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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
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<br /> Building Departrnent .
<br /> Date Iteceived � 7�� _ �"��3,,
<br /> -�-: P..hone�Contact forPermittin ` �3'
<br /> Owner's Name !� � o�/. � Owner Phone Number ��3" ��o� o�-O L J
<br /> Owner's Address ���� ��0�00 �/ I�Z=Le!'S Owner Phone Number
<br /> Fee Simple Tltleholder.Name � Owner Phone Number ' �
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<br /> Fee Simple Tltleholder Address
<br /> JOB ADDRESS S�I� JI� � � � r�j/� S �� ���I�CSIG �/Y] �/ LOT# �
<br /> suBoivisioN . e,aRce�io# �l! �lo �l D"�/d J 71�� D��C�
<br /> . . (OBTAINED FROM PROPERTY,TAX•NOTICE)
<br /> WORKPROPOSED :.'NEW.�CONSTR ADD/ALT Q' SIGN�- Q• " � ° Q� � DEMOLISH
<br /> � .B, INSTALL � REPAIR -• - _. ,
<br /> PROPOSEDaUS� - Q SFR� Q ' CONiM• - ' Q •OTHER ' � � •
<br /> TYPE OF CONSTRUCTION � Q BLOCK ' Q FRAME � �Q STEEL Q � _
<br /> �J. � �" �,\
<br /> DESCRIPTION OF WORK j ��'All,fj �q� � �L° � /d/� �/�G j�� U 1���/G' �aJ1')`,
<br /> . �,C�= , ;�: �. Ca7nn�o�en1 T.S
<br /> �UILDING SIZE - ' � `SQ FOOTAGE HEIGHT.�
<br /> QBUILDING , $ .�.._._. _. _ ' . � � ..
<br /> , VALUATION,:OF=TOTACCONST�RUCTION - �
<br /> QELECTRICAL $ ' AMP SERVICE 'Q ` PROGRESS ENERGY Q. W.R.E.C. �
<br /> QPLUMBING :$ ' '
<br /> �.�. -
<br /> QMECHANICAL ' $ i1.j p0,� VALUATION OF,MECHANICAL INSTALLATION
<br /> �7 ocd •
<br /> Q�S Q ROOFING ,Q SPECIALTY Q OTHER - . �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ;NO �
<br /> BUILDER COMPANY'� - . . , _ � ,
<br /> SIGNATURE REGISTERED Y/ N -FEE CURRE� ' Y/N". "
<br /> Address v � License# � �
<br /> ELECTRICIAN. - � COMPANY' ' � n ' -
<br /> SIGNATURE � REGISTERED Y/ N FEE-CURRE��' ' '•Y/N
<br /> E .` . . ... ., ' � ,
<br /> Address � - - � _:. License# :
<br /> PLUMBER COMPANY . �
<br /> SIGNATURE' ` � _ REGI3TERED. Y./-4N.,; „rFEE CURREA ' Y/N.�`_ „_ ,
<br /> Address � . � .�License,# , . r . �
<br /> MECHANICAL'' � A Lp/L . COMPANY nbl�S.�„OpA%1J���`"R�Gr ..�.
<br /> SIGNATURE� ` �� ' � REGI'STERED_;� Y,./ Nt, . ; FEE CURREP s. YJ�N . t
<br /> Addres's�� '77�� ���eN:� ;9� �hil. _ , t ... . ..ucense# �i���,T3q'�'�; , -
<br /> . . � . . � . .. , , . �� -
<br /> OTHER " - ' FCOMPANY � ,
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<br /> ., f:�. " a; • -< - ;•r_., � . ,.RED�
<br /> SIGNATURE .� - � • � �� ` '�REGISTe ''Y/ N,..:�` `:FEE CURRE� Y'/N
<br /> Addre� . . s ,,� , - . .. : � Ucense#� . � � - . ..
<br /> r. �r�ry..,:..,.._.. � ,,;� .
<br /> RESIDENTIAL'.:-,e :Attach''(2).;Plot�.Plans;�(2)§ets:of Bullding�Plans;'(1)sef of'EnergyFForms;`�R=O-W'Perrn,lt for'new construction,. ' " '_ ' �_ "
<br /> �-, ,.;;;;;.Minimumiten,(�1,0);�working;days�after;submiHal`date..Requireii onsite;_Constiuctlon=Plans;�Stormwa4er P1ans wl SilfiFence.installed,
<br /> ` Senitary Fac(IlUesti&�1;;dumpste_r,;Site�:Work�Pertnit for;subdivisions/large.proje�fs;y ��.-�, "- :..;'.
<br /> - - CONIMERCIAL Attach(3)�compl'ete�'sets ofs6'uildtng Plans�plus e'Cife'Safe{y Page;(1)set of Energy Forms.R O-W Permit for naw construcUon. ��
<br /> Minimum ten(10)worlcing days after submittal date. Required onsite,ConsUucBon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permi�for ail new;projects::All commerGal requlrements,must meet compllance' "� �
<br /> SIGN PERMIT Attach"(2)-sets�ofEnginee_r,ed;Plans.;.:s ��=-- � ., � .. - .
<br /> ""PROPERTY SURVEY required for all_NE�'V construcdon.. . . -
<br /> - - -- - z.
<br /> DirecNons: � ._-- - � �T' •
<br /> FIII out applicatlon completely.
<br /> Owner 8 ContracMr sign back of applfcaUon,notarized
<br /> If over 52500,a Notice of Commencement t�requlred. (AIC upgrades over a7500) ,
<br /> - „,�r_�<;:,
<br /> '" Agent(far the contraotor)or`Poviier of Attoiney�(for tFie owner)inrould be someone with notarized letter trom owner authorizing same
<br /> DVERTHECOUNTER.PERMI7TING- „•(FrontofApplication•Only) - ' � - ; ,,
<br /> Reroofs if shingles Sewers _ ::Service Upgrade's /VC�""""`"'�ences(PlodSurvey/Footage) � ., . ', " �•.,, t;:
<br /> . _ _ • ' , };. . . ,. .. . , � � ..
<br /> Drivewaya-Not over Counter if on public roadways..needs�ROW " �<; ��,. . _ ,
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<br /> � - ... . _ . '.. .a ,-� .. .. � � .��. � _, ...'r.:�+.Py
<br /> . _ . a , - �t .t .Cn i.�;o.j .
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