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a�sasaoo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Buflding Department `�'
<br /> Date Recelved : Phone Contact forPermittin
<br /> Owner's Name � e�o Il n 5S� � � Owner Phone Number �Z�Z`j3-G3`'�S�
<br /> Owner's Address ���Z ���������' ��i �L 3��� , Owner Phone Number —�
<br /> Fee Simple�Titleholder Name � ^ Owrier Phone Number � �
<br /> Fee Simple�Tltleholder Address � ��I
<br /> JOB ADDRESS 50.3� z 0�`- S/2 e,�f LOT# � I
<br /> r , • = �
<br /> SUBDIVISION PARCEL ID# �
<br /> (OBTAINED'F.ROM.PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED ,NEW:CONSTR : ADD/ALT Q` SIGN `Q Q DEMOLISH
<br /> � .�, -B� INSTALL B` , REPAIR � - ,
<br /> PROPOSED�USE , Q SFR• Q �COMM Q •OTHER '� �vG� '
<br /> TYPE OF C�ONSTRUCTION � Q BLOCK " Q FRAME � [� STEEL Q
<br /> DESCRIPTIONOFWORK F�NC� 31`fGK y142 QO X�o �
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<br /> BUILDING SIZE � FOOTAGE , HEI,GHT � .
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<br /> [�BUILDING $ ' � - � , •
<br /> 3„�Dr190 VALUA ION�OF TOTAL-CONSTRUCTION
<br /> QELECTRIGAL $ ,� A SERVICE Q 'PROGRESS ENERGY Q W.R.E.C.
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<br /> QPLUMBING $ - �
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<br /> QMECHANICAL $ VALUATION OF'MECHANICAL INSTALLATION -`'.
<br /> � � . ���a2�
<br /> C��S Q ROOFING .Q SPECIALTY_� ; OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
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<br /> BUILDER F COMPANY ' - - `
<br /> SIGNATURE REGISTERED Y/ N '�E cuRttEn ''Y/N'
<br /> Addre�s . �
<br /> , � Ltcense:# -
<br /> � � � .
<br /> ELECTRICII,4N. C'OMPANY � -
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�= "Y/N
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<br /> Address ' ' , � License# 1 .,
<br /> PLUMBER j - .. COMP;.ANY ; ' ,. ,� ,
<br /> SIGNATURE � , f ,REGIBTERED- , : Y./=.N_- , ..FEE.CURREP � " Y-/N. •�:
<br /> Address • _ � , . . , �- ��
<br /> . , .- , ,:UCenseY# , .. .
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<br /> • - � t., -=. - ..
<br /> MECHANICAL ' � COMPANI( _ _ �
<br /> SIGNATURE " , y: � ' r
<br /> REGIS7ERED,,. ,..Y,/.N. , �.,FEECURRE�. � Y,IN' a
<br /> Y - r+,� �- . . . . _. .- • . . . ., �
<br /> Address' - � • . - ' : . � � - ` � , 1 � .Ltcense# .
<br /> I ,� �. , _. . . :_ , r -
<br /> OTHER ° . . ._ . - .. . � ;r,- - ,. . . s . . ,.
<br /> ,COMPANY �
<br /> SIGNATURE � � ' " `' ' ° `REGISTERED ' ' Y/ N�.� � '�FEE CURREP Y/N. ,
<br /> Address � � • ;' . � , . # . _ . .
<br /> - - L'ice'nse
<br /> RESIDENTIAL��, :Attach'(2)�PlotPlans;;(2)sef§:of:Boilding�Plans;'(1)sef of-Energy�Fo'rms;�R=0-1N>Perrriit for-new construction,. '
<br /> ?.�:„�Minimum;tenr(:1.0)iworking}days;afte.r,`.submiftal"date:;:Requlreil onsite;°ConBtiuodon-Flans;'Stormweter Plans`w/SIItFence installed, '
<br /> � � Sanitary Fecllldes-&::1,,dumpste,r„S(te•Worlc;Permit for`su6diyisions/large:projects::._ . ',_ "' � '` ' '_
<br />- COMAAERCIAL AitacF►(3)�compl'ete sefs ofB'uilding Plans�plus a Life Sefety Page;(1)set of Energy Fortns.R-O-W Permit for neuv constructlon.
<br /> Minimum ten(10)workfng days after submittal date. Required onsite,ConstrucNon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes&1 dumpster.Site Work Permit for all newr'projects:All commercial requlremen�must meet compliance � ° �
<br /> SIGN PERMIT Attach"(2)sets ofEngineer,edPlans:; ..��, � � �" . - - -
<br /> "'"PROPERTY SURVEY required for all NEW constructlon.
<br /> Directlons: ,- � �
<br /> FIII out appiicatlon compietely. ,
<br /> Owner 8 Contractor sign back of appltcatlon,notarized ,
<br /> If over;2500,a Notice of Commencement is requlred. (AIC upgrades over bT500)
<br /> , ,,s>,�, ;.
<br /> " Agent(for ttie contractor)�'or Powe�of'Attomey(fo�ttie owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER•PERMITTING�- --(Front:o(-Application Only).. .;�� ,. � ' }
<br /> eroofs lf shingles Sewers �Service Upgrades A/C Fences(PIoUSurvey/Footage) "
<br /> rivewaya-Not over Counter tf on public roadways..needs ROW � �
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