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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � � Building Department .
<br /> Date Recelved , ;�ppane,Contact�for•P.ermlttin - '
<br /> Owner'a Name .Q �j Owrn�r Phon�Number
<br /> Owner's Address � Owoer Phone Number
<br /> � , T
<br /> F�e Slmpl�Titleholder-Name � � Owner Phone Number •
<br /> Fee Simpla Titleholder.Address � �
<br /> JOB ADDRESS ✓�e r c U�Q LOT# �
<br /> SUBDIVISIOW ' P.ARCEL.ID# ' -
<br /> ,_ • , � (09TAINED F.ROM PRGPERTY TAX N0T10E)
<br /> WORK PROPOS�D, �.:�.NEW�CONSTR�:, ADD/ACT 0= SIGN=• Q 0 DEMOLISH
<br /> � �.,8, INSTAtL_ 8, -, REPi�tIR -�-
<br /> PROPOSED�USE . , Q SFR. [�� COMM ''Q kOTHER' ' �- '
<br /> � TYPE OF CONSTRUCTION' <•. Q` � BLOCK " [] FRAME _�] ;STEEC Q
<br /> DESCftIPTION OF WORK .t Q -' � �.IIQt r _ '�, � , �' g S � �SC�i��
<br /> BUILDING'SIZE`' � SQ FOOTAGE `` �,HEIGHT�, _
<br /> - s:.
<br /> QBUILDING $ : VALUATION`OF=1'OTAL`CONS'I'RUCTION „ �
<br /> Q�LECTRICAL. $ _ ' AMP SERVICE Q �PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING� :$ � �
<br /> MECHANIGAL $� - VALUATION OFMECHANICAL INSTACLATION. ' �� � �
<br /> 1 �l�., � .;.. � �
<br /> OGAS Q ROOFING .Q SPECIAL7Y, Q OTHER • ���D 'Z �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPi4Nlf' � '
<br /> SIGNiiTURE REGISTERED Y/ PI FEE CURRE� Y/'N� '
<br /> Address ' � Ltcense#' '
<br /> ELECTRICIAN-;.;: : �- - � _ :=COMPANY � � ' � „
<br /> SIGNATURE � REGISTERED Y/ N FEE�CURRE�°-� ��==Y/N` � '
<br /> AdcYres�'� . • ' ' � „ ' � � -... Ucense;#, . ' �
<br /> PLUMBER ' - ,COMPANY • • �
<br /> SIGNATUFtE' ` " 'S" � ' �.REGISTERED. Y/,.N. ;PEECt1RRE� Y./N -
<br /> Address , . , , � � , .. ;License,# _ � � ,
<br /> , _,.:
<br /> ��. :< - -x�:._ � �. �e ;�. � �
<br /> MECHAWICAI:`�`, ` ;,�,(� "' .. ` COAMPANY , �Q . (L'�'� ... .. Q.
<br /> SIGNAYURE> �''`'�' �CY`�'—— �'` `" � REGISTERED,, .X,/ N `; FeE Cuw3En.. Y-/-N. .
<br /> Address�t=', �'� � � ( — . . � ' LicenSe#� N�I O,����
<br /> ,
<br /> .... . . . .... . .. ... . _, ,-
<br /> f..,�;...:�.< ,. . . .. ._ .._ . . ., , „ . ... .
<br /> OTHER ', .a�;.�" . - ,r,_ -. . _ _ . „ , `; •..;z..• _ ._ . - • . "_ .� . ... . ..� _ ,
<br /> �,+'• ,,,COMP/�NY
<br /> SIGNATURE�: .,._ '� ��. ;,'. . _ , �� ..,�. . ,.s-; „ x<, � .�:.�:�. �. ..
<br /> �` 'REGISTERED Y/ N�:' �e CUR�n Y/N.
<br /> .�t•,:. ��s -.-., .. .. :. .. , _. .. _ _. _ .. - • . ,• ... . - -
<br /> /�df�88 �"�•:,r-,.:y+,�•" 'r'?;; '�;•``Zk^;G_" ::i -i�, a,�, ... ' � �� ' 'L�CAfl�BB'#`� ,
<br /> RE$IDENTIAI;e ''=::Al18CF�F(2),flot;Plans;;,(2)"sefs;o'f.+Building+Plaris;(1)setof�Eirergy�.�o`rrns;��R='Q=VU=Peirriltfornewconstrucdon,� , ' : ..
<br /> ,:c . ... - � -
<br /> � -�-�-t;�Mlnlmum�tent(d,0)�woriting,�dajis4afte_r;;subtnittal daC"e.�;:Requlred onslte;�Con'strucBon�Plans,=Stortnwater Plans•w/SiIE'Fence Installed,- �
<br /> ,_. �,.., . • .
<br /> -Sanitery Fac�lltles&�;1;�dumpster�Sl.�e;Work�Permit,for,su6divtslons�iaigeipro]eaCsK��w,;;:'r•�_:,. , �• � _, .
<br /> COMMERCIAL Attach(3)`complete''sets`of Bulldfng Plans plus a.Ufe Safety Page;y(i)set of Energy Forrns.R O-W Pertnit for new construcUon.
<br /> Minlmum ten(10)woricing days aiter submlttel date. Required onslte,Constructlon Plans,Stortnwater Plans w/Sflt Fence Installed,
<br /> - Sanitary Facllitles 8 1 dumpster.Slta Work Pertnit for all new:prcJects::Pdl commerGal�epulremants_must meet compllance � �
<br /> :�SIGN PERMIT AttacFi""(2)sets`ofEnglneeredGPlansr�:s:�.;�?;:�r �..;�;.���.. � • � `
<br /> "•"PROPERTY SURVEY.reguired for all NEW.conshuctlon.,. __ _ � - .
<br /> ..Dlrectlons: _�:�vv:;�;,:_.:• . _. . - - " ,
<br /> 'FIII out eppllcaUon cempletely.
<br /> -Owner 8 Contractor slgn back of applfcatlon,notarized �
<br /> If ov.er SZ600,a Notice..of.Commencement la r�qulred. (A!C upgrades over 3T500) , .:,
<br /> ,.,.=r,:;�=���:'.'
<br /> '• enC for ttie'contractor.-"or`Powe��of Attome for the owrier woul'd be someone wlth notarized letter from owner authorizing same
<br /> a9 ( ) y.�.__ __,�._. �
<br /> �-�VER�THECOUN.T.ER:PERIYIITIING--�---:�•(Frontof-Applicatlon•Only)�-- •�- - " �� ��'�
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) .
<br /> .�..._.,.�._.. ._..._. _.__.... _ ... .., - •.- - .,.- ' � - - -rr
<br /> �...''�f'..-,Jv'7�.- r�:.�_. _
<br /> Drlv�waya-Not over Counter tf on public roadweys:.needs ROW"
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