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813-780-002;1 City of Zephyrhills Permit Application Fax-813-780-0021
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<br /> Building Department _
<br /> Date Recelv�d . -�- ��� ���'
<br /> � � - :�.Phone•Contact.forPermlltin � .` �
<br /> Owner's Name [� � � �'�t�►-� � Owner Phone Number 3- t���le �
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<br /> Owner's Address ��° 1, � � .�,�'�'� ��p, � � pW�er Phone Number
<br /> Fee Slmple Tltleholder:Name � � Owrner Phone Numb�r ' r -
<br /> Fee Simpla Titleholder Addresa -
<br /> JOB ADDRESS (Q_.�, LL . • �(�,U�y`,� ' -r-�j�S . LOT# ��
<br /> SUBDIVISION �i Ivev�6a� �9�, � � PARCEL ID# ' � • • .
<br /> ' � + (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED, •rNEW CONSTR�' ADD/ALT � Q� SIGN Q • Q DEMOLISH
<br /> .. ,,B, INSTALL. �'• :�; REPiAIR •• �
<br /> PROPOSED:USE � � - , , .
<br /> . , Q S�R. [� �COMM' � y OTHER' '� - �
<br /> TYPE OF CONSTRUCTION <� Q� ' BLOCK ' ' FRAME '� ;� ,STEEL Q.
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<br /> DESCRIPTION OF WORK �R �'�-'C�QJt(l �4• g���� �} `� (�,I� �� . ��� .O GJ1
<br /> BUILDING.SIZE" ' " �''SQ FOOTAGE' ,{HEIGHT�,� .
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<br /> BUILDING (�, �� , VALUATION;OF`TOTAL CONSTRUCTION ` "
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<br /> QELECTRICAL. $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING• ;$ -
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<br /> Q MECHANIGAL' $ " ' " VALUATION OF;MECHANICAL INSTACLA7'10 �"���\
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<br /> QGAS Q ROOFIf�G Q SPECIALTY, Q OTHER�: / � �I v
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<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES. NO� <<
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<br /> BUILDER � ,COMPANY~= ° � �
<br /> SIGNATURE ��� REGISTERED Y/ N 'FEE CURRE� Y PN
<br /> Addres� ' � • •Llcense`# ' '
<br /> ELECTRIC,IAN:...,; � = ;.;COMPANY - - � _ � - . �
<br /> SIGNATURE K REGISTERED Y/ N . �E cutti��°=` i>�Y/N:� '
<br /> 4; • � ' _ ti . "' A.` - ' '
<br /> Addre�s . ' - - ,: : License.#• ; - ,
<br /> PLUIIABER''; � .C.OMPANY , � , y, „ ,
<br /> SIGNATURE"'�"� � ` �� _ ',REGIST.ERED, Y/.N•, ,;FEE CURRED � - � Xr/N . '
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<br /> Address ' . ,' Goen&ey# - �- ,
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<br /> WIECHANICAL` ' +�' - • .' ' _ COMPANY ' _
<br /> SI(iNATURE} . ,.. , . , . ,< _ , - _, :� .:,: . � . .�.• . -
<br /> REGISTERED; ,Y.,/ N� ; � FEECURREP Y,/�N
<br /> - ' tif� � ' ' .. . . � .
<br /> Addre�s-:: , ., . ---. ... , � .. :� . . ;q -. , " " ' Licen$e#� �. � ,
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<br /> OTHER �• ,�^ � ; . -r_.` ;. .. - -. , -t -.<;.:_:�. . ..•; ,;- - - � , , :,.. .. -
<br /> C_,O,MPANY _. .
<br /> IGNATURE' ,. �.,;,.-.,,. . ,�. .�:;s ,: z... .
<br /> S :=%`- -}� - • 'REGISTERED " " Y/ N.,.�. �FEE CURREA Y/N.
<br /> /�ddl'688�� tv:r^' %"!: _c�;... >pi;'... _ .... _. ,��2�._ ' `uC6nS9'�'� " ' ' ' �
<br /> 'rr,��.�.:� ,;,. •-�..- y•�: ry--' �-. - ,
<br /> RESIDENTIpL'-;;s^,=;AttacJi"'(2),Plot`_Pians;�.(2)sets:of,BufliJtngtPlan's;(1)setof=En'ergy:Fortns^VR=O-VNWPerrnit farfnew construcUon, . ' -
<br /> -��,�.;sMinimum�ten�(�1.0)�working�;dajis�afte_r,;submilfaFdate.�;Requlred onslte;FCon'siiuc8on?Plans:�'Storrnwater Plans w%Silt Fence instelled,
<br /> -- - - - ----- �-�Senitery�Fa,dltdes;�;+�,d_�m�sM,r;;Slt���lc�!c,;Psranit;tsr�sutidEvi€IorisAar;�e�p�)ect"s,': ;-;�;, ' .- - -- . , - - - -" --- --
<br /> COWIMERCIAL Altach(3)complete�sets`of'BuIlding Plans plus�a'Ufe Sefely Page;(1)set of�Energy�Forms.R-O-W Permit for new'construcdon.. �
<br /> Minimum ten(10)working days aitar submlttal date. Required onsite,Construcdon Plans,Stormwater Plans w/Sflt Fence Insfalled,
<br /> Sanitary FadliUes 8 1 dumpster.Site Work Permit for all newtproJects::All commerGal[equlr,ements_must meet campllance
<br /> .:SIGN PERMIT Attacfi'"(2).sets of'Engin'eered�Plan`s:4.��.=RM.;;:- L.�,x'.�F <:==- � •-.- � . --
<br /> ••••PROPERTY SURVEY reguired for all NEW_constructlon.,__.. .._. _._... �
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<br /> _Dlrectlons: , -..�.,,� --�: .. . � `
<br /> Fill out appUcatlon completely.
<br /> Owner 8 Contractor slgn back of applicatlon,notarized �
<br /> If over 52500,a Nodce.of.Commencemant is required. (AfC upgrados over 57500) ,_,,
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<br /> '• /�qenC(far the�contrac'tor)`flr'Power of Attomey"(fo�tFie owner)would be somaone with notarized letter from owner authodzing same
<br /> DVER`THE COUN.T.ER:PERMI'iTING-�---;-•(Front•of-Applicatlon-anly)-..- _ � • " '`
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drivewaya-Not over Counter ff on public roadways:.needs ROW'
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