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813-780-0020 City of Zephyrhills Permit Application Fax-813asaoo2�
<br /> ` Building Department -
<br /> _ • $�6�
<br /> Date Recelve� ��3 �j�� _
<br /> ;� 2 � � ° Phone-Contact'forPermittln
<br /> LLG � � -�� �: :
<br /> Owner's Name �r �G� r ��r4 � � Owner Phone Number
<br /> Owner's Address �31� �'r"o�-�'��C �,{'� � �. . G�c'�S� Owner Phone Number �
<br /> Fee Simple Tltleholder.Name � = Owner Phone Number '
<br /> � .r . .
<br /> Fee Simple Titleholder Addr�s�
<br /> d"`� -
<br /> JOB ADDRESS � �S - D �- �i� �d �, I�u� I � 3 �� LOT# �
<br /> SUBDIVISION PARCEL ID# d3�2�— Z+ '^ D�'�v ' f�Z c7 U-- B 63 C�
<br /> � . _ (OBTAINEDFROM,PROPERTYTAXNOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> ':8�, + INSTALL e ;�;;REPAIR •�
<br /> PROPOSED<USE � . • Q SFR� Q �COMM' ' Q �OTHER " v
<br /> TYPE OF CONSTRUCTION w Q� BLOCK " 'Q FRAME ' Q :STEEC 'Q
<br /> DESCRIPTION OF WORK•'' -. �I a..�� � C' �O S • ,� (Z Gf�G� � I�u��l
<br /> BUILDING SIZE" ` ` SQ�FOOTAGE ` �D�'_ , _ HEI,GHT� .
<br /> Q BUILDING , $ �J//1 Q� VALUATION lOF TOTAL';CONSTRUCTION .' � �
<br /> L�l
<br /> QELECTRICAL $ ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ,
<br /> OPLUMBING�� $ �'
<br /> QMECHANICAL $ ` ' ' ` VACUATION OF,MECHANICAL INSTALLATION ,
<br /> QGAS Q ROOFING Q SPECIALTY �] OTHER� - �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES .NO
<br /> BUILDER PANY' ` �2 " C �
<br /> SIGNATURE REGISTERED Y/ N EE CURRE�' ' Y/N
<br /> Address � - License'# � �3 2 Z� C9
<br /> . .. � �
<br /> ELECTRICIAN;< r, =COMPAWY ° `
<br /> SIGNATURE � REGISTERED Y/ N FEE CURREKr '� '''Y/N
<br /> h , � - _. , ,_ .
<br /> Address : , • � , , License#
<br /> PLUMBER.' ^ r • COMP.ANY � , � . .
<br /> SIGNATURE'' � ' ' ` "" , REGiS7ERED. , Y./-.N•; ,,, EEE CURREA Y/N. -�-`
<br /> Address � ,License,# . - -
<br /> AAECHANICAL"' :� - , ' � . COMPANY; � - ' �
<br /> SIGNATURE � � ' ` '' " - ' y� REGISTERED ,Y./.N A FEe�cuwten. Y,hN ,
<br /> ,,..; _ .
<br /> Address�'' , � � . .... . :': . � ._ , . � . � , � P License# _ ,
<br /> 'OTHER , � , - ' ,_ - _... ` � ' ',COMPANY" <` .. - - .. ' ' •�
<br /> SIGNATURE; �..� `' ' - �'-'`- ' - 'REGISTERED Y/ N,_ FEE CURRE� Y/N ..
<br /> Address� ., _j , .. , ,..:��; ,._. ., . ,. a. ', ' � ' License# , a� ., - - _. .
<br /> ":of+Bulldln�:Plans�'r 1 sef ofi.Ene'�f-,�Forrns;;:R=O;W�Peririlt fbr new constructlon,„ ' '-" " '" : � :
<br /> RESIDENTIAL'�";`S,;�Attacfi'(2);Plo.f,P.:.lans;,.(2•)sets. 9 ,(.) ►9Y...:::..:..... ,,.;,., . . „ . , .,,, . �-�:. ,... .� -',_
<br /> •�;y :Minimum;ten:(�1.0):,worliing;days,after;submittal°d'afe�s:Requlred onsite;:Constnigtlon�Plans;Stoimwater'-Plans,w/'SOt Fence installecJ,�
<br /> _...r�: . . , . . ;l"- " _ : -'__-
<br /> � s'Sanffery�Facilitiesr&�1:dump.ster;Slte;Work.Permit;foc;sutidivtsions/large,projeots�..�: : � . ___. - -
<br /> COMhAERCIAL Attach(3)c:omplete`sefs'of'B'uflding°Plans'plus a�L(fe S'afety Page;��(1)set of EriergYy Foims.R O W Permit for new construcUon:.� � -
<br /> . " Minimum ten(10)working days'after submfttal date. Requtred onsite,ConsUucBon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary:Facilidas&1 dumpster.-Slte.Work Partnit for all new�projecfs.;All commercial requiremenGs�must meet compliance'""��`��"•�' • ` '��'
<br /> SIGN PERMIT Attacfi"(2)sets`of'Enginee.r,ed;P;,lans:;�.. �;'<�-. - �, . , ` � - . � '�
<br /> .�„�. . ,
<br /> �� ""PROPERTY'SURVEY�reguired foralLNEW construction.. - � - - `
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<br /> _.,
<br /> Dl�ecttons: .:.... .. . �- . < ., ., . --- : . _ - -
<br /> 'Fiil out=appifcadon completely.
<br /> Owner 8 Contractor-slgn back of appl(caUon,notarized
<br /> If over'�2500t,.a Notice of:Commencement t�required. (AIC upgrades over 57500) __ _ , . ,..,.___
<br /> ....,;.,,<...;�-..�• � � - .. .
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<br /> '" Agenf(for th'e contractor)'or"Powe�of Attomey�(for`tfie odmer)would tie someone with notarized letter from owner authorizing same � ,
<br /> DVER T,HE COUNTER:PERMAITTING--��-;-(Front�of-Applicatton�Only) � - •-� _ ' � � _ _
<br /> Reroofs if'shingles Sewers Service Upgrades A/C Fences(Piot/Survey/Footage) _ . .
<br /> _...._ .. ._ ... ..�. .,....._. . ._._. ... _ � . . : ,. , .- ��f , . _
<br /> Drivewaya-Not over Counter if on public roadways..needs ROW � �� .,,.<,,,,.•,..,�..A .�..- .• � - - ° - ""-� " ` , �, ,_ �
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