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Q��-ra�►��u City of Zephyrhills Permit Application Fax-813-�eaoa2�
<br /> _ -� Building Department
<br /> Date RecBtved Phone Ganka�t far Perm{tt9n / ��� — �a��
<br /> Owner's Name �d�� f1 LZ � t✓' t3wnar Phone idumber �f�" ��� r�7^�
<br /> Owner's Address �p/� �a' ��� �� ��7 Owner Phone Number �� �
<br /> Fee Simple'Eftleholder Narree Owner phone Nnmber �— �
<br /> Fee Simpie Titieholder Addresa
<br /> JOB ADDRESS ✓�7 il� (/f�K /'S G�J �k i LOT# �,_,,,�
<br /> SUBDIViS10N L°I��C�LLJ�I ��.� PARCEL lD# �� �� 0�1 G�C�L�Gf ���DQ �I L D�
<br /> (OBTAINED FROM PROPERTYTAX HOTlGE}
<br /> WORK PRQPOSEQ � e NEW COfdSTR� ADD/A�T Q SiGiV Q Q DEMOLiSH
<br /> INSTALL REPAiR
<br /> PROPOSED�USE Q SFR Q COMM Q OTHER
<br /> TYPE QF CONSTR!lG7iON �] BLOCIC ' Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORIC R�o �/ 'C% ,�i/7 iF}'/1I �--C1 GP�`�`i G ?U�lv�s a� �DAJ � !`��
<br /> BUt�DlNG SIZE ���� SQ FAOTAGE�� HEIGHT ���
<br /> QBUILDING �� VALUATIQN`OF'TOTAL CONS1`RUCTION
<br /> QELECTRICAI � —� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBiNG ($_� -
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<br /> [�ECHAN{CAL $ ���� �� VALUATION OF MECHANICAL INSTALLATION
<br /> � � .. , ..
<br /> QGAS Q ROOFING Q SPECtALTY � OTHER � �
<br /> FINISHED F�OOR ELEVATIONS ��� FLOOD ZONE AREA QYES NO
<br /> BUIL.DER COMPANY'
<br /> SIGNATURE REGiSTEREQ Y! tV FEE CURRET Y/N
<br /> Ilddress Ltcense# r� :�
<br /> ELECTRICIAN . COMPANY
<br /> SIGNATURE w" REGtSTERED Y I N FEE CURREh - ' Y/N
<br /> Addre�s License# � �` � �
<br /> PLUMBER GOIVIPANY
<br /> SiGNATURE REGl3TERED Y! N FEE CURRE� Y!N
<br /> Address License# ( i��
<br /> MECHANICAL � � ll�'?�'� COMPANY f}R S�h'NE'-C� y'"�e T��
<br /> SIGNATURE �� REGISTERED Y 1 N ; t�E cu�t�R Y i N , �
<br /> Address ''y'��I �1�� i.icense# �����9''�v �
<br /> OTHER ,COMPANY
<br /> SiGNATURE REGISTERED Y/ N FEE CURREA Y/N
<br /> Address license# � i^��
<br /> RESlREP!'FIA{. Attach(2).Ptoi Plans;(2)sefs.of�Buit�ing F'tans;(i)'sef of-Energy�Fortns;R-O W Perinit far new construction,
<br /> Minimum�ten(10).working;days-after.,submittal date. i2equlrecl onsite,Construcflon Plans;Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes:&.1,,dumpster�Sfte�Work:P.ertnit tor subdivisions/large projects
<br /> COMMERCIAL Attach(3}camplete sef`s of 8uilding Plans ptus a ufe S�afety Page;(1j set of Energy Forms.R-O-W Permtt for new construeUon.
<br /> Minimum ten(1d)working days after submittai date. Requlred onsite,Construction Plans,Stormwater Plans w/SIlk Fence installed,
<br /> Sanitary Facitities&i dumpster.S(te Work Permit for all new=proJects.All commercial requlrements must meet compllanes
<br /> StGN�ERMIT Attach(2)sets of Engineered:,Plans.
<br /> •'"'PROPERTY SURVEY required for all NEW consUvctlon, �
<br /> Dtrections:
<br /> Fiil out applica8on completely.
<br /> Owner&Contractor sign back of applicatlon,noNa�lzed
<br /> If over�ZSOQ,a Notice of Commencement Is requlred. (A!C upgrades aver�7500)
<br /> " Agent(for the contractar}or"Powar of Attomey�(for the owner)wauld be someone with notarized tetter from owner authorizing same -
<br /> dVER THE COUNTER PERMITTING .,.(Front of,AppltcaUg,n�nly�,�, �u� � .,
<br /> Reroofs lf shingles Sewers� Service Upgrades A!C F.,en�es{Plot/SurveylFootags) � , ' ' .
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<br /> Drlveways-Not over Counter[f nn publio roaduvay�..needs�:ROW w , ; ;
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