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L t�13-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> -` " Building Department
<br /> Date Recelved ' ,: Phone-Contact for=Permlttin $/� /O� — �d�,� `
<br /> `1_
<br /> Owner's Name < �D/�� @ ef� � Owner Phone Number �l�'�/ ����0
<br /> Owner's Address ��� /I�� �//� , Owner Phone Number
<br /> Fee Simple Titleholder Name � . Owner Phone Number '�
<br /> Fee Simple Titleholder Address .
<br /> JOB ADDItESS /��/ �� �/�. LOT# �
<br /> SUBDIVISION /'7/ A �L� �S - p,qRCEL.ID# � o� �� �l �� � Qf,� D L/���-
<br /> , ' (OBTAINED F,ROM PROPERTY,TAX NOTICE) �
<br /> WORK PROPOSEp . NEW CONSTR ADD/ALT Q SIGN' Q �Q � DEMOL-ISH
<br /> re. �INSTALL REPAIR - - . �
<br /> PROPOSEDeU$E - • Q SFR Q COMAfl Q OTHER � • � " �
<br /> TYPE OF CONSTRUCTION Q ` BLOCK ' Q FRAME ' [_] 'STEEL 'Q
<br /> DESCRIPTION OF WORK,' '. i
<br /> ��-. � � � �� �o� � a � �N� a,��- � � ,
<br /> BUILDING SIZE � � "SQ FOOTAGE��, HEIGHT �
<br /> QBUILDING . $ VALUATION��.����'.�� � . ._ �+ . �A '
<br /> . OF TOTAL"CONSTFtUCTION -
<br /> QELECTRICAL $ - AMP SERVICE Q PROGRESS ENERGY Q W:R.E:C. ,
<br /> OPLUMBING - ;$ ' _ �
<br /> QMECHANIGAL $ VALUATION OF,MECHANICAL INSTALLATION
<br /> �5�9.�'. �d ,.
<br /> Q�S _ Q ROOFING- ,Q SPECIALTY-�] OTHER � �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ,NO
<br /> " _ � ,�a:
<br /> BUILDER COMP'14NY` ' - - � `
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� '.Y/N�
<br /> Address - �License#" - '
<br /> ",.. - • .
<br /> ELECTWCIAN; ,�COMPANY " �. _ �' .
<br /> SIGNATURE �' REGISTERED Y/ N Fee curutenr� ' ''`Y/N
<br /> ,. - �
<br /> Addreas ' ' , _ .;: Lfcense#. � -
<br /> PLUMBER ' COMPANY . .. , ' ,
<br /> SIGPIATURE` - , .REGISTERED Y./-�N�'s :_��,�FEE CURREk ' Y./.N. �. '
<br /> Addre�s �_Llcense,.# ' ` -
<br /> - f; �
<br /> MECHANICAI:� ' 1 � / ` ,... , - ' n/tiIG � .
<br /> SIGNATURE ' � C.OMPANY /���J G�tS'�.,. L��=
<br /> REGISTERED ; Y,/.N. , ,_.;,�_FEE CURRE� . Y/fN. ,
<br /> Address` , f7��� /�/le/C� j�, `Z� / S�c��. - � ' . .License.# (��G`d�3�� - - _
<br /> . , • _ ;,,,;..
<br /> OTHER ° - . , . . ' � ';COMPANY ` '- ' � - , � -
<br /> SIGNATURE �, _ ,. , . , . . . . . , :i :: ..�..... :.: . , .
<br /> - REGISTERED ' � Y/ N:.< � ' FEE CURRE� Y/N. ,
<br /> Address - - � ' - - • License# _ . , - . ' '
<br /> � f�..��..� i :M1.i� :.r _n . . }$..,-.` .... {:':::1'tt=�c :--. y.�., �.;, � .� - � .[3:! ^^;;� '
<br /> RESIDENTIAL�,, : �Attach"(2)�Plot�Plans;::(2)`s'efs::of<Bullding�Plans;'(1)'set of�Energy�Fortn§;.R-0=WiPerrrilt for new constructl,on, _; � T �
<br /> - Y�;Minimum�tenF(-1�0);�working;days�after;submittal�dafe:'Required onsite;:Constrtiodon Plans;�Storrnweter Plans w/Sllt'Fence"installed,
<br /> � �Sanitary'FacillHesr&r;1,Ydumpster_Site,Work,Permit#or.subdivi5lons/large'_projects:=_:^�::.;;,= , ` ,., �� "
<br /> COMMERCIAL Attach(3)��complete sets"ofB'uilding Plans'plus a"�Ufe Safe4y Page;(1)set of Energy Fortns.R-O-W Permit for new construction. :
<br /> Minfmum ten(10)working days'after submittal date. Requ(red onsite,Construc8on Plans,Stortnwater Plans w/Silt Fence.installed,
<br /> Sanitary Facilides&1 dumpster.Site Work Permit for all new:proJects:.All commercial requi[ements.must meet compliance° �• -
<br /> SIGN PERMIT AttacFi"(2)`sets ofEnglneered�Plans.i,:;...----. � .;. � � ' -
<br /> , , .
<br /> ""PROPERTY SURVEY regufred for ail NE4'V construcUon._� , -
<br /> - _ _ .... .
<br /> Directions: �� , -� � � --
<br /> Fiil out applicadon completely.
<br /> Owner 8 Contractor sign back of applicatlon,notarized
<br /> If over a2500.a Notice of Commencement is requfred. (AIC upgrades over 57500)
<br /> � ':��,�;•,,,
<br /> " Agent(for the ccnVactor)or Power of Attomey(for tFie owner)would�be someone with notarized letter irom owner authorizing same
<br /> DVERTHECOUNTERPERMITTING- - •(Frontof-Applicationflnly) � • � ' ` --°-� -'���� . =•._= -� .. . .
<br /> Reroofs if shingles Sewers, �y � Seniice Upgrades=AYC�••-.�s_Fences(Plot/Survey/Footage) ` � � � ,
<br /> Driveways-Not over Counter if�on'putilic roadways..needs ROW �' � , �. � ' "
<br /> � , .. , _ �;_��. ., .,� :.:�� -. .�,.
<br /> ... ._. .. _. , , .. . : , • - ' �
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