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<br /> s��-�$aoozo City of Zephyrhills Permit Application Fax-813-780-0021 �
<br /> � .- Building Department
<br /> Date Received ' _ � r a — � phone Contact for Permitting � O�3 O,7 — o��
<br /> Owner's Name T�v'�✓�. '�Q•�C Q Owner Phone Number 7 �J ' �o�`� -�S�
<br /> Q�!-t� .
<br /> Owner's Address ��� / ��, Owner Phone Number
<br /> Fee Simple Titleholder Name Owrner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS S�o� � ��. LOT# OI���
<br /> sueoivisioN PARCELID# ��'��'��'00/D - �Ia00 � bllO
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B : NEW CONSTR'�DD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPi41R
<br /> PROPOSED USE Q SFR Q COMM Q OTHER .
<br /> TYPE'OF CONSTRUCTION Q BLOCK •- Q FRAME. 0. STEEL Q
<br /> ._ � _
<br /> DESCRIPTION OF WORK �NcS�a'�� �k�'�I�i6I!'�G7��/DOOF`��+ and�S pVCi' .S`Ji� �tS
<br /> BUILDING$IZE SQ FOOTAGE O V HEIGHT •
<br />� �-
<br /> QBUILDING $ �j ,��� VALUATION�OF TOTAL CONSTRUCTION
<br /> (f7
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> I QPLUMBING $
<br /> l��
<br /> �`7
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
<br /> Q,GAS �ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COIlflPANY
<br /> SIGNATURE REGISTERED Y'/ N FEE CURRE� Y/N
<br /> Address License#
<br /> , ,
<br /> "ELECTRIC.IAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> - Address License# � �
<br /> PCUMBER.,,, COMPANY ,
<br /> SIGNAI'URE ���s7eReo Y/•N � FEE CURRE� � Y/N'
<br /> ,, Address License#` .
<br /> � MECHANIC14L' � COMPANY
<br /> "�SIGNATURE�' � REGISTERED Y/ N.- ,: FEE CURRE� Y/N.
<br /> Add'r`e"ss� i � � License.#
<br /> .,.iii;.,�:�" �� � �. / /��
<br /> < - ,�� � O�'� `�C VO�Jis/�6� l �.t/G
<br /> ` OTHER:::":.'.. `: � �,y�,�i� - � COMPANY P
<br /> �
<br /> '�"SIGNATURE;r;� _� . �� � - � REGISTERED Y/.N, FEE CURREK Y/N
<br /> ;,;�"'-?`f,�.,
<br /> Addressr-.` ,'3���dr-,5�6 : ,_..A.�,.e�:,:� �t(r- � 3 Lfoerise# �L�o�g 3�4
<br /> '_':�_ _.. ... .. .. . �._ ,. - _. . _ ..,;, .:.:,.• .:, , _ . ,.
<br /> =::.RESIDENTIAL:;;:�`i4ttacFi�(2)'�Flot Plans;?(2);sefs�of Building�Plans;(1�)°set of'Ene�gy`Forriis;R-O-W,Feniiit�or new.construction,
<br /> ;�+���.;,.�-,,Minimum!;ten��(�,10)workingpdaysiafte�sutiinittal:dafe.'Requ'i�ecJ`onsite;Gonstruction"Plans;"StoRnwater Plans w/Silt Fence installed,
<br /> - �`"�� � � ��� SanitaryyFaciflties;8r,1�.dumpste,r=;-Site;Wor,kRermitfor,subdi'visions/I'arge'proJects� ' ' : : -
<br /> . ,;-�....,
<br /> �,_`C.OMMERCIAL Attach`(2)�complete'sets'ofBuildirig Plans plus a L'ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> .- Minimum ten(10)workii�g days after submittal date. Required onsite,Conshvction Plans,Storinwater Plans w/Silt Fence installed,
<br /> ��- � Sanitary Facilitles&1 dumpster.,Slte Work FeRnit:fo�all�new projects.All commercial requirements must meet compliance
<br /> ��
<br /> +:�'�SIGN'PERMIT "Attaoh'(2)sets_of;Engineered;Plans.�c:. �
<br /> """PROPERTY SURVEY,requ(red for.all,NEW construction..
<br /> ,J,,: _ _ _ _ _
<br /> -:Directions: s'", _- _ . .
<br /> ',� �Fill<outapplication completely.
<br /> �Ouvner&Contraator sign Liack of application,notarized
<br /> , � "'If over$2500,a Notice of:Commencoment is required. (A/C upgrades over$7500)
<br /> ~-" .Agent'(fo��th'e'contfractor)�orPower:of Attomey(for tFie owne�)would be someone with notarized letter from owner authorizing same
<br /> %':OVER:THE�COUNI'ER;PERMI7'TING',_,:• >:•:(copy_of contract�requlred)--= `� � �
<br /> ;�-Reroofs if,sfiingles _ Sewers j Servlce�Upgrade`s A/C � �Fences(Plot/Survey/Footage)
<br /> DNveways-Not overCou�ter 1f on public'ro"adways::n'eeiis�ROW
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