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a�saao-oozo City of Zephyrhills Permifi Application Fax-813-780-0021
<br /> • Building Department
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<br /> Date Received � Phone Con4act gor PermitQing �� 3 � ��- -- ���"�
<br /> Owner's Pdame �'�t�h �L^n.s����` �J�� �.��� Owner Phone f�umber � ��� r��'`����
<br /> i `� �,, h
<br /> Owner's.4ddress � ��� �� 5 l �Q '� ! `���S ��' `�' S�I Owner Phone iVumber
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<br /> Fee Simple Titleholder iVame Owner 9'hone Number
<br /> , ,.
<br />- Fee Simple Yitleholder Address
<br /> JOB ADDRESS � LOT� �
<br /> SUBDIVISIO�I ���'`���W� � Pa4RC�L ID� ��� � v'�� � — �,��d� DO�� ` ��� � II
<br /> � (OBTAINED FROM PROPERTY TNC NOTICE)
<br /> WORK PROPOSED ' NEW CONSTR ADD/ALT � SIGN 0 Q DEfVIOLISH
<br /> � � INSTALL B REPAIR
<br />� PROROSED USE � 0� SFR Q COMM 0 OTHER
<br /> r YYPE OF COPeSTEdUCTIOi�I i �� BLOCK • Q FRAME � STEEL �
<br /> DESC921P710iV OF WORK ' ��-� �n5'���'�-C�-`vn — � ��'x'?�
<br /> �UILDIPEG SIZE � ` SQ FOOTAG�� G,���FiEIGF9Y �9
<br /> [�BUILDING ' $ � � f Dpc� VALUATIOIV'OF TOTAL CONSTRUCTION
<br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS EfVERGY Q W.R.E.C.
<br /> OPLUMBING $ e ��/;�/��
<br /> � _�� v
<br /> G
<br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �JG��/ f�'�S
<br /> ���G�� �.1�it�/j 1v�,
<br /> � � .J�17 -
<br /> OGAS 0 ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES v N� �`�� / �"�
<br /> � �'I, "
<br /> �UILDER * COMP,4fdY > ��� 1..6 n'i.�'�'!�C'�-� "Y� �V��-
<br /> SIGMAYU93F REGISTERED Y N FEE CURRE� Y/N
<br /> ,4c��ress � �� ��.. � ,i���ts ��`J�� License# �`�(C �� � � � I f
<br /> ELECTRICIAiV \� COMPARIY �cXS�' �G.SC.C;s �`�C.-�re G . • ��I r/�
<br /> SIGf�ATURE � �J��`�� REGISTERED Y/ N FEE CURRE� Y/N L D
<br /> Address � � � � �' License# �� �.N�`p
<br /> ��u����a - con��,a�v ��'S ���tx,��� �-: 1� I'7�'
<br /> SIGNa1TURE REGISTERED Y/ N FEE CURRE� N
<br />- P�ddress License#
<br /> ��cHawic,� co��A�av �� �v�.� `� ��(� �c,o
<br /> SIGidA7URE REGISTERED Y/ N FEE CURRE� Y/N � ��
<br /> Addeess License#
<br /> OTHER � COMPAR9Y �''� r�
<br /> SIGfdA°ITU1�E.. - REGISTERED / N FEE CURRE� Y/N
<br /> alddress 3�'�'�� S� J� Q , 1�t: �� ��.. ���{ License# ���Z✓c�-J�''�O
<br /> RESI�EMTIAL •; Attachr.(2)':Plof Plans;(2):sets ofBuildirig•Plans;�(1)set of�Energy Forms;R-O-W Permit for new.construction,
<br /> Minimum,:teri�_(�10.)working days after subinittal•ilafe. Required onsite,Construction Plans,Stbr.mvuater Plans w/Sllt Fence installed, I
<br /> Sanita.ry..;Facilities�.&:1,.dumpste�;Sife�W.ork�Permit for.sutidivisions/large projects I
<br /> COf1fiMERC1�4L Attach'(2)compiete 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 for•all new projects.All commercial requirements must meet compliance
<br /> SIGEN PERfVJl7 Attach(2)sets of`Engineereci Plans. '
<br /> � '"""PROPERTY SURVEY required for all NEW construction.
<br /> Directions: . �
<br /> Flli out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over$2500,a Wotic�of,Commencement is recyuir�d. �r4IC U��P�(➢�S OV�P$7500�
<br /> `" Agent(for the contractor)or Power of Attorney(for'the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER TF9E COUY�TER PERMIYYIVNG .,.-,..,-,:(c,opy..�f contract•required)�'- ` " � . _
<br /> Reroofs if shingles Sewers'�'; Service�Upgrades+A/C� Fences(Plot/Survey/Footage) � � � • ' -- - . .
<br /> , °_ � - � . ,..: , ,:, �;,: ."- • • :�
<br /> �... . f> , �
<br /> Driveways-Not over Counter,=if on public�roadways::needs R01N �.� � �.
<br /> ;��;,5r �� � , i,{':�< < • . --._ ' � ,
<br /> ;.ti _:%i;;�i'1'. !t _ � , ., i. , ,
<br /> � .ny-.n� y,�_;�7.st,,}sr�r.:rt,.,>•.,s L�� _ .--' , ,
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