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S'13-780-OQ20 City of Zephyrhills Permifi Appiication F�c-813-780-0021
<br /> . Building Ciepartment
<br /> DateReceived ,�l;;�i;.��",7�a,(�'F'� s�.' d`" � G�°�'���
<br /> Phone Contact for Perrr�iYting
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<br /> Owner's Nama �. � (`�;� cs r-� . � Owner Phone Number _ ��1�• C ��t1
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<br /> Owner's Address !��"�����'e�" 'ry" p'� ��~n^E°���� � �Qwner Phone Number
<br /> Fes Simple Titleholder Name , ��r�� '�._ i� Owner Phone Number ��---^ �
<br /> Fee Simple 7itieholder Address '
<br /> JOB ADDRESS `� C � { . ' ' �` r rr '. �?�"I LQT# -! �
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<br /> su�oiv�sioN J`�� u�e_r'c. ,�tc.� PARCELID# '�/.?��-��-�'�C7�0�` `� �'PD-�E��IZC�
<br /> {467AlNED FROM PROPERTY TAX NOTlGE)
<br /> WORK PROPOSED �NEw CONSTR 8 ADD(AL7 � S1GN � 0 DEN{OLISH .
<br /> lNSTALL REPAIR
<br /> PROPOSED USE . 0''� SFR [� C{JMM � OTNER
<br /> TYPE OF GQNSTRUGTIC?N ��''� BLQCK � FRAME � STEEL �
<br /> DESCR(PT101V OF WOFIK Or`t��-'� ���.' .rr 1c;�a-rv�.� �, ��'S�i��.'►�� t3 �J�c� ����-�"-L --'�c�-"t-`.
<br /> BUILDlNG SlZE � � S4 FOOTAGE i / � � HEIGHT ���
<br /> TR� r-r'r-r-�-o-'r-�r-t�-A-[Tri"i"1-rt�t-r-s-r-�-��c�'r�'r-i-r^s�r-rit�r'r`r'r-t-9"'rP'v-aTa'"'a-e-'u-r-s�-a'-e'-e�a�
<br /> C�BU(LDING � X�� fb�j VA�UATION OF TOTAL CONSTRUGTION
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<br /> �ELECTRfCAL $ AMP SEAVIGE 0 . PRO�RESS ENEFIGY ' � W.R.E.C.
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<br /> �PLUMBING $ _ �'"�'}
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<br /> �MECMANlCAL $ L� �,�� VALUATiON OF MECNANICAL INSTALiATION
<br /> �GAB �j R0C7FlNG Q SPEC(ALTY � QTNEA �
<br /> FINISHED FLOOR EL.EVA7(ONS t �{',l �� ,� FLOQD ZONE AREA �YES NO
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<br /> HUILDER � ''����__,!�`r GONIPANY �t � - ���•""'��`�'"� �J"''�
<br /> SIGNA7URE REGISTERED � Y/ N FEE GURAER Y/N
<br /> Address f���� /���'Ci�.�-7 � r" I�'r}� '�"'� Llcense# ���--��T�� �' � �
<br /> .�l.EC7RICIA(I ���„�;c,,...-,,..�''"�',�.-- � COMFANY ��?�"`l+�A�„��,�"� ,��"�!'�'�`--7��'A'� �
<br /> SIGNATUaE ---``` REGISTERED Y( N . FEE GURRER Y/N
<br /> Address 4�d..����=',0'°,0''�C� .�,� � �9� License# ��-�%�'�'����� �
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<br /> PLUMBER �� COMPANY � f'` !' �li,i�.!` .��8.���,��'� �` ��'"�";�i�'d`� �
<br /> SlGNATURE ������� REGlSTERED Y( N FEE CURRE� Y/N '
<br /> Address �,����}t,��,�� Af��� �',�u�.+�� License# ��+� +�.�c.�����a`
<br /> MECHANICAL �� CdflBPANY )"'�`"����`�����'� ��°'� �; ,%''7'��'fi
<br /> S1GNA1`IJRE f,.+^" ���"'��'`�w��-„-^-�^^�-'---REGISTERED Y�/ N FEE CURREA Y/N �
<br /> Address �`e�,"'� ,l.�Gf%t�.�- �� ,��a.,��',�,,,tf,,L.'',f`�-���. License# �������fi�:k� � �
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<br /> OTHEa ,/�_,,r,..-�.Y----. COMPANY �A<�,l� ��f':,�i�ta��.�� :�'�;����-�
<br /> SIGNATURE � �'�"'`�"" �
<br /> REGISTERED Y/ N FEE CURREA Y(N /'�
<br /> A,ddress �����`� '�a� - ��� �'���� License# �— �
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<br /> RESlDEN71AL Attach{2) Pfat Pians; (2)sets of BuilBing Plans; (1)set of Energy Forms; R-0-W Permit for new construction,
<br /> Miniriium ten(10)working days after submittai date. Required onsite,Construction P(ans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary�acilities&1 dumpster;Site Work�Permif for subdivisions!large proJects
<br /> COMMERCtAL Attach (2)complete sefs of Building Pians plus a Life Safety Page; (1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> Minimum ten(10)warking days a�ter submitta(date. Required onsite,Construction Plans,Starmwater Plens w(Silt Fence instatted,
<br /> ' Saniiary Facitities&1 dumpster.Site Work Permit for ai!new projeets.Ai!commerciai requirements must meet compliance -
<br /> SIGN RERMIT Attach {2)sets of Engineered Plans. -�
<br /> "`*"*PROPERTY•SURVEY required for alI NEW cqnstruction.
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<br /> FiII out application completely.
<br /> Qwner�Contractor sign back of application,notarized
<br /> It over$250Q,a Notice of Gommencement is reqvired. (AjC upgrades over$7500) _ -
<br /> ** Agent{for the contractor)or Ppwer of Attorney(for the awner)wou(d be someone with notarized letter fram owner authorizing same
<br /> OVER THE COUNTER PERMl7TING (copy of contract required} -
<br /> Fleroafs•if shingles Sewers Service Upgrades A/C Fences{P(at/5unrey(Faatage) , _ -, • ~� ,
<br /> Driveways-Not over Gounter if on�ublic roadways..needs ROW , ' ' ' ,_ „ , �
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