESS EtVERGY [� W.R.E:C.
<br /> � .�_,,, � ] ,
<br /> o�������� .�-- � -
<br /> . �� ��
<br /> QMECMAN1CAl. $ VA�UATtO1V OF'MECHANICAI INSTAI.lAT10N 5��
<br /> 0�5. .
<br /> QGAS Q ROOFlNG .� SPECIAI.TY [� OTHER
<br /> FINISNED FLOOR ELEVATIONS ��� FLOOD ZQNE AREA QYES. NO
<br /> BUIIDER
<br /> C .,
<br /> OMPANY�•
<br /> SIGNATUitE REGISTERED Y/ N FEE CURRE� Y/N �
<br /> . i
<br /> Addres� - � �•�� . ' Cicense�#"� I
<br /> ELECTRtC{AN. : ' i. COMPANY'�� . � , .
<br /> SIGNATURE � REGIS7ERED Y/ N FEE-CURREk�'' �• "Y/�N . '
<br /> Addre�s � . .� . _..� License#�;��' � �
<br /> P�UMBER ` , + � R OMPANY � Y/..N �FEE CUR � - ,
<br /> SIGNATURE` ' � ,, . REh_- Y Y N, � �
<br /> Addre�ss . :License,#'��,.,..a.. .., - : :, J . �.� -
<br /> MECNANiCAR:' _ �.------��, COMPANY :2 r�-7 ��'`l't t ��-� ,�•r'3 �-�'7�',``�''�S -
<br /> SIGNATURE� ���--�= REGISTERED . Y/ N . ; ; FEE CURRE�, . Y/;N: I
<br /> Address`�' - 9`�� �S"�' �1�.��`� `2 G✓t �`�$ � . 3 3!n t'�-, ,ucense# ���'' .3 ,
<br /> OTNER '� ' ,_ � � � . :CBMPANY �
<br /> SIGNA7URE �. ` ` � ' ' REGISTERED� Y/ N:.. ;FEE CURRE�' Y/N
<br /> Address � � - . - ' Cicense#�� �
<br /> .. �._�,. �, ._ .�. ,,. :_, ;.; , ,. ,... . , {
<br /> REStDENTlAt:�z� :Attacti(2).,Rtot:Piatis;�.(2}sefs�-of=Building?F'lans;{'1)set ufi Energy�Faims;`GFt=0-1N Pemilt far new'cbnstrurs#ton,
<br /> .,. . . . .. . - �:. .
<br /> ;�.Minfmumgten�(,10),warkingkdays after:_subinittal"d'ate...:Required onsite,.Constructlon�Rians;'Stomrwater Plans w7 SUt Fence installed,
<br /> �`"`�•.."Sanftaiy�Facilftles;&_1:dumpste_r„51te°Work,Permitforsubiiivisions(large_projeats;�..._, , � ' `
<br /> COMMERCIAI. Attach{3)-+r�mplete'sets of'8iiildirig Plans plus a�.ife'Safety Page;.(1}set of Energy Forms.R-O-W Pemnit for new construction.
<br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construcdon Plans,Stormwater Plans w/Silt Fence installed,
<br /> -- - San3tary Facili�es&1 dumpster.Stte Work Permlt for a!i newprojects:.Rli commerctal requl�ements.must meet camp{fa�ce -
<br /> SIGN PER(VIiT Attacfi"(2)sets of Engineer,ed;Flaris.. - ��- . � � �
<br /> ••`"PROP�RTY SURVEY regulred for all NEW,canstructlon.. . -
<br /> Directions: - - - ' +
<br /> Fill out appUcatlon completely. �
<br /> Owner&Contractor slgn badc uf appllcatton,no#atized
<br /> If aver 52500,a Plotice of Commencement I�raqulred. (AIC upgrades over$7500)
<br /> :�t_, .:,:,
<br /> '* Agent{fot the�cantractor)or'Power of Attotttey(tar ttie owner)wauld ba someone with notarized letter from owner authoriztn�same
<br /> DVER THE COUNTER PERMI'TTING - •(Front ofiApplicatton-Only)-- - - �
<br /> Reroofs if shingles Sewers 8ervice Upgrades AIC Fences(PlodSurvey/Footage)
<br /> Drlveways-Not over Counter if on public roedways..need's ROW
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