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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> •� Building Department
<br /> y�_ -
<br /> Date Receiv&d ��� �y�� _ (�I$a,�,
<br /> Phone Contact for Permitting.�•
<br /> Owner's Name �Y L��v�� ��►v'� ��� Owner Phone Number �0 3 V g�.� "� ��'7
<br /> Owner'sAddress 3 ���b � ��` ��)�N4'��I� �> OwnerPhoneNumber
<br /> Fee Simple Titleholder Name Ouvner Phone Number
<br /> Fee Simple Titleholder Address
<br />' JOB ADDRESS 3 l�� �p A� �.�, I�►. i�'1•S,�I, c3 v� 7 0Z LOT# �
<br /> SUBDIVISION PARCEL ID# " �'�o� "����d�C7Jd� ����
<br /> � (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED .. NEW CONSTR e ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> INSTALL °REPAIR
<br /> PROP,OSED USE SFR Q COMM Q OTHER .
<br /> TYPE`OF CONSTRUCTION BLOCK •- Q FRAME . 0 STEEL Q
<br /> • ti� n
<br /> DESCRIPTION OF WORK I�O�1� O Vi' 2- � S�S 1 �� S��j��/ �S �/l j� �y'�' -
<br /> BUILDING SIZE SQ FOOTAGE :/'7� . � �6�HEIGHT •
<br /> QBUILDING $ j� �S'5���� VALUATION`OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q FROGRESS ENERGY Q W.R.E,C.
<br /> QPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIOfV � j, l � L � `� �
<br /> 1�r
<br /> �
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOP.ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY d�'� �W N�C��
<br /> SIGNATURE ' �� n REGISTERED Y'/ N FEE CURRE� Y/N
<br /> Address License#
<br /> d• :. ' ;
<br />' ELECTRI,CIAN :: COMPANY
<br /> I SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Address License# � �"
<br /> ,F, �
<br /> PCUMBER.;..� • . CO{VIPAfdY� � � ' '
<br /> •SIGNA. .j--`--d -; ,
<br /> TURE �a���sTEReo :° Y/ N =.� � ,FEE CURRE� � Y/N ' �
<br /> Address - L(cense#�
<br /> - :MECHi4NICAL� � � - COMP,ANY
<br /> �"SIGNATURE'=`� � ^`�: � " ' REGISTERED , Y/ N. ,;, FEE CURRE� Y/N � �
<br /> Address�:: ' . ' � ' , " ' . License.# -��'�-
<br /> rt,,ii�b,t:° - , .
<br /> `;.OTHER'� "''.: �� � � �COMPANIY _-
<br /> :`=SIGNATURE�r:':; .� - ' - - �� , ' -REGISTERED Y./N FEE CURRE�' Y/N= . - ' .
<br /> ,. ;.Add'ress�::,._,. .,-. .-. - ' ..�-.;: ., ..... � _ � - License'# .. ,- , - • -
<br /> �F _ . - _
<br /> _:'RESIDENTIAL:�:, Attapfi.°(2);Plot�'Plans;=(2)>sefs;of�Building�,Plans;`.(1-)°set of.Energy;Form"s;;R;0-V11:Perriiit.for new.constructlon;.: . �� _
<br /> " - -::-<Minlmum,=ten;(,10).wor`_king;days after�sutimittal�date:<`Repuired onsite;'Con'stniction�Plan's;�Stormu"vater:Plans w/Silt Fence lnstalled;. �
<br /> '�r- - ' ..�- :. :-. _ .
<br /> "' • - -Sanita,ry.-Facilities,&,;,1�,dumpste�;Site;lNorlc Permit:for:sulidivisions/large"Projects:�._� - ' . • - - � _ -- �
<br /> _ ' ,..: _ ' "'.'.. � .
<br /> ='�:COMMERGIAL Attach`'(2)�complete"sets:of`Building:Plans.�plus a Life°Safety Page;.(1)set of Energy Forms�R-0-W Permit.for.neinr consVuc4ion: - -
<br /> „ ,- , - .Minimum.ten:(10)wo�king,:days after submittal date, Required onsitie,.Cons.Uuction.Plans;�Stormwatec Plans-wL Silt Fence installed,; ; .
<br /> � . � � : �= Sanftary Facilities 81'dumpste�._Site.Wo�k;Rerrriit:fo���all-new,p�ojeots.All,commercial�'�equirements:must meet;compliance. � '
<br /> '�+.``SIGN`PERMIT � --Aftach"(2)_sets.of;Engineered.,Plans.•r�:.:� � - _ .- . " � , - - ` " ' `
<br /> - � . � '' `'""PROPERTY•SURVEY requi�ed,for„aII�.NE .W.'constructlon:.. , � •-= _ , - , ' � - �
<br /> ;Directlons: ` , . ", .. ,. '. _ . ., -
<br /> ,�' FilboutapplicaUon completely:�" - - . y
<br /> ,. . Owne�:8�ConVactorsign�back of;application,notarized-; � " � , _ .
<br /> � ''If;over,$2500,aiNotice:of:Commencement is required.,;(A/C upgrades-over,$7500)` ;
<br /> �.�•,p:�.:���
<br /> ��" AgenY(fortfie•contractor);or:Fower:of.Attomey:�(for"-�tFie-owner)would'6e someone.with;notariied letterfrom;owner.authorizing:same
<br /> ,. _._ , ,
<br /> �;:OVER..THE.COUNTER;PE.RM,IT,•TING��.'"�' ''(coPYof contracf;regui�ed); :;`' ' '� '"' � ' - - ; .. . .. . � .-. --�-- -` ,
<br /> .:;Reroofs if shtngles Sewers�� -- 'Servige�Upgrades;,�A%C', Fences(PIoUSurvey/Footage) � ��'� � ' � "
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<br /> � - � Driveinrays-Nofoye�Counte�:if:oniqublic.:roadways:.n'eeiis�ROW � � � ,. ' - • � �
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