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813-780-0020 City of Zephyrhills Permit Appiication Fax 813-780-0021
<br /> Building Departrnent
<br /> s;f%tr` +,
<br /> Date Recelved - • Phone•Contact�forPernitttin � �o� - �o��
<br /> Owner's Name i^ e�12 / �/� Owner Phone Number ���'� �d O '" ��..!
<br /> Owner's Address � �/� � /� - Owner Phone Number
<br /> Fee Simple Titleholder Name Owrner Phone Number '
<br /> - ,r
<br /> Fee Stmple Titleholder Addresa
<br /> JOB ADDRESS �� W s �` �//GL S. �"L, LOT# �
<br /> SUBDIVISION PARCEL ID# �-1 �� '�� �lJ�/0 QOJ D� �/
<br /> . (OBTAINED F.ROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED _NEW CONSTR ADD/ALT Q SIGN` Q Q DEMOLISH
<br /> � .B INSTALL .. REPAIR
<br /> PROPOSED.USE Q SFR Q COMM Q OTHER � -
<br /> TYPE OF CONSTRUCTION Q� BLOCK " Q FRAME Q STEEC Q
<br /> DESCRIPTION OF WORK L � C c�°S, C�/Gf'/� L""6 LQ,Z� �O/�I o� Grl�m= a e �S
<br /> BUILDINGSIZE " � SQ FOOTAGE _ HEIGHT
<br /> QBUILDING $ VALUATION OF�T'OTAL CONSl`RUCTION �
<br /> QEL'ECTRICAL $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPL:UMBING $ �
<br /> QMECHANICAL $ �/s��' b� VALUATION OF'MECHANICAL INSTALLATION =�j�Z�
<br /> / �
<br /> QGAS Q ROOFING Q SPEC�ALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
<br /> BUILDER COMP'14NY~• ' `
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N� .
<br /> Addre�s • - r • ' Gcense# �
<br /> ELECTRICIAN: :.COMPANY:: ' " ' . � � _ _ .. -
<br /> SIGNATURE � REGISTERED Y/ N FEE 6l1RRE�!' � � '•Y/.N` '
<br /> Address � . , ! �. '� License#:� ` , 1
<br /> PLUMBER ` , � COMPANY , �' � ��., ' i � _� ,
<br /> SIGNATURE , REGISTERED Y./.N 1� '• - FEE_CURRE� '' Y/N.--::',
<br /> Address ' � __License.# � :., - - ° .
<br /> ,i�
<br /> MECHANICAL' �/ " � COMPANY �%3ffI,�S f. � !�N�,,��¢"�!i�r/��
<br /> SIGNATURE 'L-eZ REGISTERED Y./.N . , FeE cuw�e�� . . Y L N,
<br /> Address ����I l(e/� I 'Z-�I�LLS !'�.33 /' . License# �/�`GQ�1�����7 .
<br /> OTHER '�` ' � � ..CO,MPANY - �
<br /> SIGNATURE -' � •• � � ~ �` REGISTERED Y/ N... �FEE CURRE� Y/N
<br /> Address - - " � ' � License#
<br /> a-•.- . :. . ... ; . , .
<br /> RESIDENTIAL';;� .;Attacfi'(2),�Plot�.P,lans;�(2)sets�ofBuilding�Plan's;'(1)'sefof�Energy�Foirns;R=aW Permitfdrnewconstruction,
<br /> , � .;Minfmumaten;(1.0);worlcing;cfays:aftera"submittal'date.°=Required onsife;.Constrtiction=Rlans;Stormwater Plans w/SIIt Fence installed, _ _
<br /> ��, -`Sanitary Facflitles�8�l:,dumpster.Slte Work:Permit for subdiVisio�s/iarge:projects. .'-- �: , ° . -`- - _ -
<br /> COMMERCIAL Attach(3)complete'sets ofBuilding Plaris pl'us a L'ife'Safety Page;(1)set of Enargy FoRns.R-O-W Permit for new consUuction.
<br /> Minimum ten(10)wrorking days after submitNal date. Requ(red onsite,Construction Plans,Stormwater Plans w/Silt Fence fnstelled,
<br /> Sanitary Facllides&1 dumpster.Site Work Permit for all newtprojects:.All commercial requirements,must meet compllance �
<br /> SIGN PERMIT Attacfi`(2)'set§of Englneer,edcPlans:',� - � '= � „ �
<br /> •'••PROPERTY SURVEY reguired for all.NEW constructfon.._
<br /> Dlrectlons: �.- � �
<br /> FIII out applicadon completely.
<br /> Owner&Contractor slgn back of appl(catlon,notarized
<br /> If over 52500,a Notice of Commencement Is requlred. (A/C upgrades over 57500)
<br /> .i a 'A- �-,..r-..,rFa,:.�'x.,i4�:,,;'<_. ';
<br /> Agent.(for the�i:ontractor)'or Power of Attiomey�(for tlie owner):would be someone with`notarized lette�=from°oinmet autfioriiin�saine r, ,� ��,
<br /> .�_.,,::.��.,..._-= _ ." � , , . . - • �-- � - - f
<br /> �VERTHE COUNTER PERMITTING -=. (FronEof�Application Only):,i��.., �, - � ,; • � , '�' " s,�
<br /> Reroofs If shingles Sewers, � Service.Upgrades��ALC. �,:�ences(PIoNSurvey/Footage) `� �, �.. , , , � �,_ �;r, -� ` °� � r _
<br /> __ p.. ; , ..� '� 'c:' ' ".r-;;1�.�'t'{j:+ �,'? r"°.' °1 'f. _�� , � „ . . , ' _ _ _ g? .- ..�
<br /> Drivewaya-Not over Counter if on public roadways:aQeds ROVV'�:;�'-; - N% .. , , ,� '••'� '`'` f`y
<br /> :,� . �,1'. .. ::ii'� , .. �.:Y�rt�p ' �.:i�itli��� � ,' .: ... ._- : -<_ -..— .. ':�r.r�.e,n.si�+:i
<br /> ���aqt+,`'• :.�m�r •t9;�-,;�ti'n ,.'t`.c:3:.��23M''ki-r�y'v�t'r^C�°`;�"°,va �_'�-"�
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