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813-780-0020 Cifiy of Zephyrhills Permit Application Fax-813-780-0021
<br /> . Building Department
<br /> Date Received , � "� .�� Phone Contact for PermiQting �� J �u� --��� (
<br /> Owner's�ame � Q� �e. Owner Y'hone Rlumber (�I� - 3�a -ao9
<br /> Owne�'s Address ����j 1 I U� � (h� �� 5 Owner Phone iVuenber
<br /> Fee Simple Titleholder iVame Owner Phone R�urtnb�e
<br /> Fee Simple Yitleholder Address
<br /> JOB,4DD12ESS S�3 U , I� � � 1 �V 11 I I S �1 3�V�I LOT# �°' 7 �
<br /> susoivisio� �(�n o� Z N;f� 5 PARCEL ID# ��'a�- a( —dv I 0, I`l 5 6 b �O�(o� �
<br /> (OBTAINED FROfIfl PROPERTY TAX PIOTICE) C �
<br /> WORIL RROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH � �
<br /> B INSTALL e REPAIR p Q
<br /> PROPOSED USE Q SFR Q COMM 0 OTHER — CI1 �
<br /> TYPE'OF COPJSTRUCYION 0 BLOCK - Q FRAME 0 STEEL 0 d
<br /> !- II_ ) C.1 �
<br /> DESCRIPTION OF NVOR{G T�Ql.�(��� r e-rw� �5 s C�A-F-T,m bef l��Q �S F'�k.�� l�►)I(1 I� l.Q)f�
<br /> �n -� ��y�.
<br /> BUIL'DIPIG SIZE SQ FOOTAGE . ���� HEIGHT �'`��
<br /> OBUILDING $ �J�C Q — VALUATIOfV'OF TOTAL CONSTRUCTION
<br /> I ��
<br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS EIVERGY Q W.R.E.C.
<br /> �PLUMBING $ �/1� /
<br /> � � r
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �(
<br /> �GAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
<br /> BUILDER COfIflPAPIY
<br /> SIGNATURE REGISTERED Y/ N _ FEE CURRE� Y/N �
<br /> ,�cBdress License#
<br /> ELECTRICIAN COf1�PAR1Y
<br /> SIG�IATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# il
<br /> PLUfUi��R COM PAP1Y=
<br /> SIGNATURE REGISTERED Y•/ N FEE CURRE� Y/N
<br /> Address . License#
<br /> iIAECH�1PlICAL � CONiPAPIY
<br /> SIGR�IP�ITURE' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre"ss License.# I
<br /> a,_ -
<br /> OTHER COMPAfUY �� vO� �n�
<br /> SIGNA7'URE., -• REGISTERED / N FEECU E� /N
<br /> ,�ddress 3�p� S . ,_c�y � h ((�r��S �( 33s�d1 License# C�(3°1 5 Sbs
<br /> RESIDEP�TIAL ; Attach�(2)`:Plof Flans;'(2)=sets of�Buildirig Plans;�(1)'set of`Energy Forms,'.R-,O,VV.Permit.for new.construction,
<br /> , - ,, ;Minimum.tem,(;10)working days aftersutimittal�date. Requireii onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary;Facilities�,&;;.1;.dumpster;S,ite�W.ork�Permit foe:'sutidi'visions/large projects
<br /> COMMERCIAL Attach(2)complete sets"of Builiiing"Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Pians w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit foF�all new projects.All commercial requirements must meet compliance
<br /> SIGiV PERfVIIY Attaoli(2)sets of:Engineered Flans. � �
<br />, "*"*PROPERTY SURVEY required for.aII.NEW construction.
<br /> ...� ._. _... .
<br /> Directions: - . -
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over$2500,a IdoQice of Comenencement is requir�d. (,AIC upgrades over$7900)
<br /> *" Agent(forthe con4ractor)�or Power of Pittorney(for'the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUMTER;PERMITTIIVG (copy of contraet�required)
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
<br /> ._..-�---...�...., ._,_ - - �..._
<br /> Driveways-Not over Counterifpn,public road'ways.:needs ROW � � , , . , , .
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