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813-780-0020 City of Zephyrhills Permit Appiication Fax 813=780-0021
<br /> � Building Department
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<br /> Date Received Phone Goataat for Permitting - �r � �d' � -- ��" �-
<br /> � • ,.—
<br /> Owrner's Name � /C"+= i�i�} L- / Owner Phone Number
<br /> Owner's Address � . �f S/{ V I r �� �- Owner�Phone Number �� �
<br /> Fee Simple Titleholder Name � � Owner Phane Number � �
<br /> Fee Simple Titleholder Address
<br /> JOB�1DDRESS � � S�/7 1��/ G� �� L07# L,�
<br /> Sl3BDIVISiOT1 �^-- � PARCEI.ID# �� " �G'r <'../.— t?�t G?r- C>tJ�C?G3.- a/� Cy
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � ., NHuv CONSTR 8 ADDlALT [� SiGN "[� Q DEMOLISH
<br /> INSTAI.I. REPAIR
<br /> FR4POSED USE Q � 8FR � COMM � _ OTHER ,
<br /> TYPE�'OF CONSTRUCTION Q BLOCK - Q FRi4ME 0 ST.EEL Q �
<br /> � "` �� t . _
<br /> DESGRIPTIQN OF WORK �C�-'''�� � �o � �� �
<br /> � ' �- � SQ FOOTAGE �
<br /> BUILDING SIZE �___��� HEIGHT • �
<br /> � .6 ������� �
<br /> �BUtLDING $� O� � ,.-,� VALUATIOtV�tOF T<1TAL CQNSTFtUCTiON
<br /> ��
<br /> ..QELECTRICA� $ AMP SERVICE Q PFtt3GRESS ERfERGY Q W.E2.E.G.
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<br /> �P«����� C� � � ����
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<br /> QMECHANICAL � � VALUATION OF MECHANICAL INSTAILATiON I�� -j�-L� f
<br /> �1 I
<br /> QGAB � ROOF{iVG [,� SPECIA�T.Y � Ol'HEl2 ,
<br /> FINISHED FLOOR EI.EVATIONS FLOOD ZONE AREA QYES NO ����� ����1'
<br /> •BUtLDER j ) • COMPANY /�� 8 —" � �
<br /> SIGNATURE /'"`✓ REGISTERED Y' N FEE GURRE� Y N
<br /> Address "License# � �
<br /> ,`ELEG,T;Ri,G,IAN _, COMPANY
<br /> SIGNATURE REGISTEREQ Y/ N FEE CURRE� Y/N.
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<br /> � Ad'dres�� - License# �Y �
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<br /> - PLUMBER.,,, ^ GOMPANY= ' '
<br /> 'SIGNATURE [REGISTERED Y-/'N= - -.FEE CURRE� Y/N •
<br /> � .- ..,,.,
<br /> Address �� License#-�� ��
<br /> ,'.MECHANICAi;. ' , COMPANY -
<br /> s' 'SiGNATUR�'�' ' � ' REGISTERED ; Y/ N - • FEE CURRE� . Y/N =
<br /> Addre'ss��` ' ' License.# � �
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<br /> _.or����,.�:--:: �. ., � ' c.dr��a�ir
<br /> �:'SIGNA�'URE 3.+;�::< ,� " " REGISTERED Y/ N . FEE CURREK , Y/N
<br /> 5 �►ddress;r , . �� ,�� , , .` , � License# � �
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<br /> `';�RESID.ENTIAL.;�:.: Atta,ch�;(2)�PIofAP.tans;':(2)�'s"ets�of;Buildirig�Plans;(1�)`set of�Ene�gYrForms;,R=Ow�(tt.Peimit for new.constructiori,
<br /> -,:�.,i,=;�:h;r��-;-„Nlinlmum�:ken�(;10)working""cJays'-,aftersutimittalodater,'Require8='orisite;ConsVuction Plans,�Stoimwater Plans wr/Siit�Fence installed, - -
<br /> >�' ;4..:.:.;}...: , ....� ��, :a.,-,...��r:. - �:p. �: : ,
<br /> �>�.,;<,�., � SanitarygF,,acili�es�&�1_;.dumpster„Site;}Wortc Peittiik for.-,subdivisianstlarge;:praJeets ..-`.'� �� � _ ,
<br /> �,::.COMMER61i4t, Aftacfi��2)�aomplete sets of�Builiiing�Pians ptus a I.ife Safery Page;(1 j set of Energy Fartns.R-O-W Permit f6r new construction.
<br /> �'' -° � Minimum fen:(10)working days after submittal date. Required ansite,ConsVucUon Plans,Storrnwater Plans w/Silt Fence installed,.
<br /> •`*�� ° Sanita F
<br /> . .. . .
<br /> hti,v; ,., ry .aatifies&1 dumpster..Site Work Permit for�all new prbjects.AI!commercial requirements.must mee#comp{3ance
<br /> •::$IGt�_rP:ERMIT "Atfacti(2)sets>of;Engineered�Plans:�s�' . �•- - • � '
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<br /> `.���-F;�:;� *""*PROPERTY SUR\/�Y required for,aO,NEW canstrucUon. _ _, , , ,
<br /> ..DiFecfSons: ,µ:,;:�. .. -.,.. - -
<br /> ew!�:=f Ftll;.out,application completely.}�3� ,
<br /> , Owner'&Coritractor slgn'tiaak af�appticatian,notarized
<br /> �"' `If over$2500,a Notice:af:Commencement is required. (AIC upgrades over$7500)
<br /> °` �.�,.-� - - -�
<br /> �''*'-: .�Agen#�(f6t'#h�e contiactor)ror.PowerofAttomey{f6ftlie'tiwner)wouid be sameone with notarized letter from owner authoriz'sng same
<br /> ;���OVER;THE�COUNTER;PER,MITTING.� ..-- ..(copy�of-contract required)�" '` � "
<br /> ;,�"�Refoofs•if stiingles Sewers Servlce Upgrades A/C Fences{Plot/SurveylFootage)
<br /> qriveways-Not over Counter if on public�roadways..needs ROW
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