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<br /> 813-780-0020 City of Zephyrhills.Permit Application Fax-813-780-0021
<br /> •• � Building Department
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<br /> Date Received ` 2 .
<br /> � �� ,.�% Phone Conta'ct for Permitting ; �� J• `�, ` "� -_ ������.
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<br /> Owner's Name ����(C �j /1/ � L Owner PFione•Nur'r�ber-' . - � ��+��� d �
<br /> Owner's Address ���� 1 C L�'S C��� Owner Phone Number'�`� ������ .�+-
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<br /> ee Sim'1�Titleh�l��r Nam� Own�r�h�n�NumY�r i
<br /> Fee Simple Titleholder Addcess ���� B� � .. ',
<br /> JOB ADDRESS � ' ✓✓ � " /t �SC �j OI�-K S (A� �q C�'� LOT# ��U� p ��..."�
<br /> SUBDIVISION PARCEL ID#
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B ., NEW CONSTR ADD%ALT Q SIGN Q � Q DEMOLISH
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<br /> REPAIR
<br /> ' PROP.,OSED USE [� SFR Q COMM Q OTHER . ^C9 /� G`� _
<br /> TfPE�'OF CONS7RUCTION Q BLOCK � Q FRAME � STEEL Q ,
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<br /> DESCRIPTIOPI OF WORK � G �� ��� � �`QG I
<br /> BUILDING'SIZE � � l SQ FOOTAGE -�� • HEIGHT � ''��
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<br /> �BUILDING $ �t DU VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ ' � � �� -
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<br /> QMECHANICAL $ VALUATION OF MECHAPVICAL INSTALLATION
<br /> Q,GAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> ���e�-�v� �='��LG� �`
<br /> BUILDER COMPANY ��l��' �Ur�,�� . ���`� �G''�lG��,� p
<br /> SIGNATURE � 7 9 ^ e REGISTERED Y�! N FEE CURRE�. Y/N
<br /> Address � Cieense#
<br /> _ 'ELEC7'�ftI,CIAN COMPANY ' '
<br /> SIGNATURE REGISTERED Y/ N � �Fee CUR�tEn Y/N.
<br /> � Address - License# ''�
<br /> f:;��� .. -
<br /> PLUMBER.,... - � � COMPANY � -
<br /> •�SIGNATUR�t ' �REGISTERED Y•/ N� �FEE CURRE� Y/N
<br /> Address �-License# .
<br /> - =��� � :
<br /> MECHANICAL` ' COfliIPANY -
<br /> 31GNATURE'' ' REGISTERED Y/ N - ' FEE CURRE� Y/N :
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<br /> Ad"dre`ss��= - � - Llcens.e.# -
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<br /> +.,OTHER<�.':��'" � � COMPANY
<br /> "�"�SIGNATURE�?q- � .° ` �� � REGISTERED Y/.N . �_ FEE CURREK Y/N
<br /> �i4�; � ., - " .
<br /> �Aaa�ess�-�• ;;•� - --- � - License# �
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<br /> :'�v;`� . , ;.. . . _�_ . _ . . � .. . �
<br /> i.:;'.RESIDENTI,'AL<;:���Attac6;;(2):�PIot:Plans;�;(2•);:'set`s•of�Building=Rlans'(1)`set of�Energy Forms;R=;O=VV Permit',for new.construction, , -
<br /> =•, , a rs
<br /> =Mmimum�tem(;10.)'working;days'after subinittal:d'ate:�Required onsite;�Construction�Plans,`Stortnwater Plans w/Silt Fence.installed,
<br /> "._ f..,.-Ct.. a,-�' ' ' y � . �. ,x
<br /> �� . Sanifary„Facilides4&��1ti.dumpste.r.•;,Site,Work Permitfori§ubdivisions/large.pro�ect"s • �
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<br /> �;::COMMERCIAL Attacfr{2)�co�riiplete sets of'B`uilding Plans plus aVLife Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> - Santtary Facilities&1 dumpster.Site.Work Permit"fo�all-neuv�piojects.All commercial requirements must meet compliance
<br /> <y�:.SIGN'PERMIT 'Attaoh(2)`sets:qf;Engineered Flans:��� y�� , - � - •�
<br /> l�-���- " "***PROPERTY SURVEY required for.all.NEW construction:- -
<br /> :°v:� _ .. � . �
<br />' r�;Dl�ections: :,,.,n„;-.,::.,,.�;, ,:
<br /> - "�` '�Fill%out application completely.
<br />' '- 'Owner"&�Contractorsign back of application,notarized "
<br /> � -1f oVer$2500;.a Notice:of`Commencement is required. (A!C upgrades over$7500) „ , _ . �
<br /> :''*:'"' .Agent`(for'�th'e'contractor)�or�Power�of'Attomey'(for'tFie owner)would tie someone with notarized letter ftom owner authorizing same
<br /> <;<OVER�.THE COUN7'ER'PERMIl'TING.. .- .(copy.of-.contract-.required) ` ��'`' � - "
<br />' �"Reroofs;if sliingles Sewers Serolce Upgrades A/C Fences(Plot/Suroey/Footage)
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<br /> D�iveways-Not over Counter if on.public'roadways..needs ROW -
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