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a„-'�u-°°l� City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � , --� _� Bullding Department . i.
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<br /> Date Re,aelved ' .. Phone>Conta�'tor-P�rmittin - �� � �a _ 5c7� 3 �
<br /> Owner'a Name ��'T-T�� /��ir ' ��.�"'20 0�" ,fL '
<br /> l��/t/�� Owner Phone Number
<br /> Owner's Address 3 /�� � Q../� Owner Phone Number� ' !
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<br /> Fee Slmple Tltleholder.Name Owrier.Phone Number
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<br /> Fee Simple Tltleholder Address '
<br /> JOBADDRESS 37�'� g � -e m f�f�' f�� LOT# �
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<br /> SUBDIVISION �— PARCEL.ID# ��� �� E�I �1�� �� DL(p�
<br /> � (OBTAINED FRON1 PROPERTY,TAX•NOTICE) 4
<br /> WORK PROPOSED -_NEW CONSTR� ADD/ALT , Q` SIGN Q Q DEMOLISH ¢'
<br /> ,B. INSTALL 8 . REPAIR � . - �
<br /> PROPOSEDaUSE Q SFR� [] COMM• Q OTHER
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<br /> TYPE OF CONSTRUCTION - Q' � BLOCK " Q FRAME _ Q STEEL 'Q �
<br /> DESCRIPTION OF WORK � �. �� ��'/If �`-�LC�i� � p� p� (�rJ'yYj d���(J� ?
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<br /> BUILDING"SIZE ", �"S61 FOOTAGE � . ,HEIGHT}. . ;
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<br /> QBUILDING $ VALUATION`OF T'OTAL CONSTRUCTIi�N` • ' �
<br /> ELECTRICAL $ � AMP SERVICE 3
<br /> � 'Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING , $ , �
<br /> OMECHANICAL $ �-n��` a� VALUATION OF MECHANICAL INSTALI:ATION �
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<br /> QGAS Q ROOFING ;Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO !
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<br /> BUILDER COMPANY� �
<br /> SIGNATURE REGISTERED Y/ N . "��E CURRE� Y/N i
<br /> Address ' � Lfcense# '
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<br /> ELECTRICIAN 'COMPANY �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�'' '-'- -``Y/N
<br /> Address License#. '
<br /> PLUMBER COMPANY
<br /> SIGNATURE " . _REGI3TERED, Y./r N- : " FEE•CURRE� Y/N �
<br /> Addreas ' Ucense,# r : : .
<br /> MECHANICAL" .. � , � , COMPANY, �nL S �!9/1J���-v '��c°�
<br /> 31GNATURE i- �" REGISTERED � Y./.N �E CuwtEn.. . _ Y.[-N :
<br /> Address'� � � /eI`1�� � " License# « �1-F��'�
<br /> OTHER . - � � ;COMPANY �A~ , .
<br /> SIGNATURE �'��' . �� ` • � � " " REGISTERED` Y/'N... FEE CURRE� - Y J N.
<br /> Address - �. - � 3 Ucense#: '
<br /> RESIDENTIAL'N;:: :Attacfi"(2),iPlot°Plaris;.(2•)s"ets:of,<Bull'dfng`lPlan§;'(•1)setof?Energy'Fortns;R=0=1N�PertnlffornewconstruoUon, ' _
<br /> ; �„-Mlnimum;.ten;(;1A);worfcing;,daysqafter;"subfniHal'date.z;Requireil onslte;:Constiuctlo'n:'Plans;�$tortnvirater Plans�w/SIIt-Fence lnstelled,
<br /> � y Sanitery Faciltyegr,.&fi1,dumpster•SIte�Worlc:,PermR#or:sutidivislons/large'.pruJects�:.,:_,;.;�� ` = � � �
<br /> COMMERCIAI. Attech(3)`i�omplete'sets'of Bullding Plans plus a�Life Safety Page;�(1)set of Energy Forms.R-O-W Permtt for new constructlon.
<br /> Minimum ten(10)working days'after submitlal date. Requlred onsite,ConstrucNon Plans,Stortnwater Plans w/Sflt Fence installed,
<br /> Sanitary Facil(des 81 dumpster.Site Work Permit for all newsprojects`:.All commerGal requlrements,.must meet compllance �
<br /> SIGNPERMIT Attach'(2)setsof�Enginser.ed�.Plans��.�.::-;��.. ,��,�.� � �
<br /> "•'PROPERTY SURVEY required_for all IVEW construction.. � -
<br /> Dl�ectlons: ,. _ �- . . ' .
<br /> Ftll out epplicatlon completely.
<br /> Owner 8 Contractor sign back of appltcaUon,notarized '
<br /> If over a2500,a Notice.of Commencement Is requlred. (AIC upgrades over 57500)
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<br /> Agent(for tti�e contraotor)or PoweP of�4ttome (for the owne)woul' be someone wtth notarized letter from owner authorizin sa�me
<br /> �.�r.�::.__,.s��,�:4..��.�,�:�:�t.,,;�.��•- , _ : ........:....�r....��e ,g�A_�
<br /> DVERTHE COUNTER:PERMITTING:��,t�.�,�(FronQ'of-Applicetio�E�r�ly),;, ��: ..J.13N�t1���.,;A!'.I>>.; '
<br /> Reroofs if shingles Sewers �,.-+ ��Service UpgradesoA/C?,f;�;�'�cies�Plot/Survey/Footage) �, ,. "!=�k�orv?2-�tirt�4 G•�a;i���" �
<br /> ._ _ _ ..... ...... _ '. ; -;.i:;�;_.{,"c.�•ta.`(}y,�el•c� , 6L'� '� '.; :'� !ui,�9i:�7�.i1"�Sc'.' ,� ' ..
<br /> Drivewaya-Not over Counter lf on public r,oadways:;needs ROW"r,�,� t�' c �;b;U�u};��,��,,.;,,,..,;,, e
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