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$�saeo-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> ,;,,� -, . Building Department .
<br /> Date Receiveds _ - �,Phone Contact�forPermittin �_J • �d � _ �(��
<br /> Owner's Name C�z7� ' ' � /,l) Owner Phone Number ��� '�,���s��� •
<br /> Owner's Addrass � . � S Owner Phone Number •
<br /> Fee Simple Titleholder Name • Owner Phoee Number "
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRESS ��(P I L�i/t� �f LOT# �
<br /> suBoivisio� rar . o���o P,��E��o# 3� a�' �` o.d � oao� . D83z�
<br /> , - (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED _.NEW CONSTR ADD/ALT Q` SIGN' Q - Q DEMOLISH
<br /> �B. INSTALL REPAIR •
<br /> PROPOSED:-USE � Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION - Q�' BLOCK ' Q FRAME � � STEEL �Q
<br /> DESCRIPTION OF WORK • L°S �C o- �L"� � �p d/V��� J ���
<br /> BUILDING SIZE - SQ FOOTAGE�� ; ,HEIGHT �
<br /> QBUILDING $ VALUATION�OF'1'Ol'AL CONSTFtUCTION
<br /> QELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ '
<br /> QMECHANICAL $ �J Q�, - -1 VALOATION OF;MECHANICAL INSTALWTION
<br /> ! (JU
<br /> QGAS Q ROOFING ;Q SPECIALTY Q_ OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY �
<br /> SIGNATURE REGISTERED Y/ N - FEE CURREA Y/N
<br /> Address License# ' �
<br /> ELECTRICIAN, � .�COMPANY - � � '
<br /> SIGNATURE ' REGISTERED Y/ N FEE�CURRE� � '�Y/N .
<br /> �,.. - - ., .
<br /> Addre's's � .- Ucense:# �
<br /> PLUMBER � , „ COMP,.ANY , � �
<br /> SIGNATURE " , .REGI�TERED Y./..N,.. ; �EEE CURRE� Y/N,
<br /> Address License,# � � - -
<br /> MECHANICAL: + ' � �e „ � � COMPANY ���S �/���C�"!�t'S�'" C-�CJ
<br /> SIGNATURE � Recis7ERe�,. Y./ N ,,�E Cu�tEn Y/��N -
<br /> Add�A88`'' ���1�'� i'III�' _ , �J��L;1.5 �j��� License# ��7��v � �
<br /> OTHER . °" . -. . � =;COMPAMY � ,. .
<br /> SIGNATURE -�-.:` . " ` � "` �` ' ' ' ` ' 'ReGisTEREo "' ' Y/ N_... � �e CUR�n Y/N
<br /> Addreas - - . ' - ~ - L`icerise# " �
<br /> �� .. _..«, " "'4 '.".' i I:.: .,:�.. �, .
<br /> RESIDENTIAL_�c�Attacfi'(2),:Plot%.P.lans;;.(2)§efs�-ofcBulldingiPlan§;'(1)set of En'ergy�Fortns;R=O=W Permit for'new.construcUon,
<br /> �_.Minimum�ten;(�1,0)tiworkingpdays,after„submittal'date.�:Requlred onsite;.Construction�Plans,Stormwater'Plans w/Sllt Fence installed, .
<br /> y�� �Sanite'ry,Facilltl,es;&,,1,,dumpster.�Site Worlc;Pertnit forsubdi�,sions/large pro]ects�_,_"...:_ , � '
<br /> COAAMERCIAL Attach(3)`complete sets ofBullding Pians plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction.
<br /> Minlmum ten(10)working days after submittal date. Requlred onsite,Constructlon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects:.All commerGal requlrements,must meet compliance �
<br /> SIGN PERWIIT AttacFi(2)sets ofEngineered:Flans.::- :^r- �,. �:; � ' ' '
<br /> "••PROPERTY SURVEY required for,all NEW construcUon.
<br /> Dlrectlons: ' -
<br /> FIII out applicaUon completely.
<br /> Owner 8 Contractor sign back of appltcatlon,notarized
<br /> If over�2500,a Notice of Commencement is requlred. (A!C upgrades over$7500) �
<br /> '• Agent(for the contraoto�)or"Powe�of Attomey'(fo�=tFie�owner).vvo�ttlb�someone virith notarized letterf�p�owr�er authorizing same
<br /> ' �_" '^l�.r r,Y,�:��(^ �>s✓.5...:,q:;�� :_s;`a.::i',. _ T _ � '
<br /> � ,,. ,t���.:J�,, ' �n:72:�..-:;�a r!? .-�_
<br /> DVER THE COUNTER,P_ERMITTING-,;���-.-(F[ontwof�4ppl'�,}t�on Qnly)�'� • �' � -- �-. � �r5 i��j�;;, ;;;;� '" '��
<br /> Reroofs ifshingles Sewers�� ,r;:�;Service.,Upgrades���/G� _,�;�+ance°s':(P(ot/Suroey/Footage) � _•�� ��., ._ .,,?�„�, ;,,, --_ °' �
<br /> . .... .,. ... _�r . :1(... : � 5.rl. ty nry.y �y� �r _ i i '.� i ;i .. 5 ' '� :i,'M �J, ,. -_
<br /> . :... `"i�'��; ;4(�li:�"'�'1!i i ^ �T.\`::4.'.,. � . • - .�1�',i`v ;C�� ,{'`',i-,`!,J '�y'
<br /> Drivewaya-Not over Counter,•if•on.public;roadvii��iys..needs ROV1/�=`',' �� �� .. ' ''
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