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a�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> _ - - • Building Department �_ '7_��
<br /> Date Received (�
<br /> Phone Contact for Permitting �� d a — ���
<br /> Owner's Name e�l�/�f Lie C� Owrner Phone Number ��� ��� " TTS
<br /> Owner's Address ��/ �� Q, � Owner Phone Number
<br /> Fee Simple Titleholder fdame Owner Phone Number �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��D � L+LJ � Ud G� !7/L� LOT# �
<br /> SUBDIVISION PARCEL ID# / v� �I �/�� ��DDD ���d
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR� 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 0 STEEL Q
<br /> DESCRIPTION OF WORK L� �� L� �/v � "" �L� T�/v �!� �/C
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br />� OBUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> �ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $
<br /> '1J MECHANICAL $ �� j� D� VALUATION OF MECHANICAL INSTALLATION
<br /> Lp .
<br /> OGAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N I
<br /> Address License# '�
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Cicense# r
<br /> PLUMBER. CON1PANY
<br /> SIGFVATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br /> , Address License#
<br /> MECHANICAL p��' � ` CONiPANY ��}N/a S �� I�-/��C� ��L`- �
<br /> SIGNATURE ��""`'� REGISTERED Y L N FEE CURRE� Y/N ,
<br /> Aild�ess � `7"�' � � , G'/�7�/ ! License.# � L!J T� /�
<br /> OTHER COMFANY
<br /> SIGNATURE � � RE�ISTeReo Y/.N FEE CURRE�' Y/N
<br /> Address - License#
<br /> RESIDENTIAL. Attach(2).Plot Rlans;(2)=sets of'Building�Plans;(1)'sefof'Energy Forms;R,O-W Permit foc new construction,
<br /> �- Minimum.,ten;(10)working.iiays aftersubrriittal date. Required onsite;Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities.&•1 dumpster;Site Work Permit for subdivisionsAarge projects
<br /> COMMERCIAL Attach(2)complefe sets of BuilBing 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,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> i 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 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. (A/C upgrades over$7500)
<br /> "" Agent(forthesco�t��otor:j,�orPov����of,Attpmey;(for,=t4e,�wner•)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUN�ER PERMITTING� "�`�� �(copy,of contraef required) `'�`�""�"''�'�``'"'�`'`�`�'""`�"`�"�`'�S""`��`�
<br /> Reroofsifshingles+`' .� `Sewers'`'`. � ; � s.:;�"c�r';� Ah;'d.sY? ,.,�,.` :,.•
<br />'� ,, _ 'Se'rvice�Upgrades.�A/C ; Fences(PIoUSurvey/Footage � , �y„�;'•.
<br /> '•,�i�; .`? ii�� .,:i. �. ;,�•�" i �;.�� • ' et•1iUa'�IL'.3F4i�.�i-Jiitili`i`!C1::Y .�/.=.:+,y+.:
<br /> , . ... �. ' .,.. . . ..,.t. 4;�i N ,,H-, i. ,.. �i'
<br />' Drivewa s-N � •�r� z v �.,.., . :, , ,�+i ;m �' .. ,,, , � �::• +.; ",.~ �
<br /> y 'ov�r��Counfer if on pukilic��oadways.. eeds ROW ���'� ��jL 1,�`��''` +� �"'' �� .`�' �
<br /> ,� �t .� :,;n,,,, � �,;� .f;;: , �,, . E, .,,,,,.
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<br />'i nz ���..r��.,rn: �.f;::,., �°:s� • �' ;;�_:_�-,.
<br />� $�}'z"��aa�y`"�ts`�`otmw�'�1's"`n';'ym�r`i'tiR',�i'"a`;Sa �1 �,�,. ,,,v�;V.;r�:'C r�a..�In;;i' �'`^"f'� �i�:i.�,'''.
<br /> � . „ 11.�i� Ct,.u�r�
<br /> 1='�'�'"...'.i-`�'s'�"e�'°a�-iF"'"-�'
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