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813-780-0020 City of Zephyrhills Pe�mit Application 21
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<br /> BuDding Departrnent `
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<br /> Date Received , � V y l 1 �Z _ 0.,�
<br /> b � Phone�CantacEfar�Permfttln
<br /> Owner's Name t `1 1- ���� �b��� Ownsr Phone Number � ��� � i �-QSg'�
<br /> owner"s Addres� ��5 4 3� ��" Qwner Phone'Number - �i � �q� � / � ✓ 1
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<br /> Fee S1mple;Titleholder Name � Owner Phane Number �
<br /> Fee Simple;Titleholder Address
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<br /> �OB ADDRESS S 7 L'E S t 3 +� `�J� ` LOT# �
<br /> SUBDIVISION �- � PARCEL ID#
<br /> , � . (OBTAINEQ PROkI PROPERT-YTAX.NOTIGE)
<br /> WORK PROPOSED NEW CONSTtt ADQ/ALT � SIGN Q - Q DEMOLISN
<br /> i ' ��. INSTALL �� >_ REPiAIR � .
<br /> PROPOSED�-USE Q 5FR Q COMM [,,,� �OTHER -
<br /> TYPE OF GONSTRUCTION Q� � BLOCK " Q FRAME �. STEEL Q
<br /> DE3CRIPTiON OF{NORK �t�K f� �� b�l. a.r�r�S ant ,t'�o� � l��f�-1.�. lX�i i`�'`Lc'ns f/�QW
<br /> , �. �j��.J �l�b r� !b� �7 ��.
<br /> BUILDlNG SlZE �o�.�X�'�i �' SQ FOOTAGE ,.HEI,GFIT l� ��,� '�
<br /> B.UIL G �, $ �[„�m��p Q_� VALUATtOttil�`tJF TOTAL CONSTFtC1C`iION� �
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<br /> QE,LECTRI AL� $ ' AMP SERVICE Q 'PROGRESS ENERGY Q W.R,E.C.
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<br /> [,�PLUMBING� .($ �
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<br /> QMECHANICAL $ VALUATIQN OF,MECHANICAL INSTALLATION ` jy�(
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<br /> QGAS Q ROOFING .� SPECIALTY C� OTMER� � -
<br /> FINISHED FLOOR ELEVATiQNS � � FLOOD ZONE AREA [�YES. NO
<br /> �UILDER , ' {� ������ COMPANY'- tr1'��Z�. �C�{Nl�ZE/L..
<br /> StGF1�►TURE T�` REGISTERED Y/ N FeE cuR�� ` Y'/N
<br /> Address l:icanse#'� � �
<br /> ELECTRICIAN, � COMPANY ' ' � �
<br /> StGNATURE � REGISTERED Y/ fV FEE'CURREP'' '' '��Y/N"
<br /> Addresa ' • f , ' I.Icense# �—. � !
<br /> PLUMBER' . COMP:AIdY� - '
<br /> StGNATURE`� ' ,`REGISTERED �Y/�N�� , ,�FEE CURRE� Y/N
<br /> Address � , 1 ' . t;tcense,# ��i._..—.��:
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<br /> MECHI�P1iCAL � ' „� COMIPANY - .
<br /> S1t3NATURE � " ` ��isTEREo.,' Y,/ N . ,, ;; �Ecu�n, Y•%N �
<br /> Address� - '{�� � - � ,, ' -. � , , l.lcense# �� ----� ,
<br /> OTHER �. � . . � ;COMPAWY � - . - -
<br /> S!{$NATURE '--. -. ' `� " • ; .. . - ` ' REG137ERED�` � ` Y/ N,..� FEE CURRE� Y/N
<br /> Address ' ' , _ , - ' L:icense# � � � ' .
<br /> RESiDBNTIAL� Attach"`(2j,Plot%Rlan`s;,(2)sets�of'8'uil'dlrig�F'ian's;�(1)'sefofEnergysFomns;;R=O=W_Perrrilffarnewiconstruction, � �
<br /> �_�Minimum,ten;(1,4),workirsg tlays after,'subritittai'date:;:Ftequired onsife;,Gonstnic�on:Rians;SMrtnwafer`Plans w/Silt`Fence installed, � -
<br /> �� A 3anitary Fac(Itties:&�.1-,dumpstereS(te�Woric:Perm9E tor subd�visioi�"sJlarge-pro]ects;... .-...•: �" , '. � _
<br /> COMMERCIAL Attach(3)-c6mplete sefs`of'Building Plans plus a�Lffe Safety Page;(1)set of Energy Forms.R O-W Permit�fo�neW construcUon. �
<br /> ' Minirr�um ten{90)working days after submlfta)date. Required onsite,Constnuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 durripster.Sife Warlc Permtt for ait nev�rprojects:AI!commerclat requlrements,must meet campfiance
<br /> SIGN PERMIT AttacFi(2)sets ofEngfneered�p'lans:, - ��� , ..�' . , '
<br /> "'*PROPERTY.SURVEY reguired for all NEW canstruction.. , �... . -. ' � ' • � -
<br /> Dlrectlons: .. :.,fi;.,=� .. .. , - .
<br /> Fill out apptica8on compietely.
<br /> Qwner&Contractor sfign back of applicaflon,notarizad
<br /> If aver$2500.a Ncttce of Cammencement is required. (AfC upgrades over�T504)
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<br /> `" Agent(for ttie ca�tractor)'or'Power of AttoriSey{for ttie'ownerj would be'someone writh�notadzed letter from owner suthorizing same '
<br /> QVER THE COUNTER.PERMITTING--- ..-..(Front•of-ApAltcstion Only)- ' , ' � � �
<br /> Reroofs if shingies S�uvers Service Upgrades A/C . Fences(Plot/Survey/Footage) . , �
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<br /> Drlveways-Nat over Counter if on publtc roa'dways:�.iised's ROW- `
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