a�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department
<br /> '�Date Received •,Phone Contact for Permitting �Z�7 t� -- �J J S
<br /> Owner's Name �J�L� N/��fJ K��G/N C/� � wner �hon�Number .
<br /> Owner's Address � � � S���� � �`� � �� � Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address.
<br /> JOB ADDRESS S I � � SV M- +�^-l� � '�t � L—L-- u� LOT# � \
<br /> SUBDIVISION U�✓v`�� PARCEL ID# Z '�b' Z� � � l a O ' C��o a� � � � �
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED B ' W TALLSTR B �PAIR � SIGN Q Q DEMOLISH
<br /> PROP.,OSED USE Q SFR Q COMM � OTHER �
<br /> TYPE'OF CONSTRUCTION Q BLOCK - Q FRAME Q STEEL Q
<br /> /ti�r n -
<br /> DESCRIPTION OF WORK �9 ��� ��' N K��-�G�M���
<br /> L � �r tJ/
<br /> BUIL"DING SIZE �E � C b HEIGHT •
<br /> QBUILDING $ (� j `Z VALUATION'OF TOTAL CONSTRUCTION
<br /> I
<br /> QEI:ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY �P�-�— ��N ��
<br /> SIGNATURE REGISTERED Y`/ N FEE CURRE� Y/N
<br /> Address �.3 D��--51�.7�1�. 5�1 License#
<br /> 'ELECTRICIAN COM PANY
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> Address - License# '
<br /> PLUMBER,._ COMPANY � '
<br /> �-'SIGNATURE REGISTERED Y•/ N ` - FEE CURRE� Y/N
<br /> Address , License#`
<br /> .'.MECHANICAL � COMPANY
<br /> SIGNATURE`"' � � REGISTERED , Y/ N , FEE CURRE� , . Y/N -
<br /> Addre'ss`�' � ' � License.#
<br /> .;�.; :, , - .
<br /> ,: OTHER�.=_': ' " � COMPANY
<br /> `"SIGNATURE�,, � ° ' REGISTERED ` . Y/.N FEE CURREK Y/N
<br /> �.', y. , '
<br /> , �Address�:- • - � � License#
<br /> ='=.RESIDENTIAL;,�;. .Attacfi.y(2);PIot=P..lans;�`(2):sets of Building�Plans;(1)'set of�Energy'Forriis;R=0=1N Permit for new.const'ruction,�
<br /> - : .. , ::, ;: . . •
<br /> �.;. ��,:•;�;�:>.�r,.--�Minimum:tern(,10)-working;tlays'after:su6mittal�iiate:;Required`on§ite;Constniction Plans,Stormu"vater Plans w/Silt Fence installed,
<br /> :�;__,' �r �� i� ��Sanita.ry;Facilitiesz&=.1+.dumpster;Sife:Wor,ir Permit for,subdivisionsQarge'project"s � � �
<br /> r;:COMMERGIAL Attach'(2)`�complete sets of'Building�Plans plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new consUvction. _
<br /> '�- - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes&1 dumpster.,Site Work Pertnit fo�all new pinjects.All commercial requirements.must meet compliance �
<br /> �.:;.SIGN"PERMIT Attach�(2)sets.of-,Engineered.;Flans:��a ,-� ,_�
<br /> ""•"PROPERTY SURVEY required fo[.aII:NEW construction: , ,
<br /> _�Directions: . �:><r ,- _ _ _ . , . . ,.
<br /> �Fill::out application completely.
<br /> O.wnet.&Contra�tor sign back of appllcation,notarized
<br /> If over.$2500,a.Notlbe of Commencement is required. (AIC upgrades over$7500)
<br /> :"' Agent(fo�-th'e�cont�actor)�or PowerofAttomey(for ttie owrier)would be someone with notarized letter from owner authorizing same
<br /> ;,',OVER.THE;COUNTER;PERMITTING, (copy..of contract-.required) = -
<br /> �:.�=Reroofs if•sfiingles Sewers Service Upgrades A/C Fences(FIoUSurvey/Footage)
<br /> Drlveways-Not over Counter-if on-public=roadways:aneeds•�ROW=�����-•-•�
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