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s�saso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 `
<br /> �--�� � -�- �� Building Department
<br /> Date Received � � � �/� phone Contact for Permitting -` , .�� �C� — � ��
<br /> Owner's tdame ld Owner Phone Number U ' �.� '7
<br /> Owner's Address � r�r1TGi� G(' T• Owner Phone Number
<br /> Fee Simple Titleholder Name Owne�Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISION i�// O� PARCEL:ID# �J 7 � 02 Q� � C�v d �
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED ,. NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> B INSTALL B REPAIR
<br /> PROP.,OSED USE � Q- SFR Q COMM [� OTHER !/
<br /> TYPE'OF CONSTRUCTION Q BLOCK •- Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK ^ � � �itPiG 1 / e �'L �
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> `F�
<br /> QBUILDING $ VALUATION°OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ \
<br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �\�
<br /> � S /d � o� �.
<br /> Q.GAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZOiVE AREA QYES NO
<br /> BUILDER COMPAPIY
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� 1'/N. •
<br /> Address License#
<br /> ,..
<br /> ELECTRICIAN .; COMPANY
<br /> - SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Address` � �� - License#' �
<br /> �1 j,_�.r ' . _;
<br /> PLUMBE,R.,, , COMPANY.-__'" . ' _.
<br /> �SIGNP�TURE,�, , _ REGISTERED ; Y.•/`N t� ":FEE CURRE�� " Y/N �
<br /> Ad'dress � License#` - �
<br /> ..- : .`;a� .:' ` - ' . .
<br /> MECHANICAL' . . COMPANY ��i / G
<br /> - -� _ / TERED N - �� FEE CURRE� � ' N ' ' - ^
<br /> �'SIGNATURE�'A REGIS, ,
<br /> �',�;'_;.. � /J
<br /> Add're'ss-' '�. ; � L-icens,e.# f�''�.������ .
<br /> . .r;'�{M:�r, _, . - . . . � -
<br /> ,�;:=OTHER�=:'>..,., ;; _ .. - . . . � � - COM,PANY _ � , ,,_ - ,
<br /> `,SIGNATURE:i's;:3' � ' �� � - REGISTERED� .Y./:N: FEE CURREK , Y./N' - i .,
<br /> . .Address._�- - . . .. ' ..�., • , ,... � ' � Cicense:# ' : .., : ...
<br /> - -r. - �s•� �.rt ' � `��+4::'i. - . _ � - � _ _ . .�'r-
<br /> �'�' �.� ' - .Forms•'R-0=1N<Ferinit-fo'r new.construction;; � - :- -� -
<br /> ?�RESIDENTIAL;.;;:;Attachr,(2);Flot Plans;;;(2):"sets�of�Buildfrig�l?lans;;(1�)°set:of�Energy, , ,..r.:. .
<br /> :j `- � ��r-��:�.�-:M'nlmum:•.tem.�1U,:wiorkin"`da:s;after:submittal:date:'Required°'ons'ite;-'Construotion;Plan's;`Storrnwafer .Plans;w/Silt,Fenceinstalled, .
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<br /> ':�•.'', '+4�.�,.+.;�✓ini'.. ... . ._ ,. ,_.F ,- , , —
<br /> _ - -_ ; _ Sanitary�Facilities�8�;^1,,du,'mpste.r:;Sifg;Wo[k�.Permit:for,§ubdivisions/la.rge.projects:�..�'-•�=_ ,- : - :
<br /> �%;.COMMERCIAL'n Attach�(2)complete sets"of Building Plans'plus a�L'ife Safety Page;,(1)set of:Energy Fonns.R=O=W Permit:for:new�constniction.'`• .
<br /> •� � ��,Minimum ten,(10),'working,days after sutimittal date. Required onsiCe,-Constriiqtion Plans,:StormvuaterRlans w/.Silt Fence installed,.
<br /> :.j.:_, ,' � ' � `�Sanita.ry,Facilitles 8��1.du'mpstei.:Site,Work.,Permit:for all=new projects.All,commercial reguirements.must meet`compliance '
<br /> , :SIGN,PERMIT '"�Atfach=(2)sets of�:Engineered;Plans.`�� ,��. _ =�-• �'�•` - _ ,
<br /> ; ��� . .�� ` -"'""PROBERTYSUR�/EY;regui�ed;for.all;NEW-construotlon:. � � . ��• ;t � : -
<br /> :<<:'+_Directlons: . - . .,...,v_- _.. . ' ., . : - , .. _ . . . . ,, . ' -
<br /> - ' FIII_ouYapplicatiorrcompletely.y-. . ;`. �-' ,':' ,,:
<br /> , Ouirner&Contra�tor sign back:of.application,notariied: . '.s,.. -�,,,; ,, , .. ' ` �
<br /> -.��"If over$2500,a Notice-:of-Commencement:is required.' (NG,upg�ades.over$7500) -;_,-,, , ; _
<br /> �"`" 'Agent'(for th'e�cont�actor)`orPowerof.Attomey..(foc'tFie owrier)would ti,e•someone�with notarized.letterftom ownerauthorizing-same
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<br /> ;�°OVER;THE�COUNTER PERM,ITT'ING '.. .,`(copy of.-contract=,required)�,'�,`�'� ``:=' , �' - �
<br /> ;�.��Reroofs if:shingles, ' ' ;Sewers., �"- �:,Seniice Upgrades:AIC 'F.ences_(Plot/Survey/Footage) , ;
<br /> � . =Drivewa is-Nof�ove�.Counterifon�publiq�r6advv�y"s::ti��8s"�ROW.�=�-�.�� � ,�- .-, ....- � „,-�.=.•. -__u�- _.__.:._.. .� ' y
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