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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> . Bullding Departrnent
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<br /> Date Received + , " . ; Phone-Contact'foc�Permlttin .� S� . �I — ��' •
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<br /> Owner's Name � OU Owrner Phone Nlumber 6�' �02� �9�0. '
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<br /> Own�r's Address 0 � � 1 C ' -OwoerGr Ph'one.Number� 0-�i 7 ' �o�" ���V I
<br /> Fee Simple TItleFiolder-Name • � Owner Phone Nuinb�r
<br /> Fee Simple Titleholdet Addresa ' �
<br /> JOB ADDRESS �y _� LOT� �
<br /> SUBDIVISION � PAttCEL ID# ' ' ' �Q I O 'v� 0 0 � O C�
<br /> , , (06.TAINED F.ROM.PROPERTY,TAX NOTICE)
<br /> WORK PFEOPOSED , NEW CONS7R' ADD/ALT �� SIGN' 'Q � Q �DEMOLISH
<br /> ;.e, INSTALL 8 .�;:REPAIR
<br /> PROPOSEDr.U$E Q � SFR• [�. °COMM : � �OTHER .�.{�
<br /> TYPE OF CONSTRUCTION'{ �'� r'BLOCK r � � FRAME ' ..� STEEI 'Q ,
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<br /> DE3CRIPTION OF WORK' -� �i�'C� ' /�� V rir'L U��
<br /> BUILDING'SIZE � � �'SQ FOOTAGE�, HEI,GHT_�.�. ��
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<br /> QBUILDING S VALUATION"OF'TOTAL-CONSTRUCTION � �
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<br /> QECECTRICAL $ ' AMP SERVICE: �Q '�PROGRESS ENERGY [� � W.R.E:C.
<br /> QPLUMBING • $ - ' �
<br /> �MECHANICAL' • $ VALOAI'ION OF;;MECHANICAL IN$j'AL,Lr4TION. •�� � c �p
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<br /> �c,4s , [� ROOFING. ,Q: � SPECIALTY�:� �� _ OTHER�;_;; �
<br /> .. 1�b3 ��
<br /> FIPfISHED FLOOR ELEVATIONS FLOOD zONE AREA ,QYES. ,NO
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<br /> SIGNATURE REGISTERED Y/ N .^ �;� FEE 6URREK'° ' ` Y Y'N` '
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<br /> Address ;t .. - F _�; f.; -� _. -License#` '�3' - -
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<br /> ELECTRICIAN, •- . . , - _ �,COINF!AWY�:; ;.., `;.::.:;:,.,�: _ _ ,.;:� :��.� : � - �
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<br /> SIGNATURE � REGISTERED Y/ N FEE:GWRRE�4=�'-'3` :�'Y/-:N.- ° "
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<br /> Address� ' - L(cense,#�; -
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<br /> PLUMBER � ,C.OMPANY _ •t. - ..
<br /> SIGNATUitE'�` ��` ` ," ' , � REGI3T.ERED :Y./,�N:s • ��.CuwtE�.� - Y;=/.N,,.,, -
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<br /> Address • ' � . . . . -� - .;,,Licenset# - - � �
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<br /> MECHANICAL:` � � , l � COMPANY . C�.,� .t M1
<br /> �J�D-�`P � � REGISTERED • Y ,N �- .,FEE�CURRE�:, -Y ��N`...:
<br /> SIGNA7URE: :: �� ;�.-:��..,,.., .� �.;,.s
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<br /> ;COMPANY� ,, ...:.. f ,
<br /> SIGNATURE•: . ._ "�a " - .. , ="' Y ` . "- . " • `'REGI§TERED��•"' ` Y/ N:..°: (�E'GURREn'�� � Y/N,
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<br /> Addre�s s' f j t-Yy ..f..r •..L,` - `�i - ''} "�. � ;S'f+...� , ��LICeIISe}f�� � ' � � - ,
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<br /> RESIDENTIAL; .�;Attagh?,(2);PIot;PJens;;;(2)_sefs;of'Bu�Idfrig;Plan"s;'(a)'set'of'En'eigq�Forms;,R='0=W"Permlf fo�nedir�constru�ori, � .,
<br /> ;�rt,,.:i±AinimumttenE(1,0)�,worl�ing;d�ys�aiterisubmlftal.:dat"e.`S�Requlred ornslEe;�Constiuodon'Plans;Stoimwater`Flan's�vir7 Silt•Fence installeid,'
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<br /> SeNtary FaGlftles�&,1.;d.umpster�iSite°Work�Permi.t;#orsuqtlivis'lons/Iarge:proje;cls:=.N:.-j;;.;�:" ` :•;'�° - . _. -
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<br /> COMWIERCIAL. Attach 3'°com lete sets`of Bulldin 'Plans lus'a L'Ife Safe�"Pa e;j 1)set of Ene Forms.R-0-1N�Permit for neW construcUon:• �
<br /> - Mlnimum ten(90)working days after submitfal date. Requtred onsite,ConsWction Plans,Stormwater Plans w/Silt Fence installed,
<br /> San(tary Facllitles 8 1 dumpster.Site Work Permlt for all new3proJecfs:All commerctal.requlr.Qments_must meet compliance �'�
<br /> . SIGNPERMIT AttacFi"(2�sefsofEngine`ejed�Piens:,;��:R';�°�;;. �.. -,.. . - .. - . `- ' -' .,.
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<br /> "••PROPERTY SURVEY required for all NEW coostruction., _. - - - - - �
<br /> Dliectlons: ��^::�t - �. . ,. -
<br /> FIII out appltcatlon completely.
<br /> Owner 8 Conhactor slgn badc of applfcaUon,�otarized
<br /> If over�2500,ra,Notice�og_Commencement is requlred. (AIC upgrades over 57500) .._
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<br /> Agent(for the contr'�ctor)or'Poviier`of Attorti`ey'(for the owner)�wiould�be someone with notarized letter from owner authorizing same
<br /> �VER-THE.COUN.T,ER,.PERMITTING-��---�;--(Front•of-Application�flnly) -•--- "
<br /> Reroots if shtngles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage) _ _ ,.
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<br /> Driveweya-Not over Counter if on public roadways..needs ROW'
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