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' 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � • • Building Department
<br /> 7 i , -
<br /> Date Recaived . .Phone Contact tor Perm€tting' - _
<br /> ' Owner's Name �t� ' 0 i" V�� Owner Phone Number
<br /> -7 �- 7�d
<br /> � Qwner's Address "l ��lD l� Jr"�� '//nU �(/R /�G l Owner Phone Number � � i
<br /> Fee Simple Titlehotder Name � � Owner Phone Number �— �
<br /> � Fee Simple Titleholder Address ,
<br /> � ` �.� 1D ��t �4t1�E� t1�'YU �.or# ��
<br /> # JOB ADDRESS
<br /> � ` SLIBDIYESION lGlt c° l.�.i � GdCt CC)/1 PARCEL ID# '
<br /> - , (OBTAINED FROM PROPERTY TAX N4TICE) �
<br /> WQRK PRQPOSED t , N�W CONSTR ADDIA�T � SIGN Q � Q DEMOLIBH
<br /> e INSTALL 8 REPAIR
<br /> PROP.OSED USE Q SFR Q COMIVI � QTHER '
<br /> TYPE':OF CONS7RUC7'ION Q BLQCK • Q FRAME � STEEL Q
<br /> � DESCRIPTION:OF WORK• _ C` �/i � �(/ ! �(�i7�q/���4°/ �(~��-, ��f��(
<br /> � BUIIDENG'S1ZE S4 FOOTAGE C� FtE1GHT •C,.i��
<br /> ��������G �_� VALUATION't7F TOTAL CONSi'Rl7CTION
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<br /> QELECTRICAL �sa�� AMP SERVtCE Q t'ROGRESS ENEftGY Q W.R.E.C.
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<br /> QPlUMBENG �> � �
<br /> � . . (�` �
<br /> � QMECHANlCA� $ 7 VALUA7'tON QF MECHANICAL INSTAl.LATION j a
<br /> � � �
<br /> � � ��.'"
<br /> � C]Gas Q R40FING Q SPECIALTY C� UTHER
<br /> � FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES N�
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<br /> � BUtLDER CONIPANY
<br /> �� — 'SIGP7ATO,iR�—�- - -- - _ - REGISTERED_ Y'/ N _ FEE CURRE� Y 7 N
<br /> Address License# �� � ~
<br /> ��E�.EC.T-RtG1At�! .. COMPANI�
<br /> ._ SIGNATURE r.. ,, REGISTERED Y/ N �FEE CURRE� Y/N
<br /> Autdress License# � a y �
<br /> P1:UMBEt2.,. . COMPANIf. �
<br /> SIGNi4'TU12� � ,REGISTERED Y•/ N F��cuRREn Y/N
<br /> � Addrass License# � �
<br /> � MECHi4NlCA!_ � � ��?/f�I COMPANY !J/1 fl{/G lj r � f�
<br /> , SIGNA7'URE" REGISTERED , Y/ N FEE CURRE� Y/N :
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<br /> { Aildte"ss=;• " i{�i" I� ` �7,7�t( j Licens,e.# ��� ,� r ` ,...�
<br /> � '��{4:r. ' .,. _ , .
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<br /> � :,•o�r�ER�: '.,; , . co�wP�nr
<br /> "SIGNATURE'�, ,:.:;•• REGISTERED Y/ N. FEE CURREK Y/N
<br /> i :1 M'� . �
<br /> ��tBSS•... �. • • .- _ . . �.._____-L.iCB(i5E3#
<br /> s>'.RESIDENTlAl.�„,;��Attach,(2)sPlof`.Plaiis,'`(2)�sefs�tsf Builifing-Plans:(1j�set bf�Ene�gy`Fii�itis;R=Q=W,F'errnlf.for new,canstiuction,�� ,
<br /> �`„r�=.�-�,...-;�Minimum;:ten�1Q. .workin ,da s afte�submittaGdate:''Re w�ed�onsite,"�Gonstriiction Plans;Stbrinwater Plans w/Silt Fence installed,
<br /> .. s,.,�.,,::c:.. � �. .)_ 9' Y" • 4 .
<br /> . �.,:.. ,.y__.�... .�,.;�.A.-... ...,. .. . ,
<br /> ( � . -, Sanita,ry;Facllitles,&V1�:dumpst�r�Sife,Worlc.Permit.for:subiiivisions/large;projeets �` _ ��
<br /> �Y;'GONIRAERClAC--�Attach�{2}'complete sets'of'Bufldln'g`Plans plus a L(fe Safety Page;(1)set of Energy Forms.R�-lA+Permit for new construction: � - `
<br /> � ; Minimum ten(10)working days after submittal date. Required onsite,Constnuction Pians,3tormwater Plans w/Sil#Fence installed, �
<br /> -�` Sanitary EaciliUes&1 dumpster.Site Work Permit"fo"r•al!-new piojects.AA cammercial requ�rements must meet comptiance
<br /> f�`'`SIGRt PERMlT "Aftach 2 sets-of:,En ineerecl�i?'tans::<�. :•
<br /> ' I �.>. c �,___.._�._$ ,
<br /> � '�"`� ""'*PROPERTY SUR�Y required for aII.NEW conskructfon..
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<br /> I � f:l.iilratCif��R�� :``>;p�... ., ' ' � . ,
<br /> �� ''� �'Fill-outapplication completely. �
<br /> O.wner�&Contractor sign back af applicatian,nofarized
<br /> - ' tf;over$2500,a Notice�.of Cammenaement is required. (A/C upgrades aver$7'S00) . , �
<br /> �'`"' Agent(for'fhe�cont�acto�)orPower`of Attomey(for tlis owne�)would tie someone with notarized letter from owner authoriz3ng same
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<br /> ;.,OitER�,7NE COUNTER;PEFtMiTtIN�, .. ,(c:apy.of conUact-required}�•, ' -. :_ _ _ _.
<br /> �:�Rerobfs:if sfiingles Sewers Servlce Upgrades A/C Fences(Plot/Survey/Faotage)
<br /> ! ' Driveways-Nat over Counte�'�fi oii`�pi�Filic't�adwa�is..n�eds ROVV"� �; Y
<br /> � - �f JJii-1"�����-=:�;...�_...i, ��i,;�! ��
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