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s�aaso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �,=,,� • Building Department
<br /> Date Received �L� ��� _ �Q`�
<br /> Phone Contact for Permitting •
<br /> Owner's Name �7�L����Lb ROG��.�f.� Owner Phone Number �b�" �o�'����
<br /> Owner's Address J �� !� " U� Owner Phone Number �
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �/�c�D �l� ��/G, �L/' DI`Y Z4/�7 LOT# �
<br /> SUBDIVISION PARCEL ID# �"�` �J ���"'�L��^�� ���v
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEw CONSTR ADD/ALT � SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP..OSED USE Q SFR Q COMM 0 OTHER
<br /> TYPE'OF CONSTRUCTION Q BLOCK - Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORK � e (/ Z� 2 D-LL� � �D/V J�j4 �1� ` G�'Cfr11 Q/�
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> OBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> [�MECHANICAL $ �� � VALUATION OF MECHANICAL INSTALLATION
<br /> i
<br /> QGAS Q ROOFING Q SPECIALTY 0 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 COM PANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � �
<br /> PLUMBER, COMPANY
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� ' Y/N
<br /> Address License# �
<br /> MECHANICAL �� � COMPANY �f�/2 S� A�/�/r� ��'%�--
<br /> SIGNATURE REGISTERED ;�i .Y/ N FEE CURRE� Y/N
<br /> Addre§s - `Z'��1 � '` ��/L�` , Licens.e.#. �.!TC--� �'�✓� /�`t
<br /> OTHER• � COMPANY .
<br /> SIGNATURE�- � � REGISTERED , Y/.N-. FEE CURREk .,.- Y./N
<br /> Address � ,.� � License#
<br /> RESIDENTIAL Attach"(2)'Plof P.lans;(2)sets of�BuildingPlans;'(1)'set of Energy Forms;R,O-W P.ermit for-new construction,
<br /> . Minimum�ten.(.10).inrorking;days after.submittal,date. Required onsite;'Constnictlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> . Sanitary Facili6es;&�-1��.dumpster;Site Work Permit for.subdivisions/large projects �� - �
<br /> _ .� COMMERCIAL Attaeh'(2)�complete sets of Building 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 /> Sanitary Facilities 8 1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance
<br /> - SIGN PERMIT Attacti(2)sets of;Engineered Plans.•
<br /> • "'*PROPERT`f SURVEY required for.aII.NEW.construction:
<br /> Directions: �• ._ :•
<br /> Fill.out application completely.
<br /> - Ovirner&ConVactor sign back of application,notarized
<br /> If over$2500,a Notice of�Commencement is requlred. (AIC upgrades over$7500)
<br /> " Agent(for th'e�cont�actor)�or�Power'of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER �:,�,�r�.(aop�iPof:cseatStra�f-r€�uil�ed f +����.��e��-lu�����,�.:�
<br /> ,��Reroofs ifshingles ewers.t�#?;:�?r5ervice 0 rades A/C"''".Fence PI .����`���_� '?��;y.iy'� ,"':"��,,,, ,
<br /> pg s( oUSurvey/Footage) ,. . ,��
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<br /> 1 �� n;�!" ;7
<br /> Driveways-Not ov Gou ter if=on:public roatlways.:nbetls.'ROW�• ,! c I.!�.�:S I�!�~ou��z� cr•:��n:�yr,i _ 9 ''� ;� _
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