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81.3-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ^' ' Building Department
<br /> '� -�.. '"�
<br /> Date Received � •Z2 �. � � phone Contact for Permitting � — S�1�
<br /> Owner's Name q' TNi �P.i � Owner Phone Number ^I�i-[ � S �7
<br /> Owner's Address � / Owner Phone Number
<br /> Fee Simple Titleholder Name `jqV��yF- �'/�iG��, �� Owner Phone Number
<br /> Fee Simple Titleholder Address ��.'f 3 � � �h
<br /> JOB ADDRESS � � � �� LOT# ' G 9�0
<br /> SUBDIVISION PARCEL ID# �l`2�i 'Z 1'O(�/�0'' �3 700"0070 Cqroc�Q9/o /
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED e . NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER _
<br /> TYPE':OF CONSTRUCTION Q BLOCK �• Q FRAME � STEEL Q
<br /> . " -�
<br /> DESCRIPTION OF WORK y► �i h �p��C��i 2,5 Yrc,.r- ��y�H 0�.S
<br /> . ' �1
<br /> BUILDING SIZE i'�� SQ FOO GE Z�d � , HEIGHT �.
<br /> �,- .
<br /> QBUILDING S ����I�
<br /> � �' ALUATION'OF TOTAL CONSTRIJCTION
<br /> QELECTRICAL (�i�``� ^,' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> _ � _
<br /> OPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ` � �
<br /> ���� �
<br /> QGAS Q ROOFING �
<br /> Q SPECIALTY Q OTHER �J,�'�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA OXES NO � �., ;'
<br /> i�
<br /> BUILDER COIIflPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address -License,#
<br /> ELECTRI.CIAN - COMPANY �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Address . License# �
<br /> F ' ' �
<br /> PCUMB,ER.,_ COMPAIdY :
<br /> SIGNATURE REGISTERED Y/'N � •� :FEE CURRE� Y/N
<br /> . Address. � License#� :
<br /> - MECHi4NICAi:' � , COMPANY -
<br /> SIGNATURE" � REGIS�TERED , Y/.N, � FEE�CURRE� .` Y/N -
<br /> ; .,
<br /> Add�ess- � � Licens.e#
<br /> ,:;f�:;�-� - � . .
<br /> . O'fHER° :'�:,= � � ���� COMPANY � � i� G . ��']G ��I G
<br /> � �
<br />_ ;'�SIGNA7'UREu� s:= -�'C/.�G�i�"' ,,,�p��� ' REGISTERED /.N.. FEE CURREK v ,. Y/N
<br /> — -- .Aaa�ess. ._ .J•S�Sor�t.�=�eNi1 v�Yu1- - - --- - ------ .- - -;;�c�;�a�= C-'�C--/-3-2 =- -/-9 _-
<br /> .. ,�. ._ . � ... . �.. ' - . . .�.�.,,.�.., . . .
<br /> �;=>'RESID,ENTIAL�^•:. :Attacfit:(2):PIot�Plans;`((2)':sefs-of�Building'Flans;_(1�)`set'of�Energy.Forms;,R=O=W Permit,fornew.construction,. .
<br /> <•�;,�-:.c.�. -:Minimum;ten,(1Q)working;days afte��submittal•date. Required`on§ite;'Cori`striiction Plans;'Stormvirater Plans w/Silt Fence installed,
<br /> �•..-.�,,,..; ... -. ,
<br /> �y:-.. Sanitary;FaciNties,&�t,1;,�,dumpster;SiteiWor,k P.ermiYfor;subdivisionsflarge:projects ' '
<br /> ,°;c;COMMERCIAL Attach`(2)_complete'sets of'Building Plans plus�a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> � Mlnimum ten(10)working_days after submittal date. Required onsife,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> `�` Sanitary�Facilities 8 1 dumpster,.Site Work'Permit"fo�•�all•new projects.All commercial requirements must meet compliance
<br /> 'r".SIGN PERMIT �Attach(2)sets of;Engineered Plans.�� � �
<br /> � ""'PROPERTY SURVEY required for aII.NEW.construction. , `
<br /> �x.
<br /> °�:Directions: +::;,_;.;_.�,
<br /> `� ` ��Fill out application completely. -
<br /> ; Ovirner�B�Contraotor sign back of applicaGon,notarized �
<br /> If over$2500,.a Notice.of Comm�ncement_is requlred. .(AIC upgrades over$7500)
<br /> ,. "' Agent(fo�'the�cont�actor:)•orPower�of'Attomey(for'ttie owrier•)would tie someone with notarized letter from owner authorizing same
<br /> �,OV'.ER:THE-COUNTER;:PERMITTING,�� � �_;,(copy-of,contragt•,required) � �
<br /> �:1Reroofs if sliingles Sewers ' Service Upgrades A/C.,,,. Fences(Plot/Survey/Footage)
<br /> Driveways=Not over Counter if.on public roadways.:needs ROW
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