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e�saeaoo2o City of Zephyrhills Permi��pplication Fax 813-780-002�
<br /> Building Departrnent ,
<br /> Date Received �` �'' •_ `-fj"/.'� ^_ ,,��'`
<br /> • Phone>Contact.for•Permlttin�_
<br /> Owner's Name �' � /,� ,� =S Oarner Phone Number
<br /> Owne�'s Address D J� n9 ��C o�9� Owner Phone Number
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<br /> Fee Simple Titleholder Plame � `c� Owner Phone Number
<br /> Fee Stmple Titleholder Address
<br /> JOB ADDRESS ��/ �i�f},�G�� (/�Ury � �� /�'�j5'J LOT# �
<br /> SUBDIVISION PARCEL.ID# � � �� " ' " ' 7"' `'L�
<br /> - _ - , (OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED � NEW CONS7'R ADD/ALT Q SIGN Q Q DEMOLISH "
<br /> --B. INSTALL . REPAIR • �
<br /> PROPOSED�USE � Q SFR Q 'COMM ' �Q �OTHER '
<br /> TYPE OF CONSTRUCTION = Q"` ' BLOCK " � FRAME � `� ,STEEL' Q
<br /> DESCRIPTION OF WORK' l//�'/�� ' Q �'�� ����r,� •/ , /��i z ' �` .
<br /> BUILDINGSIZE ' " � SQ�FOOTAGE��, ,- _ ;HEI,GHT � .
<br /> •,
<br /> BUILDING $ VALUATION�OF`TOTAL"CONSTRUCTION
<br /> , �� �
<br /> QELECTRIGAL $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING � :$ � -
<br /> � .-��� �Oz
<br /> QMECHANICAL $ VALUATION OF:MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SPECIAL7Y � OTHER
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ,NO
<br /> BUILDER , OCOMP�. ���i9�17G��r,/� �D��i�N9�'�v�2
<br /> SIGNATURE � REGISTERED Y/ N 'FEE CURRen ' Y/N .
<br /> Address � �c345✓ �G � Gcense',# ' ��/�
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<br /> ELECTRICIAN:. ; � C PDwY l�C�U���-�� /`� l���i.�r l�,f�
<br /> S I G N A T U R E ' REGISTERED Y/ N FEE CURRE�' ` = "�Y/�N'
<br /> , /�,�
<br /> Addre�s �f��%C�1�1�� 31� 1 �`� ��?y �� VW , < License#: J� C.l��d Jr✓r' �C�
<br /> PLUMBER ` � COMPANY . , . -
<br /> SIGNATURE''� ' h _REGISTERED, Y/.-N.� :•,�Y.FEECURREA "�Y.•/N �
<br /> Address • \ - :- ' � , �
<br /> ..License#� � �
<br /> , , � � - . , -
<br /> MECHANICAI: `,` - ., O ;� ., Cu.✓ ' _. (�� �v �SO L at-T�G✓�S
<br /> SIGNATURE REGIST'ERED.,, „Y../ N. .�,. ,; FEE CURREA= .: X,/N � ,
<br /> I Address°, � - �, �.. --. _, . � • � � ' ,se#� �L� 6 - ,
<br /> , - - . . ... -, .. • , Licen �.
<br /> OTHER � - ' . ` ' � ';COMPANY � ' .
<br /> SIGNATURE .. . - : � � '�3 ' ' ` .
<br /> REGISTEREDS Y/ N�� FEE CURRE� Y/N�
<br /> Address - - . �� � . � , . .License#- ' - . -
<br /> RESIDENTIAI;�; :�Attacfi�(2)nPlot-Plans;::(2)sets_oftBuilding�Plans;(1)sefof Energy`Foiins;�R=O-W'Perinit far new construcUon, � ' - �
<br /> • e�,;Minimum-ten�_(1.0);woricing�,dags;afte.r,�submittal'date:;,Requi�eiJ onsite;,ConafiucBon=Plans;Stormwate�'Plans�wl Silt Fence installed,
<br /> � � �SanllaryFaciltties:&c.1,,dumpste,r.�Slte�Work;Permitforsutidiyisionsqarge'projects'. ,_;'" .:: '
<br /> COMMERCIAL Attach(3)`coinplete sets`of Buildirig`Plans plus a-Life Sefety Page;(1)set of Energy Fortns.R-O-W Pem►it for new construction.
<br /> Minimum ten(10)woricing days after submittal date. Requlred onsite,ConstrucNon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes 8 1 dumpster.Site Work Permit for all new;proJects.All commercial requlrements,must meet compllance '
<br /> SIGN PERMIT Attach"'(2)sets ofEngineer,edyPlans:, � •-�� .<� . .. - , �
<br /> . �
<br /> ""PROPERTY SURVEY reyuired_for all_NEW,constructlon.,
<br /> DGectlons: � _„�, .-- � �
<br /> Ftli out applicaUon completely.
<br /> Owner&Contractor sign back of applicaUon,notarized �
<br /> If over�2500,a Notice of Commenceenent Is requlred. (AIC upgrades over�T500)
<br /> : ,.:.� �;,,.•,.
<br /> " Agent(for the contractor)or`Power-of Attomey(for tFie owner)would be someone with notarized letter from owner aufhorizing same
<br /> DVER THE COUNTER.PERMI7'T6NG-- -:.•(Front�of-Application Only) 3, � ,
<br /> Reroofs If shingles Sewers Seryice Upgrades A/C"' --�erices?(Plot/Survey/Footage) ,•• � � .
<br /> Drlvewaya-Not over Counter,if on public roadways.:needs ROW,, � �
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