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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �' Building Department
<br /> Date ReceiYad � -Phone Contact for Permitting -� � `1 - Z, cj' �
<br /> Owner's Name e G�. Owner Phone Number �l 3- 7 S8 - 3Q C2S �
<br /> Owner's Address '� ,. z- � ( � Owner Phone Number
<br /> Fee Simple Titleholder Nam � � (�(,� O�niner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS r�c. �h J'7". Z�2 � /� i�� F�- 3 3Sy 2 LOT# � � �
<br /> SUBDIVISION PARCEL ID# +� �� Z- � - 2� " �O �� " ��� �Q - � �� �
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED ,. NEW CONSTR ADD%ALT 0 SIGN Q � Q DEMOLISH
<br /> B ,INSTALL B REPAIR
<br /> PROP,OSED USE . Q SFR Q COMM 0 OTHER
<br /> TYPE"OF CONSTRUCTION Q BLOCK •• � FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK ��1l,OQt P Q-1��1 1 r a`I lUn '��USS �2Oa. � �
<br /> UA � � t -
<br /> BUILDING'SIZE SQ FOOTAGE : � I I 1iJ HEIGHT � l �
<br />� OBUILDING $ r 5 a o o VALUATION°OF TOTAL CONSTRUCTION
<br />� QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> ,. . '
<br /> QPLUMBING $
<br /> . ���� ��
<br /> , QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QXES NO
<br /> BUILDER �� � COMPANY �Tv�`����� �������t `�'��'��T lr L
<br /> SIGNATURE �' �' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address , �� �V �v..''� �P-n �License# `C'1 �-�S���t 3
<br /> ,:7 �
<br /> ELEC'iRICIAN -, COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE'CURRE� Y/N
<br /> Address License# '
<br /> PLURABEjR;: . . COMPANY- ; _ � '
<br /> -'SIGNAT.URE _ -REGISTERED Y-/ Ni ` , FEE CURRE� Y/.N
<br /> Address. - License#" .
<br /> � '.MECHANICAI: � COMPANY
<br /> -' ,SIGNATURE'''' ? '' � - � ' ' � REGISTERED , Y/ N FEE CURRE� Y�/N
<br /> ABdress=`° ' � � � � License.#
<br /> ib`:Sr_ " : � .. . . . .- _ , ' '
<br />, '- :OTHER�� ", `, , , • , ' - ` - - C;OMPANY ' ,
<br /> �`:$IGNATURE�a;:'� ,�� - ' � � =-REGISTERED Y/ N- � FEE CURREK Y/_N ' . _
<br /> .. �,,, . .. � . ._ .. . .
<br /> � Address:�;. _ :;�• ,,; ,.}.��a:,. :�.;_ .. , ,_,. . , . License# - , , "•: , I
<br /> ; , ,
<br /> =RESIDENTIAL.; Atta"cFi:�,(2)iRlof;Plans;�:(2)=sefsof�Building�Plans;u(1�)°sefofnEnergy;For'ms;:R;O=VV;Pertnit•.for new.construction;.�- � '
<br /> - .' ' �..p�,sti�a^-�-.Minlmum;:tem(:1,0)wo,r.king;daysafte�;su6mittal:date:.°Reguireii'onsite;:Constriiction'Plans;:Stormu'vater'Plansw/�Silt,Fence.installed, ,
<br /> :. - - ,•_,, .
<br /> �,�.. '�' ' Sanitary;Facilities;&��1�.du''m ster;Site„Work�P..,ermit:foc`§ubdivisions�arge;projects��. - - ` �� ' � ' � � -
<br /> . . . ..�;, . . p '�;.`.:. ,: ° . ' :• ;', �' ':..
<br /> ;�:COMMERGIAL'� - Attach�(2)�complete"sets+of;Builcling:Plans.�plus a Life,Safery Page;(.1):set of:Energy:Fomis:.R-O=W�Permit.for_new construction:
<br /> -, ' Minimum ten�(10)'working-da'y,s,after:submittal date..Required onsite;:Gonstruction Plan's,',:Stormwater Plans w/Silt Fence;installed,
<br /> � - ' -� ' Sanitary Facilitles&'1'dumpste�.Site:Work,Permit:fo�;all new,p�ojects..i411:commercial.requir"ements must�meet compliance � ,
<br /> '� SIGN.PERMIT AttacFi�(2)'setsof,EngineeredFlans.<<. �, = ' '" � � ' - - - - _
<br /> -- , - '' "•°*PROPERTY SURVEY,�equlred foc aIf.NEW construofion.� "- � • , _ �
<br /> � 'Diiections: � - • . - _ . , , - _ , :. • ' .. - , . -
<br /> • , Ftll out application`.completely:-. : � - ���,.�,- .
<br /> , Ownec&Contractor sign back of•.application,notarized-, -- " . - , �'
<br /> � If'over$2500,a.Notice of_Commencement is required:',;(ALC upgrades;over$7500)�' �; . � _
<br /> :'": .Agent.(for`tlie�cont�aotor)�or�Power`of'Attortiey.(for'tFie�owner)would�tie�someone with notarized.letter from owner authorizing.same
<br /> ;-OVER.THE'COUNTER'PE.RMITTING. '..,..' (cop'y.8f contraqt-required):"-�. ' " � �- '�
<br /> �Reroofs,if'shingles: , Seuvers, _ �Ser•v�ce.Upgrades�,.A/G: 'Fences(Plot/S ro�ye /F�o�q�, � ' �
<br /> .,t Y^..��.. .." _'''�.��r;i?'�J.:.,..w,r:s-•�•,:.-: _.�;.:'�{ :.:_�� �.,•"��..'^ ;•.� _ .. .KI i11'IIII�� ��
<br /> ; � Drlveways-Not'oyer`Counter if�on.public rnadways needs'ROW,� - � ' - J3�E��l�.1U'G tius?A� ' -'=•v�, f
<br /> i;�,1. :ti 4I�:t S•1+� ��, l _ . � ,,`�;.' ��
<br /> . � `.. - , � nl,ltOli�p�lgr?- .;i's'.I�:�1.y*y;.i(161 1�''.a.'�:��`�^'
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