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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> - Building Department
<br /> Date Received ' O�— -� �C.3 �O � _ ,j�l3
<br /> Phone Contact for Permitting
<br /> Owner's Name �ueGC'�.��` . (iL. � Owner Phone Number O��"" /�7 '"D
<br /> Owner's Address %�.3� ��� �u G'�!/�l Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Mumber
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �J �(/ OLL�� � IJ� Z-�IGC��✓- LOT# �
<br /> SUBDIVISION PARCEL ID# � "� �� �� D/CU� L�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR� ADD/ALT 0 SIGN Q 0 DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP.OSED USE 0 SFR Q COMM 0 OTHER
<br /> TYPE OF CONSTRUCTIOId 0 BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK �7�� ��� �7l �./ C%/� � � e `�U '��/��(`eS� LI�H��l7e
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT
<br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $
<br /> OMECHANICAL $ �D VALUATION OF MECHANICAL INSTALLATION r�����`� ` �
<br /> �9 0 �D
<br /> ' GAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
<br /> BUILDER COAAPAMY
<br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN COiVf PAfdY
<br /> SIGPIATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> �lddress Cicense# s
<br /> PLUMBER COMPANY
<br /> SIGNQ,TURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Add�ess L•icense#-
<br /> OTHER• " iy,";,,,,,o ^" f l�y.d-�/l�h� COMPANY JAN/�S /`D y/1I� 5 �7��jL' .T/1✓�°.'�
<br /> SIGNATURE-. ��`"`�����` � ���"
<br /> REGISTERED Y/.N . FEE CURRE�' Y/N
<br /> Address T'�'� � G � �/'7/�ls � ��S�f License# �� �
<br /> RESIDENTIAL Attach(2)Plot'Plans;(2)�sets of Building Plans;(1)set of Energy Fbrms;R,O-W Permit for new construction,
<br /> , �Minimum ten_(10)working�.days after.submittal date. Required onsite,Construction Plans,Stormwater Plans w/S'ilt Fence installed,
<br /> - Sanitary Facilities.&1 dumpster;Site Work Permit for subd'ivisions/large projects �
<br /> COMMERCIAL Attach(2)'complete sets of Builiiirig Plans�plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> ' Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities 8�1 dumpster.Site Work Permit for all new projects.All commercial requirements 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)or Power of Attomey(for�the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER4REF�MfTGfP1Gn��L(c�fpy*of�°c�ntractrequiF�ii) ��''�G=�:''':'R�""�"R'�"`'�""'�B"°��'"�'
<br /> s �;Sewers r, �;:S�rvid��U�P9 - ,., tt 46 .,;^,,.:•,.i w;
<br /> Reroofs if shingle � ""�� � �ences(PIoUSurvey g ) =':�''y,+;�6°'} ',r4 �_ , ",�;-;i ' �
<br /> , } rades;`A%C;�<;' /Foota e �, , ,; �, - „':
<br /> �; s 4ii�,��'f��� :i :-� � � t:'1 r iut(.�� :' laa1 1,~ . '•^. �1 v:1:�11:- . . '1! i�[fi 'S, � .+h�
<br /> Driveways-Not ove�Gou 6r s• : t •s" ' ' ��c: ��i f�:L'•.��;. � ;a�'„" ,fi' j�},:,•,� ���•
<br /> nti ifion�pUtilic'r'oadway��he�ejs RO.Vkf ,, , �;,,*,�, `�
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<br /> � �P;e:,tl, h�'i�;n! .�7'�!C'�q'^1 ;r;S�7��4 ��'r:ej�:�"�� �{i ^�a:;� i�� ;f�.r�...r�i'p�o.. r.on,- ' :'.n�' �
<br /> S?� '�7Ni�'t,�'°'3�.�T4L°%�iF�"`-��'+� `d�'�c��'�y'ax�tu.s,�`-�'�'3.'�c e'r�;,-:.�°=d'o x'•��'�`+�•Y:,
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