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� -:8'�3-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> . Building Departrnent
<br /> Date Recelved • p p
<br /> � P.hone�Contact�for:Permittln C� � �d�- — � �'L�
<br /> Owner's Name OQ l Gt� Owner Phone Number o�� ''7� —�L�
<br /> Owner's Address aJ-7�v �D- �D� 4� /, Owner Phone Number
<br /> Fee Simple Titleholder Name - � Owner Phone Number
<br /> ,r •
<br /> Fee Simpl�Titleholder Address
<br /> JOB ADDRESS ✓l DD �B Gu '°.�! LOT# �
<br /> SUBDIVISION PARCEL ID# l� a� a� ���o o�9ao ��30
<br /> (OBTAINED FROAA PROPERTY,TAX NOTICE)
<br /> WORK PROPOSED _NEW CONSTR - ADD/ALT Q SIGN' Q Q DEMOLISH
<br /> � B. INSTALL ,. REPi41R
<br /> PROPOSED;USE - Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME Q STEEL Q
<br /> DESCRIPTIOPI OF WORK ��5. �/C (��J�'/v �8�� 3�a Ta� �L,G�'n �1l�YS
<br /> �UILDING'SIZE ' SQ�FOOTAGE HEIGHT �
<br /> QBUILDING $ VALUATION:OF✓TOl'AL CONSTF2UCTION
<br /> QEL'ECTRICAL $ ' AMP SERVICE Q PROGRESS ENERGY Q W:R.E.C.
<br /> QRLUMBING $ ' �
<br /> QMECHANICAL $ ��2 �a �� VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
<br /> BUILDER COMP'14NYr• � ' ' �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N �
<br /> Addres� - , � Cicense#
<br /> ELECTRICIAW: : ..COMPANY'� '" , ' , . ,
<br /> SIGNATURE � REGISTERED Y/ N FEE GURRE� '' � °tY/'N
<br /> Addregs � _. ,,, License.#_,°
<br /> PLUMBER ' � COMP.ANY - �
<br /> SIGNATURE' � REGISTERED Y.I,.N;' ;_ -•FEE CURREP �. Y�/N. • �
<br /> .= ;, . r: _ 5. ; ,'
<br /> ...... . .
<br /> Address „License.# �. � ,
<br /> MECHANICAi: ��� � COMPANY. ���"� �S �'6f�A"N�C�/-5 t�e- �1�I�
<br /> SIGNATURE � REGISTERED Y,L.N , , -;FEE CURRE� - Y;/:N,• .
<br /> Addreas' ;..; 7�7/ �� c�N . ' � License#� � . .��J��
<br /> OTHER " � ` � � ,COMPANY - �
<br /> SIGNATURE -� - ' ' REGISTERED ` . Y/ N .. FEE CURRE� Y/N
<br /> Addre� ° - " ' ' " ticense#�
<br /> : _ .-. -• . - : .
<br /> RESIDENTIAL;� Attach''(2),;Plo.t%P,lans;(2)'sets:of�Building Plans;`(1)`"set of Energy>Fortns;R-O-W�Permlt for new constructlon,
<br /> � � �:;Min(mum,,ten�(10),working;days after_"submiftal date:`:Requlied onsite;.ConstruoUon.-Flens;Stoimwater Plans w/SIIt Fence installed,
<br /> " ` Sanlfary�Facilities&:.1:,dumpster Slte Worlc;Permit for,subdivisio�sAaPge:projecfs:-.. _.��_;_ ' � � �
<br /> COMMERCIAL Attach(3)�complete"set`s"ofBuiltling Plan's plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction.
<br /> Minimum ten(10)workfng days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaclliBes&1 dumpster.Site Work Permit for all newrproJects:.All commercial requlrements.must meet compllance
<br /> SIGN PERMIT Attacfi`(2)�sets ofEngineared-,Plans.;< --�s�°� . . - ' ' � �
<br /> ""PROPERTY SURVEY reguired for all,NEW constructlon.. •
<br /> Dl�ectlons: � ����' �� � �
<br /> Fill out applicaUon completely.
<br /> Owner 8 Contractor sign back of appllcatlon,notarized
<br /> If over�2500,a Notice of Commencement�is requlred�. (A!C upgrades over 5T500) _
<br /> " Agent(for ttie conVactor)' Powe�o�e�t�,q�ey r�t,�j,e owner yypu �ie meone with nota�ized letter m ovu�ey�} ��fne ,,:,,��: :�
<br /> �� s v ��s._,.
<br /> �Y�,t kq.. J�C";.:...�.``� . ..
<br /> OVER THE COUNTER PERMF NG - ' ('�1bnt�f'f�A$►511t�bnz��'�'`q��' � ; ' �i„
<br /> RS�`�l�Q. ,y 4.`� >hi7ei�ta�4cd2-3ii��7�t�lt�vt _..�/y�
<br /> Reroofs if shingles Sewers� �'SenRce'l)pg�ade�!r1�YCd''�+ s°F� (�' USurvey/Footage) 1 FQ5.�f E;tL 2�3!i�Y:�.r7lfitq��F,3 _•f;_Y : , .: I
<br /> ''!" 14 rp •�,�;_�:3 "% �� Q����t�"z7 tit-Rt1t8�;tif;a3',n;.`
<br /> Drivewaya-Not over Counter if on public roadways.:needs ROW�;,;��•'� .'�8s�d{gtC4?�ar.t�;f����,�:�1T?,sc;r•.:` ��' -
<br /> - sc;:^...,��s�:�...u�a`�'''�� ' .'�''�'�`'tiy".-���:�a,,qp,..�:,•"'y
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