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a�aasaoo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> '' - � Building Departrnent � `
<br /> Date Received � ° P.hone-Contact for Permiltln ��� /3 _o J�' �
<br /> Owner's Name E'�'/�� ��ts� Owner Phone Number O / / Z�7�3� ,
<br /> Owner's Address - D�� v �� �y ST G �1 Owner Phone Number .
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<br /> Fee Slmpls;Titleholder.Name L�7`r�1�'`� LfJ�ZSro� Owner Phone Number
<br /> Fee Simple�Titleholder Addresa S�� v�C��� .
<br /> JOB ADDRESS �C� /"L��'C�- �T /// LOT# �.
<br /> 3
<br /> SUBDIVISION ���� � ' .17� P.ARCEL I�# ' •
<br /> , (OBTAINED FROM PROPER71f,TAX NOTICE)
<br /> WORK PROPOSED , �,NEW-CONSTR . ADD/AlT �` SIGN Q ' Q DEMOLISH
<br /> , _ �.8.; INSTALL 8, REPAIR ^ -
<br /> PROPOSED�.USE � Q SFR• [� -COMM `Q �OTHER �
<br /> TYPE OF CONSTRUCTION Q'� BLOCK " Q FRAME � �Q STEEL Q
<br /> DESCRIPTION OF WORK G ��— Q���`�� ��'�L
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<br /> BUILDING SIZE "SQ�FOOT�IGE�, . � ,.N@I,GHT���. , .
<br /> QBUILDING $ VALUATION�"OF`TOTAL CONSTRUCTION '� �' `
<br /> �LECTRICAI $ - �,q AMP SERVICE J� � -PROGRESS ENERGY Q W:R.E:C.
<br /> CiL�
<br /> QPLUMBING � �$ _' � .
<br /> � � � f� � �9�
<br /> QMECHANIGAL $ VACOATION OF;MECHANICAL INSTALLATION �I"l/�
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<br /> QGAS Q ROOFING .Q SPECIALTY.Q OTHER• •
<br /> FINISHED ELOOR ELEVATIONS FLOOD ZONE AREA QYES. _NO
<br /> BUILDER COMPANY=' -� �- ✓
<br /> SIGNATURE REGISTERED Y/ N FEE cuRt�K ' Y`/N' .
<br /> Wddre�s � Cicense# � '
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<br /> , ; . � �j,��
<br /> ELECTRICIANI; � -�COMPANY ��i � G.� �—(,�-�"����
<br /> SIGNATURE �� /I / � —"� � REGISTERED Y/ N FEE CU RE�`' ��Y/N
<br /> Address �:'C:j�� ��� t• �� C.l�� G�;:.; ' � - ::. License# = , �i�5 � �,
<br /> PLUMBER; . � � CONAPANY ...� . ' '_
<br /> SIGNATURE` ` ; _REG�sTEiiED � Y/�.N"i `�_ F.,EE CtlRRER YI N . -
<br /> Address ' � - � t Li'cense,# � .. � _ .
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<br /> MECHANICAL " - - .. •. C,.OMPANY_, ' . - : , ' �
<br /> SIGNATUPZE • fi� � � " ^ ' ��� � REGISTERED_y Y:/-N . ; FEE CURRE�;_ = , Y./'rN -
<br /> Addresa°`--�-°' , ` • . , .°` ' , • , . ' ` ' License# -
<br /> OTHER `� � . - . _' r;COWIPANY, ,
<br /> ,,
<br /> SIGNATURE � - " ' • � ' f " REGISTERED' ` Y/ N.. �FEE CURRE� . Y/N. ,
<br /> Address '-- ._,_, . ,.j� -•- � � ,� - .. ' License# " ' � .
<br /> r. ., . . .
<br /> RESIDENTIAL:;:: •Attacfi�(2)„Plo.f Plans;;(2)sets:of�Bulliling�`Plans;'(1)�set'of�Eneigy,Forms;R=O=VV;Perinit far new construction,
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<br /> • � ;,;��-,Minimum�ten;(1A)�working�days aftet.submittal date:<R`equired onsite;:Ctinstructlon Plans,�$tormwater Plans w/Silt Fence installed,
<br /> ' � �SanitaryFacllfties,s&,,15dumpster;Site�WorkuPermitfqr;subdivisions/Iarge�proJecfs,�.-� ,��• �
<br /> COMMERCIAL Attach(3)oomplete'sefs of'Building Plans plus`a Life S�afety Page;(1)set of Energy Fortns.R O-W Permit�for new construction.�
<br /> Minfmum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w!Silt Fence installed,
<br /> Sanitary Facilides�1 dumpster.Site Work Permit for all naw.projects:.All commercial�equlrements must meet compliance
<br /> SIGN PERMIT Attach(2)"§efs of�Eng,i'neer.ed;Plans:,.��._:-:-`•. -: . .� • "
<br /> ••••PROPERTY SURVEY reyuired for all,NEW construcHon.
<br /> Dlrectlona: °� ��i: � , • �. �
<br /> Fill out applicadon completely.
<br /> Owner&Contractor sign back of applfcaUon,notarized
<br /> If ov�r 526�0,a Nottce of Commencement is required. (AIC upgrades over;7500)
<br /> '" Agent(for the contractor)�or'Powe�of Attomey(for ttie owner)�would be someone wiith notarized letter from owner autho�izing same
<br /> DVERTHE COUNTER.P:ERMIT�TING � ---,-(Frontof-Appllcation�Only) - � �� �`_
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage) _
<br /> Drlveways-Not over.Counter If on public roadway"s::�eed`s ROW
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