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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> , , , Building Departrnent .
<br /> Date Recelved �-y i ,.- ,. -
<br /> ; . L� ` ;'.��Phone-Cont�ct�for.-�Permlttln � � '
<br /> Owner's Name //l 7 cJ� Own�r Phone Number ��� cJ/ ��9!� �
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<br /> Owner's Addre�a O < � f� � � Oweer Phone"Number,; <
<br /> Fee Slmple TItI�holderName � - ' Owrner Phone Number � � �
<br /> Fee Slmple Tttleholder Addresa
<br /> JO�ADDRESS �O� � TI�� �J�c� - )�• �� �S- -�� � LOT# �Y�
<br /> SUBDIVISIOPI - • � P.ARCEI.ID# � ° �
<br /> - :. _ • r ,�f : (OBTAINED:FROM PROPERTY,-TAX NOTICE)
<br /> WORK PROPOSED, NEW CONSTR ADD/AI:1' I�I SIGN �Q [� DEMOLISH
<br /> , ��8.� ' `.:~INSTALL. �:`<,REPAIR ��`� �
<br /> PROPOSED�USE - Q� SFR.- �] COMM 'Q �OTHERf � �
<br /> TYPE OF CONSTRUCTION - Q ' BLOCK '� FRANIE � ,STEEC Q
<br /> � �X .
<br /> DESCRIPTION.OF WORK . ��v� �V��� d�s'- /���1� ' ��/�%Up0�/�/S
<br /> BUILDING SIZE� ' � � SQ'�FOOTAGE ' .,HEIGHT`�. .
<br /> ,��; _
<br /> QBUILDING $ -+ _ ' , � . ,
<br /> . �,�� (}�J' � VALUATIONyOF�TOTAL"CONS7RUCl'ION
<br /> Q�LECTRICAL. $ - AMP SERVICE Q PROGRESS ENERGY Q W.R:E.C.
<br /> QPLUIIABING '$ '- -
<br /> � ` - II ��
<br /> QMECHANIGAL ` $ - VALU�►TION OF'MECHANICAL INSTALLATION. j �
<br /> Q�S , Q ROOFING Q SPECIALT-Y �] OTHER�: • ,
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
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<br /> BUILDER �jM
<br /> SIGNATURE � REGISTERED Y N 'FEE CURREk` Y`/N '
<br /> Address � •Llcense# '
<br /> � , . • .. . .
<br /> ELECTRICIAN•. _ � `° ;'COMPANY - - � ' - .
<br /> SIGNATURE '� REGISTERED Y/ N �E:curtit�n= �� `Y/N ' '
<br /> Addre's's ,. , � ` ' . _ : License#• ` - ,
<br /> PLUAIIBER " ,.COf�PANY , ; . .. J -
<br /> SIGNATUitE''`"� ' ' �� _' ,`.REGIBTERED. ; Yl,N� . Xn;FEE�CURRE� � •- ' Y/N • •
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<br /> Address � ' License,# � . , - ,
<br /> . �,<.' .. . . - . '_ ''`';'� ``
<br /> MECHdP11CAL': ` ,-_. � - ' - � � COMPANY . , _ :,• -, ,
<br /> SIGNATURE� •'' ' • � • ' ' ` � }'" � REGISTERED ,� Y./ N �" FEE CURRE� Y•./_N:
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<br /> Address�� • ,. � . �...-.. , _- . ... - � ,. 4� • � License# � . , ,
<br /> ��%'� - . . _ . . . ... .. ..: _ , , .. ,:��
<br /> OTHER '; z`� .��_ , .. ;�. ` �° ,. .. , ,#.•; .;�,., . , ., _ •;, ,- :. -
<br /> :.f COMPANY _ . . . .._ ... .. -
<br /> SIGNATURE; ,,, _:,:�_. .,•., `1:4-. ,�..>_.., . .._...., .. . , . _:,;R _ . - _ , _ .
<br /> .,.:��:. �,: .: : � :.. � w -:.. .���..-�-.... .
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<br /> •. -' ' ' •` ' ' EGISTERED ' " Y/ N..,. �ecuR�� ,. Y7N.
<br /> _.�..-,: . .. . _. .. �... _ .. . � , . - - -
<br /> Addr�s� r,- -,,?- .=�vp :_;; n��� - ;i >t`� �, ,: ,,,' ., ::License.#�� -. , .� ,
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<br /> RE$IDENTIAL"- '��AttacFi"2 PIot�Plan Z' S S . .. .. .vR ..-ntlif�: •_. �n y,..;�.;__, ,:, _ .:�_.,- .,,.: -; - , • .:.. _ _ , -
<br /> �;;��.�, (--} s;i..( ) et's`;ofBulltling`Plari§;(7)set;of�Energy�Foiins;�R-O=W�Peiniltfbrnew.construction,
<br /> y-•:Minimumpteanr(�1Q)�working�days�after;sutimiEfaYdate:�,Requlred onslte;,Con''s`tni'��on?Plans;S4oRnwater Plans�w/SIft�Fence�lnstalled, A
<br /> �` SanitaryFadllUes:8l�dumpste,r,xSlta.WorkfPermit#or.subdiyi�lons/large:proJects:':�,�,;_:.r;-� 'i` � _ � .. ' � �
<br /> COMMERCIAL Attach(3)`ccmplete`sets`of Buildfng Plaris plus a.Life§afety Page;(1)set of Energy Fertns.R-O-W Permit far neW construotion.
<br /> Mtaimum ten(10)working days after submlttal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence Installed,
<br /> Sanitary FaciliUes 8�1 dumpster.Site Work Permit for all new:proJect's::All commerclal requir,ements_must meet compllance " �
<br /> ,SIGN PERMIT AttacFi"(2j:`set§ofEngir�:eeiedr,Plansci.�z:�;^w�� � ; <. � .. - ° ' . '
<br /> ""PROPERTY SURVEY required for all NEW,cgnstructlon.._.. _ _.. .
<br /> DIf9CtIODB: .:r-t��<::;';:r," ._ - , ,
<br /> Fill aut applicatlon completely.
<br /> Owner 8 Contractor sign back of applicaUon,noharized �
<br /> If over�2500,,a.Notice of Commencement is raquir�d. (A!C u�grades over 3T500)
<br /> �f- .5:1i'<"G:_J`����ti.,y:
<br /> i�yenC(for the contractor)or Pouirer'of Attoiney(fo�the oiivner)'woul'd be�someone virith notarized letter irom owner authorizing saene
<br /> �VER'THE COUN.T.ER+PERMITfiFIG- ---,t�(Front•of-ApplicatiomOnly)-- •- • " � �
<br /> Reroofs if shingles Sewers Service Upgrades A!C Fences(Plot/Survey/Footage)
<br /> Drivewrays-Not over Counter If on public roadways.:need`s ROW�J �
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