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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Departrnent
<br /> : • - '
<br /> Date Received _ Phone:Contact for Permlttin � � � — �
<br /> Owner's Name CI��I S�L� LLTy � G(�. �/`�/U b Owner Phone Number
<br /> � ��u GL�A- 4��0 �� p `
<br /> Owner's Addrass � � /tyt.(� � Owner Phone Number
<br /> , r�s
<br /> Fee Simple Tltleholder Name � - � ' `} Owner Phone Number
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRESS .�Z���C/� �\ LOT# ��
<br /> SUBDIVISION PARCEL ID# lD-��2��D�f `�� �-�j�
<br /> - (OBTAINED FROM.PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED ���NEW�CONSTR ADD/ALT [� SIGN� `Q Q DEMOLISH
<br /> . ,,B. INSTALL B' ; REPAIR � �
<br /> PROPOSED:USE � , , Q SFR Q �COMM Q OTHER ' -
<br /> TYPE OF CONSTRUCTION Q� ` BLOCK � Q FRAME [� STEEC 'Q
<br /> �
<br /> DESCRIPTION OF WORK ��A�DU�i �JC/Sl f�� �� � � �' �//�(� �{��f,�
<br /> �� �� � ,�7--��Ti�. L�ac/�i
<br /> BUILDING SIZE 'SQ FOOTAGE�_l�'1G�; , HEIGHT �
<br /> QBUILDING , $ ��Q VALUATION�OF�TOTAL'CONS7RUCTION `
<br /> QELECTRICAL $ ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ,
<br /> QPLUMBING $ - - '
<br /> QMECHANICAL $ VALUATION OF;MECHANICAL INSTALLATION �
<br /> Q�►S Q ROOFING .Q SPECIALTY Q OTHER�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA - QYES NO
<br /> BUILDER * � ���������T /��M/,\/!�J(� ;
<br /> ,- COMPi4Nlf�
<br /> SIGNATURE REGISTERED Y/ N . FEE CURRE Y/N
<br /> Address �` � T�UjQ�� �� , License# �1—C_ (�Z�
<br /> ELECTRICIAN_ , � 'COMPANY ' " - �
<br /> SIGNATURE '� REGISTERED Y/ N FEE CURRE�� ` Y/N
<br /> Address ' ` �� - � _ .:. License# ,—�
<br />, PLUMBER , � . COMP,ANY • -
<br />, SIGNATURE' ' ' ' "' REGISTERED � Y./�.N,� ,. - FeEcu�n Y�/N •
<br /> Address ' Ucense,# :� - ,
<br /> MECHANICAL:" , y . • , , C.OMPANY - -
<br /> SIGNATURE ` REGISTERED .�.. Y/ N _; FEE CURRE�- Y/-N-
<br /> .' „ . : ,,. .�.� �� , : • -- . , „ '
<br /> Addre�s� ,. '
<br /> _ L�cense#� �
<br /> O'THER • , � - ' - ' , ' � � �`;COMPANY -- . - - ' .
<br /> SIGNATURE _•- • � � `^ =REGis7Eii��`� Y/ N_.. FEE CUR�n Y/N.
<br /> :7. .,.-�. i � .. .. ,. . .. . . " . - � . _ 1
<br /> Addre�s - - � r License# ' ' -. �
<br /> ,�,.,_,. .. ,, , . s., ,•.,;;.�,,; :..;., . ;_ . _. .
<br /> RESIDENTIAL;;--:�•AttacFi?(2).;Plot�Plans,;;(2)sefs.of�Bufldtng�Plaris;'(1).set of-Energy�Forms,;.R-0-V11 Permit far new construction,,,. -� - ' ' ' �
<br /> � � - . �, .. . .
<br /> ; �.:Minimum,ten;(:1,0)worktng;d'a,ys;after,;submiftal�date:.'R:equlred onsite,=Constiucdon-Flans;�3tortnwate'r'Plans•w%Silt Fence�installed,
<br /> �� �Sanitery'��Facili8es;&i_1�dumpste_r,.Site:Work;.P.:ertnit#orsutitlivislons%la'rge.proje'cts�:.__--..�,.-:,� __ ' ' ��� "'" , �
<br /> COAAMERCIAL Attach(3)complete se4s�of-8uilcJing`Plans plus a'Life Safety Page;(1).set of EnergyrForms.R-O-W Pertnit for new'construcflon. ' �'
<br /> - Mfnimum ten(10)warfcing days after submittal date. Required onsite,Construcdon Plans,Stortnwater Plans w/Sflt Fence installed,
<br /> .. ,
<br /> Sanlfary Facilitles 8 1.dumpster.Site Work Permit for all new'proJect"s..All commerGal requlremen�must meet compllance�'�'� ^ � � -
<br /> SIGN PERMIT Attacli'(2)"sets�of'Eng(nee[ed�Plans:; �°;��-�-' '., . ,: - . � ' �. � � ` .. . � . .
<br /> �.<< . - �.
<br /> i ""PROPERTY SURVEY:r _uired,forall�NEW_construction... . - :> > .-.� --- -- �-
<br /> ---- ..�. . _ . ;<_� - . ,.. .
<br /> Di�ectlons: . ._,. . , . - - � --. . . ._ . . . _
<br /> Ffll out appllcatlon wmpletely.
<br /> Owner 8 Contractor sign back of applfcatlon,notadzed
<br /> If over'$�500,a Notice of�Commencement Is requlred. (AIC upgrades over 57500)
<br />� 'R :..�:,�.Y�17�,�tw.��` _ ... . .. r _" _ _
<br /> Agent(for ttie cantiaotor)or Powe�of Attomey(for�the owner)woul'd be someone with notarized letter from owner authorizing same _,
<br /> DVER THE COUNTER�.PERMITLING-- --,•�(Front of�Application-Only)•- -� - � • � - � ' ��� � ��
<br /> Reroofs If shingles Sewers Servlce Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drlvewaya-Not over Counter if on public roadways:.needs ROW " - :
<br /> -� -- - �_ ,. =%;
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