:;-. - s�'3aso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> = Building Department
<br /> Date Received ' gl?, �8� _ �' �
<br /> Phone Contact for Permitting
<br /> Owner's Name U �� ��" � 6 Owner Phone Number ��J ^ /�� y�L
<br /> Owner'sAddress � �� f l���1�, ��-b(,S � `. OwnerPhone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS l��-33 ���t��. (/�5 �p�� LOT# �
<br /> SUBDIVISION �L�U�� A-KS PARCELID# (13 �l� �I l/`crYs Ow�� �� �
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED - e NEW CONSTR B ADD/ALT 0 SIGN Q � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM � OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK • Q FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK �� I� � (.r � e'o T��e S �r� P, a � �t�'
<br /> BUIL'DING SIZE SQ FOOTAGE HEIGHT
<br /> �BUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> �PLUMBING $ j .
<br /> �ECHANICAL $ -+ VALUATION OF MECHANICAL INSTALLATION �/�
<br /> .� 9Do, oa Z
<br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER ,
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
<br /> ��
<br /> BUILDER COMPANY �
<br /> SIGIdATURE REGISTERED Y/ N FEE CURREt� Y/N
<br /> Address License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N
<br /> � Address Cicense# � � �
<br /> PLUM BER COIM PANY
<br /> SIGNATURE REGISTERED Y=/ 'N FEE CURRE� Y/N
<br /> Address ' License#•
<br /> MECHANICAL j�,��� ����� , COMPANY �} �S ��e[sf/`�t�C � (�
<br /> SIGNATURE �'���� �41 � ' "` REGISTERED . ; Y/ N FEE CURRE�- Y/N
<br /> Address `7`"�� �'7��G License.# ��✓/�-�! �v�
<br /> OTHER•� "''� COMPANY
<br /> SIGNATURE• � - tiE�isTERe� Y./_N FEE CURRE�' Y/N
<br /> Address - ' , � ' License#
<br /> RESIDENTIAL_ Attach-(2)=Plot Flans;=(2)�sets of'Building�Plans;;(1)'set ofEnergy'F,orms;'R-.O-W P.errriit for new construction,
<br /> •� , �;•. --Minimum:ten;(10)wo�king`.iJays after:submittal-clafe. Required�onsite;Constniction Plans,Stormwater Plans w/Silt Fence installed,
<br /> ' - ` �Sanitary;Facilities,&�1:.dumpster;.Site.Work Perrriit for�sulidivisionsAarge projects� � - �
<br /> _ .COMMERCIAL Attach�(2)`complefe sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> - Minimum ten(10)working days after submittal date. _Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> . Sanitary Facilities&1 dumpster..Site Work Permit for all new projects.All commercial reGuirements must meet compliance - --
<br /> -SIGN PERMIT Attach(2)sets of;Engineered Plans.•
<br /> ****PROPERTY SURVEY required for.all.NEW construction.
<br /> "Directions: �- .• -,
<br /> Fill out application completely.
<br /> Owner&�Contractor sign.back of application,notarized
<br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500)
<br /> " Agent(for th`e contractor)o�,Power�,of,�A�o�g,ey,(f9s th&��eYp�ou(�b*�''s'omeone with notarizeddettectfiA�p�p,►�,t��e�[,�ytho�izi���arr�e�,�__`�zy^
<br /> �<,��c„ . •",,':1,,%� ..,:...,�, .j1a � ,.l..:a���;='; , < �'I�'ii �� r?.
<br /> �.:OVER�THE COUNTER_PERMI7TING •� � "(copy of contract-required):-•- �- � � - ;;
<br /> ' Reroofs if shingles Sewers.� '��'Service'Upgrades`A/C� _ Fences'(Plot/Survey/Footage) �; r" ' � � � ` ' •- .� �
<br /> � , ;;' _ - � . ;7 ,$ �� ,
<br /> Drlveways-Not over Count�if on putilic�'r'oadways:,needs.ROW;�; ,,�' � � '' ' - _-
<br /> � ,,.�;:, �,.i�DG:�:;;,�+,�., . - . �� � � :��r.r,�;;;;;;,, ,,�,,;t. ,W��n� e �,�o� ''�,�.,,.�-• �:,
<br /> �.�'i*':NY���+1 t�"`�' -.i4.. ...)"t��•-��Y����E:n�:�f... �Q��'r'"c^'�.R�`!Va".W'ny y�,��_.31�y� y.���
<br /> y�vS,L: �'�' �49� Ai.i'b"A'S�'A.g%]:��
<br />
|