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,_„ ,- 813.�saoo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> , , Building Department .
<br /> Date Recelved �; Phone:Contact�forPermlttin � O� .! �0 � — ���J�
<br /> Owner's Name � ��l�j ��� !v ��'/ ra • R.'ti��' Owner Phone Number O I� %/ 9� �J�Cl
<br /> Owner's Address � �v��o�� �[L� G�� Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> . > -
<br /> Fee Simple Titleholder Address
<br /> � Li/ ! �v �=�'�:;�'�"" �'���"�:�;� �
<br /> JOBADDRESS 38 � e� e�! r ���'�. - •'=`'`�-.`...�-`�' LOT#
<br /> SUBDIVISION ���r fe��n� V/�l,t, e A , PARCEL ID# :�a ���-�I.• ���� D��� �.vp�
<br /> - (OBTAINED FROM.PROPERTY TAX NOTICE)
<br /> WORK PROPOSED_ :�NEW CONSTR . ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> e. INSTALL REPAIR . �
<br /> PROPOSED?USE Q SFR [� COMM Q OTHER "
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FRAME Q STEEC Q
<br /> DESCRIPTION OF WORK z 1C�o �� �/�lV e"OLP � CO�'a'7 /l�� �j � �/1�
<br /> BUILDING SIZE ' SQ FOOTAGE� ; .HEIGHT �.
<br /> QBUILDING $ VALUATION`OF TOTAL CONSTRUC7'ION
<br /> QEL•ECTRI6AL $ ' ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ �
<br /> QMECHANICAL $ ��p� VALUATION OFIMECHANICAL INSTALLATION.
<br /> / i
<br /> QGAS Q ROOFING .Q SPECIALTY Q OTHER ,
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> - - p,
<br /> BUILDER COMPi4NY�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � 'License#
<br /> ELECTRICIAN= COMPANY � - �
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURRE� �Y/N
<br /> Addreas � Ucense# .
<br /> PLUMBER COMPANY �^ �
<br /> SIGNATURE' ' REGIBTERED Y,/-.N -;FEE CURREn " Y•/N.
<br /> Address License,# � �
<br /> ; `
<br /> �MECHANICAI:` y �� � - , COM_P..ANY, �"�R S_ /'D FI/���j,�jG �
<br /> SIGNATURE - �� � REGISTERED.; Y/ N , ;,FEE CURRE�. . Y l;N -
<br /> Addres's'�' ' - .. , , . � ^ License#�
<br /> ,«. . � � `
<br /> OTHER - � ` - , ` ' ' ' ` '` ','COMPANY � � -.
<br /> SIGNATURE �'::ti� . : i � ° � REGISTERED ' `Y/ N:... •FEE CURRE� n Y/N
<br /> Address � ' � • _ �L'lcense#� �
<br /> RESIDENTIAL�:.,r �Attach(2),;PIof.P..lan's;:.(2)sets.of:Building?Plans;(1)sefof'En`ergy`Fortns;�R-O=W'Perrrilt f6�new construcUon, "
<br /> -��, r,,.,r.;,Minimum;ten�.(:10):working;days,after,;submiEtafdate:::Required onslte,=GonstiucBon=Plans,Stortnwrater Plans�w/Sht Fence installeiJ,
<br /> �� Sanitary FacillUes:&:.;1.,dumpste,r,RSite Workr.Permit forsubdiVislonsAarge.proJecfs_ _ ; • �
<br /> COMMERCIAL Attach(3)�complefe sets ofBuilclin`g'Plans-plus a Life`Safety Page;'(1)set of Energy Forms.R-O-W Permit for neW construcUon.
<br /> Minimum ten(10)worldng days after submittal date. Required onsite,ConsWcdon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Fecilities 8 1 dumpster.Site Work Permit for all new;projects:All commercial requlrements.must meet compllance �
<br /> SIGN PERMIT Attacfi(2)sets of Engineeied_Plans.; .�-,�- -. �� � �- _ �
<br /> ""PROPERTY SURVEY reguired for all NEW constructlon.. r ' �
<br /> Dlrectlon�: ��� � �
<br /> Fill out applicaUon completely.
<br /> Owner 8 Contractor sign back of applfcatlon,notarized
<br /> If over 52500,a Notice of Com e�,c�rp��t�Is�c�ulr�d.,�.,�Al��u��de�s qqer�5T500) ��.,,_�.,n,,,,,�,
<br /> :t.
<br /> " Agent(for the contractor)or`Po�of Atforiiey�(fo�Uie�owner).would b�'someor�with notariz` letter from?owner authorizing same
<br /> �.:;;,�� �,� ,, ,� r :' °>^--,;.,;•; � rtit,,;;
<br /> DVER THE COUNTER.P_ERMITTING'� ���:�;(Front�of-Application On�y)v� �" '� "�,'= � � �f;;• - � "
<br /> :} , �,,;. • � , �f.�--. . _ �.
<br /> Reroofs if shingles Sewers �;Seniice�Upgrades A/C Fenc�'s�R�ot�Sur��y/Footage)� - , _ _ -- i
<br /> ; �c.. : , ,�„�,_ : �.�;,^��::.� �.`; "' , .
<br /> . _ _. _. __ ; ` _. ,... .. ,,., , , . •- - -
<br /> Drivewaya-Not over Counter if on publfc'roadway's:.needs ROW_ _ _ '°' . :�^� ' ' �0'�� ' � _� , "„ ���
<br /> - - •+-,,— v 2`T�"r�r,a:,,�.,, V''r�i:�,�', '� .,.',:
<br /> - ,. , . Y '�r°'�","y��.,a�,.,,;Kr�".qr���'�'i�`s`+� ,
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