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e��-�saoo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Bullding Department
<br /> Date Recelvad . .° Phone:Contact'for�Peririlttln �
<br /> Owner's Name Owner Phone Number
<br /> Owner's Address .��-����/ ��`b C-LU�—/ �'j O/�I L�! Owner Phone Number
<br /> Fee Simple TItleFiolder Name � � Owrier Phone Number
<br /> Fee Simple Tltleholder Address 3J lo��� ��}'N� / N � /� v �
<br /> JOB ADDRESS �O �P�� �'�N S l r � �j �/ � LOT# �
<br /> SUBDIVISION - PARCEL ID# ���^ �G 'a/� "ab v_ � � o o c� -/z u �
<br /> (OBTAINED FROM.PROPERTYTAX NOTICE)
<br /> WORK PROPOSED �.'NEW COPISTR ADD/ALl' Q SIGN� 0 Q DEMOLISH
<br /> ,� INSTALL 8 - REPAIR
<br /> PROPOSED.USE Q SFR Q COMM' Q OTHER
<br /> TYPE OF CONSTRUCTION Q' "BLOCK ' �Q FRAME Q STEEC Q _
<br /> DESCRIPTION OF WORK ` ` � ��'��T� �(�� ��`"�� 33�
<br /> BUILDINGSIZE � � SQ�FOOTAGE '3 30 � HEIGHT � � � I'I
<br /> �ILDING . $� ,OO` O o VALUATION�OF`l'OTAL'CONSTRUCTION � f '
<br /> QELECTRICAL $ " AMP SERVICE Q PROGRESS ENERGY Q 'W.R.E.C. � '!
<br /> QPLUMBING•• $ �� ���
<br /> . � �l
<br /> QMECHANICAL $ � VALUATION OF,MECHANICAL INSl'ALLATION I
<br /> Q�S „ Q ROOFING Q SPECIALTY Q OTHER�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES. ,NO I
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<br /> BUILDER / � � COMP74NY' ��C U ��✓`��� �v l r C �,
<br /> SIGNATURE h/ REGISTERED Y/ N �FEE CURRE� YY N" . �I
<br /> Addre�s �� . � Lfcense#' ' I
<br /> ELECTRICIAN, ,,. , - � . .
<br /> , =COMPANY
<br /> �
<br /> SIGPIATURE REGISTERED Y/ N FE
<br /> E CURRE�� �'''Y/N
<br /> I Address ` y , ... Llcense# =. � �
<br /> PWMBER ' COMPANY ; �
<br /> SIGPIATURE" � ' , REGISTERED Y_/:N,� �,FEE CURRE� " Y./N
<br /> Address � _Ucense,# • .
<br /> MECHANICAL' , � . ` , �COMPANY �
<br /> SIGNATURE �� �`' ' REGISTERED , . Y,/ N . ;' FEECURRE�- . Y/:N , �
<br /> Address�' , • � - -` , . . � � � _ . . ' License# ,
<br /> ,}:, ,. � � . . .. ,. , . . � , ,.
<br /> O'fHER . -
<br /> ';COM,PANY" .,
<br /> SIGNATURE: . - � '`' .. � - � " - ' ' "'REGISTERED' ' Y/ N_�: FEE CURRE� Y/N _
<br /> x:,, . . • .. _. ., _. � - _ � - - -
<br /> Address _ �- - � . - �, " _� L'icense# , ' ',. � :. -
<br /> RESIDENTIAL,-;: Attactr(2),Plof Plans;:,(2)sets-of'Buililing``Plans;(1)set of;'Energy;Fortns;�,R-0-W-Perrrilt for new construcUon,,,, � ' - '�'`
<br /> - , :.. .__. . ,. .. .
<br /> �_,�, Min(mum;ten;�,(:10);workfng;days;after�"submittal'date:':R:eijulred onsite,:Constnictton'Plans;'Stormwater Plans w/Sflt Fence instelled; •
<br /> �Sanifary FaclllUes,8:;1,;du,mpster.SIte;Work;Permit;foe�su6diVlsions/iarge:pr�oject§-:�;:.:;:._: � ` - "_ _ . _� �
<br /> COMMERCIAL Attach(3)�complete sefs'of B'uilding Plans`plus a.Life Safety Page;.(1)set of Energy Forms.R-O-W Permtt for new construction.� • -
<br />_ -- -- -Nlinirrwrn ten(10)working days'after submittal date. Requtred onsite,ConstrucHon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary FaGiitles 8.1 dumpster.Site Work Permit for all new:projects.,All commerGal requlrements_must meet compllance.�' " • � ' � • -
<br /> SIGN PERMIT AttacFi(2)sets of Engineered-Plans:, �...;f-�--- � , ' '� .. - . � , - ' � „ -
<br /> ,.r .,.
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<br /> i PROFERTY SURVEY reguired;for_all_NEW.construcd'on., e . _ .. . - --- - -.-
<br /> Dlrectlons: �� - ,= � • . - . � --. - - --
<br /> Ftll out applicatlon completely.
<br /> Owner 8 Contractoc slgn back of appltcatlon,notarized
<br /> If over�2500,a Notice of:Commencement la required. (AIC upgrades over$T500) ,
<br /> ` �i,�,-; ; _ .._. ._
<br /> '" Agent(for the�contraofor)-or�Power of�Attomey-(for ttie�ownerj would be someone with notarized letter from owner authorizing same
<br /> OVER-THECOUNTER;PERMITa1NG-� -' '��(Frontof-Application-Only)--t � - � " '' ""� � � ' � �� � ��
<br /> Reroofs if"shingles Sewers Service Upgrade� A/C'• Fences(Plot/Survey/Footage)
<br /> Drivewaya-Not over Counter if an putilic.roadways:.need`s ROW ' , ' �
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