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a�saeo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Depar#ment
<br /> ..:
<br /> Da#e Rec�ived P6�one,Contact far Permitting ��� / �1� - ����
<br /> Owner's Name ls--�.. 4Vr ,�. �4!„�AZ{l �@�. �-�.. 4wner Phone Number ,_�V� 1 �7�-7,.�Z-�
<br /> Owner's Address �31��=j ��T' ���i�ci� ��4z� Owner Phone Number
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<br /> Fee Simple Tideholder Name Cj 1�� Owner Phane Number �� �
<br /> Fee Simple 7itleholder Address �
<br /> JOB ADDf2ESS �"�-^Lp ��rL�-��� (,LL� J'J',,�,,�I- LOT# f�
<br /> SUBDiVISiON � C�e-��y ��_� PARCEL ID# �t' �2�—C�t�-�z1c��� tSZ�Z,
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PE2QPOSER e NfW CONSTEt ADDlALT [� Si�N Q Q DEMOLfSH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR CQMM � OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME � STEEL Q
<br /> DESCRlPTiON OF WORK �Q P������� �'`{�tfll ��'�6-'�s4� �ct-t-•�i��R.�{}�.
<br /> BUI�DIN6 SlZE � � SQ FOOTAGE � �� HEt�NT -r7�i���£�'Yo4
<br /> �BUILDlNG $�� ��� � VAI.UATtON{7F TdTAL CQNSTRUCTION
<br /> —�-... `'
<br /> �ELECTF2ICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
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<br /> �PLUMBING $ �� �� �7 ��
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<br /> QMECHANICAL �� VALUATION OF MECHANICAL INSTALLATION i
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<br /> OGAS Q ROOFING Q SPECIAL'TY � OTH�R � ��
<br /> FiNlSHED FLOOR ELEVATIONS FIOOD ZONE AREA QYES t�10 �����10'�
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<br /> BUILDER _,,:'�--= 1 / ��OMPANY ��'�` �"'"'v'��47C�� dfr �E--• ,�"}-�,
<br /> Sifia�NATURE REQISiEt2ED Y J N F�cuRR�n Y!N
<br /> Address �'� �� �� License# �Cs�... d������.—�
<br /> � ELECTRICIAN i OMPANY �A�7R "'a��� ��G�'�4L�JC;..
<br /> Slt'al�lATURE REGlSTERfD Y/ N FEE CURREA Y/IV
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<br /> Address �� �- License# �"0����
<br /> PI.UMBER ��COMPANY ��� �'����'��L�-
<br /> SIGNQTURE �"' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ����" 1'��'c���0 � J� � License# C}�C., (c�.�.��l,� �
<br /> MECHANICAL ���� COMPANY
<br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N
<br /> Address Liaense# � �� '
<br /> OTHER �., 1_�/1 COMPANY
<br /> SICaNATURE ��", t�� REGISTEREp Y/ N FEE CURRE� Y/N
<br /> Address License# �� �
<br /> � � � � � ri � � � � � � � i � i � � � � � � � � � � � � � i � � � � � � � � � � i � � � � � � � � � � � � � � � i � � � � � � � � �
<br /> RESIDENTiAI Attach(2)Plat Plans;{2}sets of Building Plans;{1}set af Energy Forms;R O-W Permit for new canstruction,
<br /> Minimum ten(10)working days after submittal date. Required onsite,Gonstruction Plans,Stormwater Plans w/Siit Fence installed,
<br /> Sanitary Facll(ties&1 dumpster,Site Work Permit for subdivisiansllarge projects
<br /> COMMERGIAI Attach{2}camptete sets af Buitding Plans plus a Life Safety Page;{1)set of Energy Farms.i3 O-W Permit ior new construction.
<br /> —��� ��- - Minimum iarc(10�workin�days-aftarsu.hmi:tal date.--R�q�ire�onsit�;Consteuetion?i�ns,Stormwater-P!ans wl Silt-Pence-instailed, _________—_____
<br /> Sanitary Facilities&1 dumpster.Site Wark Permit for all new projects.All commercial requirements must meet compliance
<br /> SIGN PERMtT Attach{2)sets of Engineered Ptans.
<br /> ""'PRQPERTY SURVEY required for aii NEW construction.
<br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � ._. , . . , �. ,_�. . . �._.�. ._. �. ,_.�__. . ._�
<br /> Dfrectians:
<br /> Fili out appiication compietely.
<br /> Owner 8 Conkractor sign back of application,notarizad
<br /> if aver$2500,a Nctice of Commencement is required. (A/C upgrades over$7500)
<br /> '" Agent(for the contraator)or Power of Attorney(for the owner)would be someone with notarized Ietter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING {copy of contract required)
<br /> Reroofs if shing}es Sewers Sentice Upgrades RIC Fences(PlottSurveylFoatage}
<br /> Driveways-Nat over Gounter if on public roadways..needs ROW
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