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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ' Building Department
<br /> Date Received Phone Contact for Permitting f�G� ��� – `.�i � li�
<br /> Owner°s,CJame� Owner Phone Number (�L�7 -� 7�/ –'�/�
<br /> Owner's Address �/ ��� ' �j D ,s 7/� Owner Phone Number �
<br /> Fee Simple Titleholder Name , Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �✓�/� E�/ U7Q S /�"�/� LOT# �
<br /> SUBDIVISION PARCEL ID# (JJ f p�p `' �'� �r✓���'�5 � f�
<br /> (OBTAINED FROM PROP.ERTY TAX NOTICE)
<br /> WORK PROPOSED NEw CONSTR ADDIALT 0 SIGN Q Q DEMOLISH
<br /> e INSTALL REPAIR
<br /> PROP.OSED USE Q SFR Q COMM 0 OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK R�� �C C �—GS j,,2� C v sJ7 d/��� ,5 3 ��
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> �PLUMBING $ .
<br /> MECHANICAL $ y,��` �� VALUATION OF MECHANICAL INSTALLATION
<br /> .�
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS , FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN ' COMPANY -
<br /> SIGPIATURE 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 ^�,y� R ; COMPANY �✓�Q� ���'� ��C,� �
<br /> SIGNATURE REGISTERED Y/.N •. . FEE CURRE� Y/N
<br /> Add�ess� ` � " �'N _ License-#; �'�g T�
<br /> OTHER•� � COMPANY
<br /> SIGNATURE��� ' REGISTERED Y/ N . FEE CURREM .Y./N
<br /> Address� � ' License#
<br /> '�RESIDENTIAL, AttacFi.(2):Plot Flans;(2)�sets of Building�Plans;'(1)'set of�Energy'Forms;R,0-W Perrtiitfor new construction,
<br /> -� , : �, Minimum:ten.(:10)working;ilays after`�`subrriittal'date. Requiretl'onsite;Constniction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanita,ry;Facilities:&�1..dumpster;SiCe;Work.Permit for subdi'vlsionsAarge.projects . � ' � �
<br /> =COMMERCtAL Attach-(2)�complete sets of Building Plans�plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructfon.
<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 qf;Engineered Plans.
<br /> � ""'PROPERTY SURVEY required for.aII.NEW construction.
<br /> � .Directions: --.
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of appl(cation,notarized
<br /> If over$2500,a Notice of Commencement Is requlred. (AIC upgrades over$7500)
<br /> " Agent(fo�`tFie'contractor)orPowerof Attomey(for ttie owner)would be someone with not '�'clSlettef�ry ,
<br /> OVER THE COUNTE 'i��R�f� .ga";"� py �'�n q��) iJ���II�fi�.��dE'J,�Y2' � ,,,�,,,,,,,
<br /> �,,`�c� of contraat•re uir� =*
<br /> 1a�,h;v ,+S n.s; Cu;:i�i�i t •r Q ,a -:�-,.'S
<br /> Reroofs if shingles Sewe[s� ;Sg�ce pgr�des;�;�l7C'�;;'°=Fences(Plot/Survey °'��s" •'st''' ���'riY`. '�r 4 j
<br /> s,h��rr.: �s.���.- i,,,�1 , , �� /Foota �i�; �r ;a,� . f��.� ,
<br /> " , zs�tt;�r: �,••,�'..+ Q�? � �y":
<br /> '+.' r �ii' •<ii v '?ii�U;•�sr.:•1 : ��( •�"'�� 77 ' t�A� c.�
<br /> Driveways-N r , •� G �� ��s� G£:,s.t;_, �� � ;;�.:fN.�� �.
<br /> ot o}�e�Coun{e�if,on p�b.l�c rn�dway's*�e��'s`f�OV� •'�'''""`� '•a�'�.�.����'`
<br /> iYi:;t��it' 1•G �tr.,i�trr c�.r 'hr��.....'a'_;`�� .R2u'.��i'e,S�J�IS�p;P`:'s't`.+dttt`7!!T h::�;ICi: �`•rui•s1��`'��+
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<br /> �}r,2�.'i'•G.`i'r�5i!�16i�t1�;!Ot(i�'i'Si;1:i� n•,r�n.•� p�
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