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. s�3asaoozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � � Building Department �
<br /> Data Receiv�d . -.phone Contact fo�Permitting�� - �
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<br /> ; Owne�'s Nama �f( ✓V Gt Owner Phone Number , � 3 �7 �- T� i
<br /> � Owner's Address � �� � �lDS /"l J./�(/�C��/ �p Owner Phone Number
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<br /> t Fee Simple Titleholder Name Owner Phone Number
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<br /> � Fee Simple Titleholder Address
<br /> � JOB ADDRESS J (�S �'l �v l � �� �C LOT# �
<br /> SUBDIVISION D�u/� Il � ,50 G l 0� 0 PARCEL ID# 1 - b � -/✓J 7�-o�-r�✓�- �Q� O
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � . NEW CONSTR ADD%ALT � SIGN Q Q DEMOUSH
<br /> e INSTALL B REPAIR
<br /> PROPOSED USE Q SFR Q CONiM Q OTHER :
<br /> 7YPE"OF CONSTRUCTION Q BLOCK - Q FRAME Q. STEEL Q
<br /> °DESCRIPTION OF WORK C ' . (/ r`� ( On�l7��J/j� r� �-�'/1�+-� lJi!!�n y
<br /> BUILDING'SIZE �b ( SQ FOOTAGE� HEIGHT •. '
<br /> ` OBUILDING $ VALUATIOIV'OF TOTAL CONSTRUCTION
<br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> �: �� OPLUMBING $ (� � I
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<br /> � QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � �
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<br /> i QGAS Q ROOFING Q SPECIALTY � OTHER ��
<br /> z FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES 1D�0
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<br /> _ _�, _ BUILDER COMPANY �
<br /> SIGNATURE � - — REGISTERED_ Y'/ N FEE CURRE� Y 7 N. :
<br /> Address � 'License# 1
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<br /> 'ELECTRICIAN COM PANY
<br /> SIGNATURE REGISTERED Y/ N FEE'CURRE� Y/N
<br /> � Address` License# ' �
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<br /> ; PLUMBER.., , COMPANY-
<br /> � SIGNATURE �REGISTERED Y-/ N� FEE CURRE� Y/N
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<br /> � Address - License#
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<br /> , MECHi4NICAL' ' COMPANY D�/1(>UG/I G O.
<br /> � ' SIGNATURE'"' � REGISTERED , Y/ N FEE CURREt� . . Y-/N ,'
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<br /> ; Aaa�ess�� � ll�n p. .,�I� License.# (�"�� S�7 �
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<br /> � -:-OTHER= :='°.� :; " , � ,�COMPANY
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<br /> � ``$IGNAT�RE�s. :� .-�` "� � � REGISTERED Y/.N . FEE CURREK Y/N
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<br /> i � _ Address�, - _ � _ •«.- ,� . ' License#
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<br /> � "�RESIDENTIALy;,�;;'"Attacfi;(2.)::Plot"Plans;�(2);sefs�of Building�Plans;(1�)`set of�Energ'y:Fo'rms;R-O-VU,Permit for.new,construction;-��
<br /> � � �p'-,-�,-,:-� •;��:Minimum.tenj.(1Q);_w,orking;days�afte�,sutimittal:date:rReqiiired onsite;'Constniction Plans,�Stormwate,r Plans w/Silt Fence installed,
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<br /> ; ; _ � -- Sanifary;Faciflties:�&;;1�dumpster;Site;Wor,kReFmit,foi:;subdivisions/large;;projeefs= _�_
<br /> " i s_�GOWIWIERCIAL -Attach�1�mplete`s"'�ets ofFuifdingFians pius a°Ci�e Safec�Page;=�1)se�o�er,-ergy�For�i�s:R=3=V1'-Perrritt-fo���ew=constn:ceicrr�--=- " - -_�
<br /> � 5, _ Minimum ten(10)working days after submittal date. Required onslte,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary•FaciliBes&�1 dumpster.Site Work Permiffo�all-new projects.All commercial requirements must meet compliance
<br /> �`;�SIGR1`.PERRAIT "AttaaFi'°(2j sets;of:;Engineered�,Plans.<<� .
<br /> � � ° " "`*PROPERTY SURUEY required for,all:NEW construction.. _
<br /> i ;<Dl�ections: ,. .- - .. ,.
<br /> � ;��Fill-.out application completely.
<br /> � ' O.vimer 8 ContraGtorsign back ofapplication,notarized
<br /> I�f over$2500;a.Notice:of Commencement is required. (AIC upgrades over$7500)
<br /> � '�"'�' A enY for�the�cont'ractor•or�Fower ofAttome"for"tFi'e owner would be someone with notarized letter from owner authorizin same
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<br /> � s�;.OVER�.THE"COUNTER'PERMII�TING., .(copy..of contract-required)•��"� •'�'``" •'` _
<br /> ' �=:=Re�oofs if sliingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
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<br /> ; _ :D�iveways-Not over CounteFifron•public�roadways::needs ROVV°•-��~-,�
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