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s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ` Building Department
<br /> Date Received Phone Contact for Permitting ' �(� � �
<br /> Owner's Name /�T�O� � (�� /y Owner Phone Number [��J — /6 �"��7.� �
<br /> Owner's Address �``��� !�j � o ���/ Owrner Phone Number
<br /> Fee Simple Titleholder Name � Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��v� D ��LL �', �/�/1l� LOT# �
<br /> SUBDIVISION PARCELID# �� �� �/ � a��� D/��
<br /> __ � (OBTAINEDFROMPROPERTYTAXNOTICE)
<br /> WORK PROPOSED NEw CONSTR " ADD/ALT � SIGN Q Q DEMOLISH
<br /> e INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM � OTHER
<br /> TYPE OF CONSTROCTIOId Q BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK ��s C G A .—Qu � C ,�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 /> OPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> _ ���",b
<br /> OGAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES 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 /> Address L'icense# ' �
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� ' Y/N
<br /> Address. . " License#
<br /> ' MECHANICAL ` '_ e �'` COMPANY Q�.'���,Q'','�`� AN�C� �' �G� -�/V� II
<br /> SIGNATURE' �— M i/��� REGISTERED �/ Y/.N FEE CURRE� � Y/N
<br /> Address �� � �L0/� �£, �` /s S ��, License# 9� �3 ���
<br /> OTHER "'- COMPANY
<br /> SIGNATURE., '� REGISTERED ,•Y/ N .,. FEE CURRE�' , Y/N
<br /> Address� ' - License#
<br /> ' RESIDENTIAL'�_ Attach�(2):Plot Plans;(2)=sets•of'Building-Plans;�(1)'set of�Energy Forms;R;O-W Permit for new construction,
<br /> , „ Minimum.:tem(�10)'working'.days after submittal date. Required�onsite,'Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanita,ry,;Facilities.&�1��_dumpster Site Work'Perriiit for.`sutidivisions/large projects ' - ,
<br /> ,--'CDMMERCIAL- Attach.(2)�complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcUon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities 8 1 dumpster.Site Work Permit fo�•all new projects.All commercial requirements must meet compiiance '
<br /> .SIGN PERMIT Attach(2)se'ts of'EngineerecJ Plans.
<br /> � "'*PROPERTY SURVEY requir,ed focall.NEW construction.
<br /> ' Directions:- ,.
<br /> - Fill out application completely.
<br /> �Owner&Contractor sign back of application,notarized
<br /> If over$2500;a Notice of Commg�rn�ce,ment is required. (AIC upgredes over$7500)
<br /> .. '.�. • 1' "'"�s..t"d�w,er�e.;_t��_.�t•�_.:> . ..i��,9'1�n.w�rr�i—��'�^..+ei+8,u�'vs.;ic.a,'F,`.�.�...:hr�a"
<br /> Agent(fo�`th'e•contractor)-or Power�of Attomey,(fo�the oy�n�pv�'oul��sA,�{�„�with notarized letter�om owrieY,9uthorizing+same �
<br /> ,,:,�,,., ,,
<br /> Et.r..,_ ,., , f•�i;�r�ii3.,
<br /> ,.'OVER THE COUNTER PERMI7'TING ��, (cbpy-ofcontract;requlr,.ed) ;_,��;.r,_� � ��, :, ��'�' �'
<br /> Reroofs if shingles Sewers �eivice�IJpgrades;:A/C,- Fence�s(FIoUS�y/Footage) � '�' `' �`" ;
<br /> t{ ��'�r.•.'� :i�
<br /> _, .g �);:1�{•�'." l.7 �t'.:r��; :rr�i•Y � '�w ri�,i � ',:., � .
<br /> T ��.( p'
<br /> Driveways-Not over Counter if on�ubli�`Poadways::needs-ROW.; �-� ;��, �� }�_.,� `` " .•�•' ��
<br /> "�e.'�°�°•".t,r�,�+•lz_>r.s� !iL�:a,;.,...'.t,,.• � _ �#}�.,'y,�'"t�`�':"�;`�VlS.�.�v. _, :� ' a-a. �},
<br /> (rax .... . '" ' z.y�,.re;�L'.J �7'm'ii?+`y
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