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s�s-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department ,g,�.
<br /> Date Received 3�� .�'� _ 0�-1 � �*
<br /> � Phone Contact for Permitting° � l �
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<br /> Owner's Name L �%j✓ �p/✓� Owner Phone Number
<br /> Owner's Address � � 3� .SD l/V7� /�-1/� Owner Phone Number � I'
<br /> Fee SimplejTitleholder Name p Owner Phone Number
<br /> Fee SimpleiTitleholder Address
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<br /> JOB ADDRESS ��8!�� S�G(i�!'f`" �%�G�J LOT# �
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<br /> SUBDIVISION PARCEL ID# l ;�Q� �" � —(J�-1�D --�l
<br /> , ; (OBTAINED FROM PROPERT`Y TAX NOTICE)
<br /> � WORK PROPOSED . NEW CONSTR ADD/ALT � SIGN Q � Q DEMOLISH
<br />' i B, INSTALL B REPAIR
<br /> ' 'PROP,.O,SED"USE. Q • SFR Q COMM Q OTHER '
<br /> ' TYPE'.OF CONSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q �
<br /> iy DESCRIPTION OF WORK ry �v,7�2 B/V�- D CD��/� �j74v� J,(/ `7i� 7/g'L ����1"/��
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<br /> s: _BUILDING SIZE SQ FOOTAGE�� HEIGHT �
<br /> ��' � BUILDING $ "� VALUATION"OF TOTAL CONSTRIJCTION
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<br /> ELECTRICAL -
<br /> $ � AMP SERVICE
<br /> 0. PROGRESS ENERG
<br /> Y W.R E .
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<br /> , 0
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<br /> QPLUMBING $ "(/'"
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<br /> QMECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION �
<br /> .� QGAS Q ROOFING Q SPECIALTY Q OTHER
<br /> � FINISHED-F.,LOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> E -BUILDER f COMPANY
<br /> ' SIGNATURE REGISTERED Y/ N FEE CURREt� Y%N
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<br /> : Address - "Lieense#
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<br /> ��` ELECTRI,C.IAN COMPANY �
<br /> �;r$IGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
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<br /> v. Address License# �
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<br /> ` = •;.,:��E '
<br /> ;: P.CUMBER.;i COMPANY . -
<br /> , $IGNATUR� rREGISTERED Y-/ N ' FEE CURRE� ;.Y/N '
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<br /> ,�; Address License#`
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<br /> ;•-`.:MECHi4NICAL•. � - � COMPANY
<br /> �w SIGNATURE' =' � ' REGISTERED , Y/.N._ - FEE CURRE� . . Y/N
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<br /> .Add�ess�• � D - " License.# .
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<br /> ;:=OTHER:.,.°�i:. 6 v.y���_ �U�'O v COMPANY_ (ri��l�� QO�/dl�� .
<br /> !;•`"SIGNATURE:��-.:K, ,�; � . - -REGISTERED /.N . FEE CURRE�' Y/N
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<br /> � Addres,s;- �.;�P��'��10��-.,-������l`j,. %��` Lioerise# /���76.�K
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<br /> RESID.ENTIAL.;;�``,.AttacF;�,;(2�):PIotP,lan's`;%'(2�)"s'efs�of�Builtling Plans;(1)°set`of:Ene�gy'Forms;R=.0=V11 Pemiit,fornew.constiucGon, ,
<br /> r�;_._, <�-r�;,�:.-�_._ -„4Minimum�ten,(;10);.'w,o.rking?:days,after•'sutimittal:date.�Required�onsite;Con`struction Plans;`S4ormwaterPlansw/SlltFenceinstalled,
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<br /> _ SarntaryFacilit�esF8��1:,clumpster;�SitexWork�Rermit-focsubdi,'visions/large°projects�- �"" � � �-
<br /> t ,C.OMMERCIi41. Attach(2)•complete'sets of'Buifding Plans plus aVLife Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> `�' �� Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, .
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<br /> !�`- Sanftary Facilitles&1 dumpster.Site Work Permit fo�•all new p"rojects.All commercial requirements must meet compliance
<br /> ':.SIGNfPERMIT "AttacFi`(2)sefs,of;Enginee�ediP.lans:��.. -< _� : .
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<br /> f ;=' PROPERTY SURVEY required for aII,NEW.construction:.
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<br /> e�Directions: , . „ . _
<br /> � Fill�out application completely.
<br /> �.,, 'O.wner.&•Contractor sign.back of application,notarized.
<br /> - If over$2500;a Nofice.of:Commencement 1s required. (A/C upgrades over$7500) ,
<br /> t:_"', AgenY(for�tlie�cont�actor)ror�Rower of'Attomey(for tFie owne�)would tie someone with notarized letter from owner authorizing same
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<br /> ,;,OVER T1�iE:COUNTER PERMITTING,.. (copy_of contract-.required)`"""`
<br /> `;Re�oofs if shingles� Sewers Service:Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> , Driveways=Not over Counter if on putilic"r'oadways.:needs ROW `'
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