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<br /> � a���so-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> .. - _ . Building Department .
<br /> Date Received Phone:Contact<forsPermittln ��� ol _ ,rQ f�
<br /> Owner'a Name /)/N��iQ, �!/��//y,� DI�/ Gt, Owner Phone Flumber V l3"'p� '" �A
<br /> Owner's Address �D/ . J>i 7je e /�J ES�� �;Owner Phone Numb�r •.
<br /> Fee Simple Tltleholder Name • ' Owner Phone Number '
<br /> �,a , , .
<br /> Fee Simple Titleholder Address �
<br /> JOB ADDRESS Lr GIC�i►,� �i� �,- /LLS �oT# ��
<br /> SUBDIVISION � ,� ` PARCEL ID# o�'f a�i: o�L ���'� �L�l/�L9 Dl �
<br /> , �_ , .. (OBTAINEDFROMPROPERTYTAXNOTICE)
<br /> WORK PROPOSED • NEw CONSTR ADD/AL-T Q SIGN 0 �Q DEMOLISH
<br /> �:8. INSTALL REPi41R
<br /> PROPOSED.USE [� SFR Q COMM' Q OTHER ' ' '
<br /> TYPE OF CONSTRUCTION � �Q' r BLOCK " Q FRAME � STEEC Q _
<br /> DESCRIPTION OF WORK ' �� ��/�-lV �- OLC.` � �T Il� p� �p�� ��j��
<br /> BUILDING SIZE � � � SQ FOOTAGE� HEIGHT _ • '
<br /> QBUILDING $ , VALUATION�OF`TOTAL`CONSTRUCTION , '
<br /> QELECTRICAL , $ ' AMP SERVICE Q • PROGRESS ENERGY Q W.R.E.C.
<br /> QFLUMBING� $ - ` - `
<br /> QMECHANICAL $ 3Cd��s � VALUATION OF MECHANICAL INSTALWTION
<br /> QGAS . � Q ROOFING .Q SPECIALTY � OTHER� • �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDHR COMP'14NY • '
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N ,
<br /> Address � - License# I . ' �
<br /> ELECTRICIAN� , , ' `C'OMPANY ' �
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURRE�°• Y/N
<br /> Addres� - „ License# � �
<br /> PLUMBER ' COMP.ANY-., , �
<br /> SIGNATURE` _ REGIST.ERED Y./•N FEE CURRE� Y/N �
<br /> Address License# .
<br /> MECHANICAL` ,, � ."��Y�� COMPANY K3�ffR�S i�Ne_�5� e. .i�e,
<br /> SIGNAYURE � ` REGISTERED„ :. Y./ N . ; FEE CURRED Y,/�N
<br /> r ,
<br /> Address '�::•7'T � �I P/�I '."Z-!�/LLS �, - ' Ltcense# ��/�T39� -
<br /> ., - • • ,.
<br /> OTHER ; ' � ' � ' ;COMPANY
<br /> SIGNATURE�- "-.:_ . ' - `^ - �` � �' a " ' " ' `' REGISTERED � ' Y/ N... FEE CURRE�• Y/N
<br /> Address f'�a :r,� • ' ' �� � ' Ucense#' � '. - -
<br /> >; :�.- - �i-� ��• .
<br /> RESIDENTIAL'-, ,Attacfi"(2);Plof P,lans;:.(2)sefs of�Building`•Plans;(1)set of-Energy�Forrns;R=O=W'Pertrilt far�ew construcUon,
<br /> ,;__Minimum;ten(1.0)wo,riiing�days':aRer„submlttal�date:::Requlred onsite;.Consiiiicdon�Plans;Stonnwater Plans w/Silt Fence installed,
<br /> .::;...�. , _, ,.,:.... _
<br /> SanttaryFacilldes;&;�1��,dumpste.r,-Site�Work,Permitfor:subdivisions/large:projects. ,�� .[,r ' ' � '� '
<br /> COMMERCIAL Attach(3)complete se(s`of Buildtng Plans plus a Llfe Safety Page;(1)set of Energy Forms.R-O-W Permtt far neW construotion. ' �
<br /> Mintmum ten(10)warking days after submltMal.date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Faciiitles&1.dumpster.Site VVork Permit for all new�pro)ects.All commerGal requlrements.must meet compllance
<br /> SIGN PERMIT Attach(2)sets-ofErigineered�Pians._ � � � � � .. ° '
<br /> "'•PROPERTY SURVEY reguired for all,NEW constructlon. .
<br /> DlrecNons: -- '
<br /> Fill out applicatlon completefy.
<br /> Owner 8,Cantractar sign back of applfcaUon,notarized
<br /> If over�2500,a Notice of Commencement is requlred. (AIC upgrades over aT500) , . �
<br /> .. ...:,.� ,:,..,.
<br /> Agent(for tFi'e contractor)�or Porirer of Attomey(for ttie owner)would-be someone with notarized letter from owner authorizfng same
<br /> DVER THE COUNTER.pERMIti1NG'�'�`� � "�E�o"f�`��lf`ca on Onl"y - �� ' `�'"�"'°""��`."�'��'�''�"�`"'�'��"�"`����
<br /> � �, rAD aPP �..�.. y� � �7 A sy' J�'� ,,»�. .�,,,,.
<br /> .3.ir!yr,q 'j u fE r' �� .i.i?Ff''�1�$ rJ ���i,.��, X!,
<br /> Reroofs If shingles '�ewers^ ' Service Upgrades A/CGY--_�`Fences(PIoUSurvey/Footage) � , �
<br /> .� :�i�'i#c�..ir,jr •;�i�U�_�. :fiV! ral�;� '�� !�t f,� L<;f}G?��C F�Ib'1%;.„i'nU�':1h1�: �`�a'�r.�;``�'
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