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813-780-0020 . • City of Zephyrhills Permit Application Fax-813-780-0021
<br /> , . > Buiiding Depa�tment /� /_ -j_
<br /> , � N u��C''�'�re V�G!I"����-(„�' �`f'7G�"F?�//`1r CC't/Y7
<br /> Date Received � �G phone Contact for Permi#ing --
<br /> '"1�r1"f��-i-lf�i-
<br /> Owner's Name r-. �G� � r-,. � Owner Fhone Number ���. �. �!�+Q
<br /> Owner"s Address �a6�a���e �-� �'�^ �✓` ��,�y�✓Jc„�� ,��Owner Phohe Number � �
<br /> Fee Simple Titleholder Name � 3�,-►-�. � � Owner Phone Number �— �
<br /> 1 .
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �CO � �'j �,G�!^!�tl Gt- �C f� � (� C LOT# � L
<br /> SUBDIVISION �J l�( �-�''+=('� �Ca PARCEI.ID# �tlr�'�r�� ���'�d ' ��jd�— �! j �
<br /> (OBTAINEO FAOM PROPERTV TAX NOTICE)
<br /> WORK PR�POSED �(VEW CONSTR e ADD/AL.T � SIGN � � DEM4LISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE �� SFR Q COMM � OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL �
<br /> DESCRIPTION OF WORK Y>Ct� 5��/Y'j��'�'�t'"�-� �, �'�''S����..�",/�C+G ��.°'ca� b�-'�"� a��-�`
<br /> BUILDING SIZE �^ � SQ FOOTAGE ��(� /s'�,��i�I�HT � �
<br /> rrrrrrr�rrr-rr�-r�-rrrtn-rT�rrr rr� -
<br /> �BUILDING �f/ �QG� VALUATION OF TOTAL CONSTRUGTION
<br /> � B�O� , AMP SERVICE � PRC3GRESS ENERGY � W R.E.C.
<br /> ELECTRICAL $ �
<br /> ........ .—� ��' � .
<br /> �PLUMBING ��/,�� ���
<br /> � ...... �J �
<br /> �MECHANICAL $ � ���� VALUATION OF MECHANICAL lNSTALLATION �/,t
<br /> �GAS � RdOF(NG 0 SPECIAL.TY � OTHER
<br /> FINISHED F�OOR E�EVATIONS l� , �� FLOOd ZONE AREA OYES NO
<br /> �:f•-f-hi-�1-i-�t--#-�t-�t.-E-f--1-•1•-f--6-1-�I--i--1-1-�1--4.F-1--1-4-i�-1-�t-i-�H-1-1--i-1-F-f-1-1--f-1-�-i�-' • • • • • • • • • • • 1-�1-1-�
<br /> BUILDER � "��� ��� COMPANY ��� - ��G��'^ �I�"�
<br /> SIGNATURE "��- REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ����rr��'C'��Cc�!+'� �%'r"' �+�"'� �~ License# �`-'T��-���'� �' � _
<br /> ELECTRICIAN /��� .� � COMPANY ��� J�YiOr"!5Q!'� ��'�C�f+ �.
<br /> SIGNATURE � "'°�� RE(315TERED Y/ N FEE CURREA Y/N
<br /> Address t�3 U� S k� M�'Cr I��G�"' �" License# ����C.�� �� '
<br /> PLUMBER ,,,�� COMPANY ��'rn �r�-�`�� fi �-�p"a'�..� � .
<br /> SIGNATURE � � � REGISTEREp Y/.N FEE CURREA Y/N
<br /> —._.. �
<br /> Address 'l'l y fp �C',x` �.�() � �v� G�6L , License# l/�C ��2�d��
<br /> MECHANICAL �?�,�'�,,.., COMPANY I' Y`D T�"'Sc� 3 �� M'�f`�� S'�`�•'�'y f
<br /> SIGNATURE REY3ISTEREp Y/ N FEE CURREA Y/N
<br /> Address ��Jt,�� �S�je��'�`. �prl-r'���-�"� License# VY1"'C��3(�?IG�`7 �
<br /> OTHER ��„��,,,,�_� �COMPA�NY� �I Y��Cir'��e c�Ren �Y/N
<br /> SIGNATURE �_
<br /> Address [B�� f �1�' .��`" ��.-� � License# �,(..� Q�� � � f �
<br /> 1111lt11iti1tt1lltllifl [ Ilii [ 11 [ 111111l11 [ Itllliltil [ 111 / ! ! I ! lI111f
<br /> REStDENT1At� Attach(2)Piot Plans;(2)sets of Building Plans; (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,Starmwater Plans w/Silt Fence installed,
<br /> San9tary Facilities&1 dumpster";Site Wark-Permit for subdivisionsJiarge projects
<br /> COMMERCIAL Attach (Z)-eomplete sets of Building Plans plus a Life Safety Page; (1)set of Energy Forms. R-O-W Permit far new construction.
<br /> Minimum ten (10)uJorking days after submittal date. Required ansite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Faci�ities&1 dumpster.Site Work Permit for alI new projects.AA commercial requ'srements must mee#compiiance , -
<br /> SIGN PERMIT Attach(2)sets of Engineefed Plans.
<br /> '�**'�PROPERTY SURVEY required for all NEW construction.
<br /> . ,-■--r'.-:�t-f..�' '.--•�'•--:�:�I-.i..i�l--i--I-' '•--.-:�'..�.I..i--i--S..i�-l..i..{...I-.i..,�i.-i..I�i..�..i�I..i--i�f--E.-b..i..I-.i--. , . , . , . . . �I--i-�
<br /> Directions:
<br /> Fill out application completely. -
<br /> Owr�er&Cantraotor sign back of application,notarized
<br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
<br /> ** Agent{for the contractar}ar Pawer of Attarney(far the owner)wauld be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNT�R PERMITTING � ,(copy of contract required)
<br /> Reroofs if shingles Sewers Service Upgrades A%C �ences(PIaYlSurvey/Footage}. , ,
<br /> .� � �
<br /> Driveways-Not over Counter if.on public roadways..needs.ROW
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