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s�saao-oo2o City of Zephyrhills Permit Application Fau-813-780-0021
<br /> -- Building Department
<br /> Date�Re`ceivec� I�j ��� _ 3 ��
<br /> Phone Contact for Permitting , •
<br /> Owner's Name C�.�'�� /�7!�U/ �7���'n. � Owner Phone Number
<br /> Owner's Address Owner Phone Number �
<br /> Fee Simple Titleholder.Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �O_✓ l( � �� LOT# �
<br /> SUBDIVISION PARCEL ID# t � '1=U�� — (/O!(/ � ��O � �-'�/��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � ,. NEW CONSTR ADD/ALT �C� SIGN Q Q DEMOLISH
<br /> e INSTALL e REPAIR
<br /> PROP.,OSED USE Q SFR Q COMM Q OTHER .
<br /> TYPE"OF CONSTRUCTION Q BLOCK •• Q FRAME Q STEEL Q "
<br /> DESCRIPTIOId OF WORK � . OZ, �� � � �
<br /> BUILDING=SIZE SQ FOOTAGE� HEIGHT •
<br /> OBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> �LECTRICAL $ AMP SERVICE Q PROGRESS'ENERGY Q W.R.E.C.
<br /> . . .
<br /> QPLUMBING $
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> -BUILDER COAlIPA1dY
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br /> Address �License#
<br /> _. ... _ r' i �� Gy`
<br /> ELECTRI,CI.AN r: ;' • COMPANY �
<br /> �SIGNATURE REGISTERED ^ Y/ N-`� FEE'CURRE� /
<br /> _ . .�
<br /> n.�,, Q<
<br /> Address� '�' � � License:#' G° (�[v��� (/
<br /> , .
<br /> PLUMBER.;;_, COMPANY-�, � � � '
<br /> -SIGNAl'URE � -���sTEReo ; � .Y.•/'N.;- � FEE CURRE� Y/N
<br /> Ad'dress ,•L(cense#� :
<br /> `�".MECHi4NICAL� � COiNPANY
<br /> �- , , . _
<br /> ';":SIGNATURE''-`` ' `' '` ' ' - REGISTERED ; Y./.N. a FEE CURRE� Y/N � _ �
<br /> �� S�:E" . , . '
<br /> Ad'dress��' �' � � ' � " Licens,e.# —1� �
<br /> '-4',��C. ._. ... . - - . - . .. . � � '
<br /> �
<br /> -�OTHER:.:;;".} „'� ' � . � � �COMPANY
<br /> �;'::SIGNATURE:-:,-i� .� _ � � �, ��REGISTERED Y/ N. - �FEE CURREK Y/N.�- :
<br /> - .._r;'.:;,,N�:,.,;_,:<' � _:s� ,. : .� .- ' - - >-. . , � � � � - _
<br /> - •�Address.�- _ - - .:��- - ' � -� � - _ . License# -
<br /> _ '' - pR�,�:;�;' _ ._. __ , , ., . ,. ,
<br /> �D = - , .
<br /> ARESI ENTIAL'� A� FFf'
<br /> . , �„ �_. ttacfi'`,2 ot'P.lans;-'�,2 sefs�of.'Buildin '�Rlans;;1��`set of'Ene�� ;For'ms;°R;O;VU-Permit.for new.construcUon;. _ , -
<br /> -- � . . ,�) �,.) _ ,9 �,).:^.., r9Y., - - _ - .
<br /> \�;, , - ,�,:,•.:f._`-� 'aMinimum:ten;�1U...woikin;da s:afte�su6mittal:date:"Re uired`onsite;.Constniction Plans;Sformwa'ter'Plans w/�SiltFence:installed,
<br /> . .r. . .y> � ,.) 9 _X q .a, ,
<br /> : - , . r . " - ` - -
<br /> - Sar�i �Facili i s•' ,�-1 d 'm 'Si e:VV P .
<br /> ta� te ,&�� u ster� t �. o[k. ermit:for4subiiivisionsllar e` r`o'ects`� � � „
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<br /> ;�>,COMMERGIAL 'Attaah:(2)xomplete;sets of:Building.,Plans:plus�a Li'fe S,afety,Fage;.(1)set of Energy;Forms.�R-O=.W Permit:for new constniction.; '
<br /> _"�`tt_;, Mlnimum.ten.(10)'w'o�king days;after:submittal d.a,te:�.Required onsite,.Cqnstiuction Plans;�Stormwaten'Plans w/.Silt Fence-in'stalled,. ; . - �-,
<br /> . ,.� ., ,
<br /> �;_ ' _ - -•San(tary�Facilities:���1'.dumpste"r:�;Site;VVork.P.emiit:fo�!all=new;projeots.i411:commerciaLrequirements:mu§t;meet compllance �
<br /> �:=:SIGN�.PERMIT� -:'Atfaoh�(2)sets'of•;Engineered.P;lans::�';..�,.:�����- � , . ' � ,� • - - ,
<br /> �'� " � �°""PROPERTY SURVEY;�equi�ed.fo'r:aII�.NEW'construction... - _ , , . " --
<br /> _ - - - �$ - -- =
<br /> .-Dlrections: � .. . �•. - .:,d�,;:: . ' , � . . ' . � . :_ ,.
<br /> " �Fill:out'aPPlication�.completely:.`,,-,_ ,'.� �, - ..� � ,
<br /> ,;: � . , .-
<br /> Ouuner&�Contra�to�'sign.tia'ck:ofiapplication,.notarized- � " ',,;� � '
<br /> � ; , If over$2500;.a Notice:of,Commencement is-required.�°(AlGupgrades;over"$7500) = -
<br /> �'"N t.1'.::....,��i"..::� .. . ' . -� '_'. . .- ;.. .. � .. . -..' `y..,'�,_
<br /> ,Agent�(for`;Fi'e'cont�actor)�.or:Powertof'Attorney(for�ttie owneh),would�tie someone.with:notariiediletterfrom ownerauthorizing same
<br /> t.�OVER:>THE COUNTER;.P:,,ERAAII'TING.'._., ,(copy,of-contract�,requireii):;�� ' �`� � • � -
<br /> -"�=Re�oofs if stiingles: . �"Sewers � ,;_:Senrlce',Upgrade"s.'.�A1C" �Fences;.(PIoUSurvey/Footage),� " - '�
<br /> : ,� �; . ....:�.':=w'r.-....,�a.d.`.._:_oas:.::..:w-...•-�:u�:.:b..'��:l,.i:j:. �-�-. , . . . _ - "_ . .�
<br /> � ,Drlveways-NofoverCounter-�ifion:pUblic�roadways.;n'eedsROW:,. ' ,
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