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s�aa8o-oo20 - City of Zephyrhills Permit Application '��� Fax-813-780-0021
<br /> � Building Department
<br /> y4,�
<br /> l�'�- �
<br /> Date Received �3 �8 • — �b�3
<br /> Phone Contact for Permitting �
<br /> Owner's Name � �/� Owner Phone Number l3- � a- 8�
<br /> Owner's Address ��7b� dQ% �irQ, Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �� � �VL�Lp} � de, LOT# �
<br /> j�. / �c ^��
<br /> SUBDIVISION � � � 7�/�Y ei PARCEL ID# 03 � �� ��v �(�C� Q���
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEw CONSTR� ADD/ALT 0 SIGN Q' � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM � OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK • Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORK Gs, �C e— 3� � ! 6/�J � (DDyn d �
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> �MECHANICAL $ �/� s�D' OD VALUATION OF MECHANICAL INSTALLATION
<br /> 'T of
<br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN ' COAAPAWY
<br /> SIGPIATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> , Address Cicense# ' �
<br /> PI:UMBER COMPANY
<br /> SIGNATURE -REGISTERED Y•/ N ' FEE CURRE� ' Y/N
<br /> � Address ` License#�� --
<br /> MECHANICAL �� `�n���� . COMPANY �i�-/!Q.`r—S�D AN AS �' � -1��
<br /> SIGNATURE REGISTERED 5 Y/.,N" FEE CURRE� Y/N
<br /> Add'ress � /T� �f�,J �—�//�s 3�$ L-icens,e.# �v'�`����
<br /> `s. � ..
<br /> OTHER` " ' � COMPANY
<br /> SIGNATURE: � • " � REGISTERED �Y/.N. FEE CURREk �Y/N
<br /> Address � - • � � � License#
<br /> RESIDENTIAL �> A,ttach�(2).Plot Rlans;(2).sets ofBuilding-Plans;(1)set of EnergyForms;R,O-W:P.ermit for new construction,
<br /> Minimum ten.(.10)working.days after.submittalydate. Required on�site�Constriiction Plans,Stormwater Plans w/Silt Fence installed,
<br /> �� �Sanita,rysFacitities&.1..dumpster;Site.Work Permit for subdivisionsAarge projects
<br /> ..COMMERCIAL Attach�(2)'compleCe sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permitfor new constructlon. -
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence•installed,
<br /> � '. Sanitary Facilities&1 dumpster.Site Work Permit fo�all new projects.All commercial�equirements must meet compliance
<br /> ' `$IGN PERMIT Attach(2)sets of,Engineered Plans.
<br /> �R�*PROPERTY SURVEY required for aII.NEW.construction. .
<br /> Directions: � ,. ,
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> lf over$2500,a Notice of Commencement is required. (AIC upgrades over$7500)
<br /> "' Agent(for th"e cont�actor)' f"o�T�cSfFAf�brft�y�f`,ro�`e� ��o'�'d'�beY�omeone with notarized I �a ' .
<br /> �1` i.i�tt,ry�/;,i ,.r.7's'_��.'. �\;.,""';;„,., }� ki�G1u9YlG9@C �Q��$F�w.a�d�+;�Ae�'
<br /> . OVER THE COUNTER PERM�TTING ,. .. co ,of "'�4 ' ±'�r�� � `���`�`'� '»��'��%
<br /> ,, ;� PY .contract:requiied � " �"�- � •�,� '• �
<br /> )='..�:' �, , ,. ,�_ , ;,-__,c.;,:
<br /> %: r-i�iistl. fu'i9G,c= :n:t#tv ,:r,:p'�. `i„rt—'.,�• �
<br /> Reroofs if shingles Sewer� �, Service;Upgrades,;A/,C -�,F,�nce's��P,lot/Survey/Footage) $� , �r,;;,> .�;:��"�
<br /> ;J,•� :�. ......, �...: '• � , r„' �:��M�!i�a_"� `' �'�'l)� �+ :ii�. .'?1iys! iiimr��: Y�'r`� "ta4 �s o "l''
<br /> .' ` �
<br /> Driveways-Not over Count'er if on public;roadways:.needs ROW , � � ''r�'t�t` f�� ' �" ""�• � �;'"-�> �y ,
<br /> � . ... =_ � `� z.,� .,�.,�� : , ,� : , , „.:.'��
<br /> .- -,. _. : - .- . .. � z..�x���..vo••., .- .:z:�^^�:� �_- .. ,.>�;�,. .,,J;
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