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813-7d90-0020 City of Zephyrhills Permit A plication Fax 813-780-0021
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<br /> Bull�tng� �"'�°
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<br /> Date Rec �.�1G t d�S i.rd.i . r_ a t�si. =•`���''��q.c• ,�� t 4' �`tr.
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<br /> Own�r'a ,� �
<br /> Owner's Address •���� G2� 1 ��/I GL!'✓- ' Owner Phone.Number '
<br /> Fee Simple Tltlelioldec Name �— • Owrner Phone Numbe�
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<br /> Fee Simple Titl�hoider Addresa _ F �
<br /> JOB ADDRESS �/'T� (� � � �^' l�..LS . LOT.# �
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<br /> - ;_ (OBTAINED F.ROM.PROPERTY,TAXNOTICE)
<br /> WORK PROPOSED A�NEW:CpNSTR . ADD/AI:T Q� SIGN' 'Q � Q DEMOLISH
<br /> „. ;e; �INSTALL � _.� REPAIR '
<br /> PROPOSED?USE , � Q SFR. []. 'COMM' . Q OTHER �
<br /> TYPE OF CONSTRUCTION• �-� Q� "'BLOCK ' Q FRAME � '� �STEEL 'Q
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<br /> DESCRIPTION OF WORK' - 1���'1D �� �LZL(_° � TDI�I � �f� �� 2- �-° �%11�jr
<br /> BUILDING`SIZE�' � � � , 'SQ FOOTAGE�: ,_ _ HEIGHT$
<br /> OBUILDING � VALUATION�OF�TOTAL CONS7RUCTION � �
<br /> QELECTRIGAL $ : � AMP SERVICE; �Q �'PROGRESS ENERGY Q W:R.E.C.
<br /> QPLUMBING_ � $ ' ' `
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<br /> QMECHANIGAL $' ����f ` VALOATION OF;MECHANICpL INSTACLATION.,. , ��
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<br /> QGAS Q ROOFING �Q; ,,; SPECIALTY;:Q;• :-OTNER��; : � -_
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QY�S. NO
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<br /> BUILDER COMPANY" °� ' ` `:,°'' ` • ` _ , ` . -
<br /> SIGNATURE REGISTERED Y/ N . '�"EeE cuR��=` ' ' Y/N` '
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<br /> Addrea� •;�, t..... • .. �.� _ ;Llcense:#: `s: ' "
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<br /> ELECTRICI�IPI; . � . . . - - >�COMPANY' " :-:.. '4: �.,:: =t� ,;��.;`. �-';. '• - - '
<br /> SIGNATURE � REGISTERED Y/ N F.EE CURREt�4�` � :�Y/-N
<br /> Address� .� • � " � ' � .. y,. ...LI_cense:#�:. � .'
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<br /> PLUMBER' , ' _ C.OMPANY ,..,.��, A'. ,a .� .�..,'._� .- : .
<br /> SIGNATURE'"�'` �� � �"REGIS.TERED Y.L,•N,s'� .-FEE CURREk,� , .Y/N:.;: , `
<br /> Address _ � , . - 5. •r: ' - , . _ ,
<br /> . ,:License�#
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<br /> MECHANICAL�-`� � - - � coenPi►rnr ��.�i9-lfi2 `5.�o,ol�n1��5.�` �—` �
<br /> SI(3NATURE� � REGISTERED Y.:/. N �e cur�En„ `Y.I�N
<br /> Addreas;�='_._ L�!/' �'.C�- �. .Z" %LG6- `.�� � 'License,#� ::��17�,3 !�p .
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<br /> OTHER .. ., :.- .,: _ • . < . ; ;4� , -_,.;.,.,. _k ; - _ ' ..:.�.-'; ' >. . - •
<br /> +s ,CQMPANY
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<br /> SIGNATURE�: ..�3; �.� ''`: �P� ,, _ ��`` ''a - � ' :REGISTERED • , , Y/ I�F�.,,: _y .j�e'CURitE�:• Y'/N
<br /> Address�-r_ ` ; „' .,... ,.-... ..- ; _r,- .._ . ._. #� .:. ... _' ^ .,Licerise#�� " ` - - `
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<br /> RESIDENTIAL�;- �Attaqli'(2)dPlot�Plans;:(2)s"ets=�of�Balldfng':Plans;?('1)set'of<EnergyForms;frR="O=W�Permlffo�new�oonstrucfion,. _.
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<br /> �•Y y Minimum�.ten,;(10)�v+roriiing�days;after'subm�ttal'date:4Required onsife;Constcuctlon?Plans;�StormwaterPlans�w/SIIt Fence instelled,
<br /> "'"" - - "`�"�SaMtary�adlftles,�&sl�dumpster��8lte°Worfc�Permit-fcr�subdiVislons/leTge�pro]eofsy"���`:^,;:�< " ' ,
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<br /> COiYIMERC1Al. Attach(3)-i;omple�e sets'of Bullding`Plans plus a Ufe Safe(y�Page;(1)set of Energy Forms.R-O-W�Permit fcr neW:construction. '-
<br /> Minimum ten(10)woricing days after submlthal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence Installed,
<br /> - Sanitary Facllitles 81 dumpster.Site Work Permit for all new.proJ�cts::All commerGal.re,qul[ements,must meet campllance
<br /> -SIGN PERMIT AttacFi"(2)"sets of"Engineer.ed�Plans:r:_•�:�:: . . .. . a•-_ - ' '
<br /> ""PROPERTY SURVEY required for all N�W_constructlon.,. ' �
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<br /> Dl�ec`tlons: _.,s•�,.j_--., , -. _ � - - - , �_�
<br /> Ftll out applicaHon completely: ___ _ _ - -- -�"
<br /> Owner 8 Contractor slgn back of appltcatlon,n`otarized �
<br /> If over 5�500,,a,Notice.of Commencement Is required. (AIC upgrades over$7500) ;: ' .
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<br /> qgent(for Uie oontractor)"or Powe�of Attomey(to�the owinerj�would be someone with notarized letter from owner authorizing same
<br /> _ .p!lFQt TFlE.COIlN.T.ER:PERMITI'ING-..-_---:-(FronRof-ApPlication�Only)- ---,_' , `. ;,. .: _ _, -
<br /> Reroofs if shingles Sewers -Service Upgrades A/C Faaces(PIot�Survey/Footaga)_ __ __ __ - -�-—- _
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<br /> Drivewaya-Not over Counter if on publfc roadways:.needs ROW � ' _
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