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a�aaso-oozo City of Zephyrhills Permit Application FaX-a�aaeo-ooz�
<br /> - Building Department
<br /> � -�
<br /> Date Received Phone Contact for Permitting � �� — ����
<br /> Owner's Name �C� �u� Owner Phone Number ��3- ��a"�
<br /> Owner's Address �� C�JP//1� �\ -�//Gf.� Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �/p/ �, LOT# �
<br /> SUBDIVISION 'YGLG Q LClPa PARCEL ID#
<br /> (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> B INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM 0 OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK �e-r..�'s � (j ° `f J'�J e�-dLL.� TO/1� � l�am d��111
<br /> BUIL'DING SIZE SQ FOOTAGE HEIGHT
<br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br />, OPLUMBING $
<br /> �MECHANICAL $ ��I,3�/_, � VALUATION OF MECHANICAL INSTALLATION ��
<br /> .�7. 7 �` J,
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER %��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
<br />, BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Cicense# �
<br />' PLUMBER, COMPANY '
<br /> SIGNATURE REGISTERED Y�/ N ' FEE CURRE� ' Y/N
<br /> Address -� License#•
<br /> MECHANICAL ��� `�7����� COMPANY H-�/�S G'����5 t �/G ���
<br /> SIGNATURE REGISTERED , � Y/ N FEE CURRE�. Y/N
<br /> Add�ess � 7' . ��eiJ ZGC� License_#� ��� ����p
<br />' OTHER•� • ' COMPANY .
<br /> SIGNATURE-:, ' REGISTERED , Y/.N-. . FEE CURRE�' Y/N
<br /> Address� ' , - - License#
<br /> , RESIDENTIAL � i4ttach(2):Plof Plans;(2)�sets of�Building Plans;(1)`set of Energy Forms;R-0-W,P.emiit.for new:construction,
<br /> - .. ,, Minimum�;ten;(10)working;days aftersubrriittal�date. Required'onsite;Constniction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary Facilities 8�1�.dumpster;Site Work Permit for subdivisions/large projects -
<br /> -.COIVIMERCIAL Attach`(2)corriplete sets of Buildirig Plans plus a Life 3afety 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 fo�all new projects.All commercial requirements must meet compliance
<br /> ; SIGN PERMIT Attach(2)sets of;Engineered Plans. �
<br /> � "'*PROPERTY SURVEY required for.aII.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) ' j
<br /> �a '.f,..
<br /> Agent(for the contractor)or�Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same ,
<br /> OVER THE COUNTER PEl'tM "'�""�4��������v�e
<br /> " tT'fi�ICr�'�'�.'�'��j3y"o�"cof�tra`�r�'dqiFed) �"F�"�"'""�` ,,,��
<br /> Reroofs ifshin les '� Sewers�`�`"'��' F'Ser'vi�e U ra ' :.��'�y���h P���'e��t�'' .�` =•p..�
<br /> g � pg des'�A%C�.,, ;��Fences(Plot/Survey/Footage) ., .f,r•,;t ,; �s �
<br /> S, Gui;O•'t iL�,!r�`�{ ?;i:lypr� ,g���y�� -tv��-� L_ � FJi�i:�I!TC S!6i� _ 'i:;;V . - �.- �', e
<br /> Driveways-N ~ ��� �. _ p .y =. + � ''`�'�'p r , � •z;< ;r,,,.., .,�,� .i r':�:_; ,:t,a
<br /> o�;overC`o'unfer`if o'n''ulili�`Foadways;;.r�e¢s;R W - ��•��: ` ,�.``,�9; .� ,;l�,r,.;`
<br /> !.'4(i.i: ��i ;y iu���-b•it71t�;V� r,,�.,� Dt:'•;rEil i3 # r:0�2.^.ir.tit?r� .'�.:_a•�,S•:.�
<br /> '� � . '�:.y�yf'1; t`�•` :¢ �rfe,.'q',:'y
<br /> �: ..q. .�,j,� p n��'%��4hrt ' •li����'
<br /> f.4 .�� t1�.�Jia i11�1�:p!�:��1.�i�j�i���lp�::h���i�rIa��i. :.�•�i���iyi�:����-y���� 314�ia'�1E�i:�:1.��{��t�!�3'�Li. . .,i�l
<br /> �r".v.7+��1'N,y.. '6_ l3+'—�"�L�_'e�.'"��_''r� �
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