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<br /> 813-780-0020 City of Zephyrhills Permit Appiication Fax-813-780-0021
<br /> Buiiding Department ��
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<br /> Date Raceived ,� �3 ��' Phone.Contact for:Permittin ' f (}� - � �
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<br /> Owner's Name On Gy'' Owner Phone Number b/3� l� ��
<br /> Owner's Address i� � � O :o, �,. S Owner Phone Number -, '
<br /> Fee Simple rTiHeHolder Name �Y ` Owner Phone Number
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<br /> Fee Simple Tltleholder`Addre�s �
<br /> JOB ADDRESS 5 S�I Cl �p 'vwoo� S LOT# �
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<br /> SUBDIVISIQN PARCEL ID# � ~ '
<br /> (OBTAIWED ER�O�M,PROPERTYT�7'�cE)DEMOLISH
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN`�
<br /> � _ ��B.. INSTALL � ,
<br /> PROPOSED�USE � . �] SFR. Q �COMM' Q �07HER " �
<br /> TYPE OF CONSTRUCTION • ' 'BLOCK " Q FRAME Q STEEC 'Q�" " �
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<br /> DESCRIPTION OF WORK 2�� `� -�e �`. ��
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<br /> BUILDING 31ZE S6l FOOTAGE ' - _ ,HEIGHT�
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<br /> QBUILDING $ VALUATION`OF'TOl'AL CONSTRUCTION ` "
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<br /> QELECTRICAL - $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br /> QPLUMBING $ - -
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<br /> OMECHANICAL $ � ^ � VALOATION OF;MECHANI.CAL INSTALLATION ""'V
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<br /> Q�S Q ROOFING. .Q SPECIALTI( Q OTHER - ,
<br /> FINISHED FIOOR ELEVATIONS FLOOD ZONE AREA QY�S. ,NO
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<br /> BUILDER + COMPANY' ,. • , ` �. . - ,
<br /> SIGNATURE REGISTERED Y/ N . 'FEE CURRE�" Y'/N�
<br /> Address � License# `
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<br /> ELECTRICI.AN. . . - -COMPANY -�
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�°° '` `°Y/-N
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<br /> �lddress ' " _- � , � =- License#, _ .�
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<br /> PLUMBER ; COMPAN1f .�.,. . ;+,� ,
<br /> SIGNATURE ' ' a „REGISTERED� - , Y:/,.N, ,; ;�EE CuwtEn. �. Y/N. -:
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<br /> Addre�s � ' � �- �;,1.icense,# _ � " .
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<br /> SIG A�RE ��:%%� � COMP/WY �1�C.tG ��,�..�1�7, � �'�� N�,,,; �'�, ,��
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<br /> REGIS7ERED„ „Y,/,N .' -.FEE CURREI�., �. . ,/�N' . , ,
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<br /> Address , ` .- . , <: ' - . , , � . ._ E _ .. ,
<br /> _ , . License#�
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<br /> OTHER ' � � , . . . _ - 5„ - .. . : . � ,__ r ,.
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<br /> ;COM.PANY. :
<br /> SIGNATURE >�...,.,; .. .: , , ,� . � _ . .
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<br /> •• °' '`' � � REGISTERED Y/ N,:: �FEE CURREA Y/N
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<br /> Addre�s � -- - ' . , � - �� � L'icense# � -,
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<br /> RESIDENTIAL;=>_Atta_cfi"(2).;PIo.EPiens;:(2).setis�_ofiBuildi`ng?'.P.lans;'(1)set.of�Energy`=Fo'rins;�-R=0=1N�PerrniEf6rnewconstruction, , �
<br /> �i �.,=�<Minimum:ten;,(1,0)�worliing;dayst;after�submiCtal date.?Requlred onsite;:ConstiucBon�Rlans;Stortnwater'Plans�wl Silt Fen'ce insfalled,
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<br /> Sanitary FaGllties:&=�,�dumpster=�Site`:W,ork:Permit#or sufitlivisionsQarge'tprojeots � .;..;.:; " " ' ' � .
<br /> COfNiVIEItC1AL Attach(3)complete sets"of�Building Plans plus a�Ufe$afety Page;(1)set of Energy Forms.R-O-W Permit for neu�consUuction. • � -
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConsUuctlon Plans,Stortnwater Plans w/Siit Pence installed,
<br /> Sanitary Facilides 8 1 dumpster.Site Work Permit for all neier-projects:.All commercial requlrements_must meef compllance � ��
<br /> SIGN PERMIT Attacfi(2)'sets of-Eng,i`neered;Plans:: :-•����-'- .. ��: ��:.' : � - � .
<br /> ""PROPERTY SURVEY reguired,for all NEW oonstrucVon.. � � � f � • �- �
<br /> Dlrectlons: - - • � , . ` `
<br /> Ffll out applicadon completely. ,
<br /> Owner 8 Contractor slgn back of applicatlon,noNarized
<br /> If over a2500,a Motice of Commencement ia requlred. (A!C upgrad�s over a7500)
<br /> �w 'n-,3Fy<<c:;�- ..
<br /> AgeM(for tfieicontractor)or Power of Attomey'(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER.PERMITitNG- -- {Front of•Application Only)- ' " � ` �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage)
<br /> Drivewaya-Not over Counter If an public roaduiaqs:.neads ROW '
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