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s�saso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � • � Building Department
<br /> A Date Recelved
<br /> Phone Contactfor Permitting —
<br /> Owner's Name T � Owner Phone Plumber , �t�3�loZ3"71 y
<br /> � Owner's Address J'� `L� ��+� �X • Owner Phone Number
<br /> r Fee Simple Titleholder.Name � w. i� Owner Phone Number
<br /> ? Fee Simple Titleholder Address� 'S'�L� ��" �` � n,l.�� �����N�
<br />' ;�
<br /> � JOB ADDRESS �`S L �1� �• LOT# �.
<br /> t
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<br /> f
<br /> � SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> � WORK PROPOSED > NEW CONSTR ADD/AL Q SIGN Q � Q DEMOLISH
<br /> B, INSTALL g REPAIR -
<br /> PROP.,OSED.USE � ' SFR Q COMM Q OTHER : - -
<br /> TYPE'OF CONSTRUCTION Q BLOCK - �'r FRAME 0 STEEL Q • �
<br />�, .. . �
<br /> DESCRIPTION OF WORK � �I • 170oSLS �- � W��S•
<br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT ;. �
<br /> , QBUILDING $ +p,�J�� VALUATION'OF TOTAL CONSTRUCTION
<br /> �K/r
<br /> i QELECTRICAL $ AMP SERVICE Q - PROGRESS ENERGY Q W.R.E.C.
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<br /> � QPLUMBING $ I� ��� / �G. 'S I/G�'J�ili
<br /> . . �, '`�` "+rv�JCi'� i�� `-/' �� l�j� }1
<br /> � , (� r
<br /> C QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �jll% 7"�� ` ��` ��
<br /> ; , �,,���,.�ti;�y S�2i c� (.!� /dY� 'I
<br /> ? ,[�:GAS Q ROOFING Q SPECIALTY Q OTHER � ,}�Gl���.
<br /> ; JS���.�"Gr�
<br /> f FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ,.[ �7����,
<br /> ; - �(i
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<br /> { BiJILDER -- � / � �C�MPAPIY - �t� �"L-P�P� --- : - - ----
<br /> � SIGNATURE REGISTERED Y' N FEE CURRE� Y%N
<br /> � Address "License# -
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<br /> � ELECTRI,GIAN ; COMPANY�
<br /> � .. SIGNATURE REGISTERED Y/ N ' FEE CURREA Y/N
<br /> � �aadress �i��se# ° '
<br /> � `":.k.".,
<br /> ( P.LUMBER:; . �COMPANY' ,
<br /> SIGNATURE ��isrEttEo Y•/'N.[ FEE CURRE� Y/N
<br /> i ' _ _
<br /> � ..
<br /> j .. Address Licerise#
<br />, i ;' MECHANICAI_ � COMPANY;
<br /> i SIGNATURE" REGISTERED • � Y/.N- , FEE•CURRE� , .' Y/N -
<br /> � Addre"ss:�~-� � � A - � L-icense_#
<br /> i ;�,;s�.,, - �
<br /> j �� OTHER=� ":��- '�; • � COMPANY
<br /> � �"SIGNATURE:?.�_�:: .�� - -� - � ^ � - � REGISTERED � . Y/.N- FEECURREK Y/N
<br /> � - �.; .,,= , . , i:- - . .. ,
<br /> � � Address�-.� >.,:.;� ,:<;;; - � - .° • , . - License#
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<br /> "'-"RESID.�N'TIAL s;:; �AttacFi:(2):PIot;Plans;�(2)�sefs�o'f.Building Plans;,(1�)'set ofEne�gy'Form.§;'R=O-W,Pe�Rnit,foi new,constiuction,_� _ _
<br />_ _;..� ,� . .._ ss
<br /> � ��-::MinimumF:ten,(,1Q)^w,o.rking3.days;afte�>submittal:tlate."aRequired onsite;"'Gonstr'iiotion`Plans;Stormwater Plans w/Silt Fence.installed,
<br /> � ��b...:��:-l:i��:: '.. . ' . .'A. . . > >
<br /> � Sanifa.:ry,`;Faciltti,es;i8xl�,dumpster;vSite:Work_B.ermitfor.subdivisions/large;projects� � � ` - � � �
<br /> �A�COMI�ERCIAL Attacti�(2)`compleCe'sets'of'Building Pfans plus a Life 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,ConsVuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � :;;;:_ , Sanftary Facilities&1 dumpster._Site Work Permit fo��all-new projects.All commercial requirements must meet compliance
<br /> f �;�<SIGN;PERMIT "AttacFi(2)sets:of:aE�gineered�Plans:�t= �:,°- ` -. •
<br /> 1 �;�:;:,, "**PROPERTY SURVEY requlred,for,.aILNEW_construction..-
<br /> � Y���_ -- . _ _
<br /> ; �.'Directlons: ...��;�=�r- , .. , _ �
<br /> �P �Fill:out application completely. I
<br /> _ O.wner"&Contra+ctor-sign.back ofapplication,notarized
<br /> �If over$2500;a Notice�of Commencement is required. (AIC upgrades over$7500) .
<br /> � ,�.•r-.
<br /> "" AgenY(for'fHe'contFa6toi')or�P.ower ofiAttomey-(f'or°tFie ou`vne�)virould'tie someone with notarized letter ftom owner authorizing same
<br /> , ;;''.OVER�,THE�COUNTER�PERMITTING,.. ,. .(copy_ofhcontract�.required) ' l �� - "
<br /> :=Reroofs if sfiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) .
<br /> ! D�Iveways-Not over Counter if on public roadways..neetls ROW '
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