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�'13-780-0020 City of Zephyrliills Permit Application Fax-813-780-0021
<br /> ' Building Department
<br /> Date Recefved _� - �
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<br /> Owner's Name � � �y r a � � .,
<br /> Owner Phone Number � �� �L�i�'. � �� �
<br /> Owner's Address ���OQ�.�c�� �ra ,�-. � .� '�'��^f��j�� ��-�.�-)
<br /> , � / Owner Phone Number
<br /> Fee 5impie Titleholder Name ��„ �.,�. ,� -
<br /> , Owner Phone Number
<br /> Fee Simple Titleholder Address �
<br /> JOB ADDRESS �j( �,v/ P�� n��' � �� �l.yr�
<br /> _ �� �,(� i �1x7 ' �
<br /> • � LOT#
<br /> SUBDIVI510N s�i l U��('G �(� /7 / / �
<br /> PARCEL ID# "'r'F�� ,,��(' "�C�� � ''C.���7OQ�����'�QQ
<br /> WORK PROPOSED ' e (OBTAINED FROM PRbPERTY TAX NOTICE) '
<br /> NEW CONSTR ADD/ALT � SIGN � � DEMOLISH
<br /> � 'INSTALL e REPAIR
<br /> PROPOSED USE �� SFR � COMM
<br /> TYPE OF CONSTRUCTION ��' gLOCK 0 OTHER
<br /> � FRAME � STEEL � •
<br /> DESCRIPTION OF WORK ��L� j��/�-„r(.c.�'��� � ��L'Sd�c��, �
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<br /> "�• �`'J C G�'�C: ��:'1—�^l ..r�{�,..��.
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<br /> BUILDING SIZE Zc�L ,
<br /> SQ FOOTAGE HEIGHT
<br /> TY^�-1�1-�"T-reZ_iT�_P`iT-Til'-'P-�T
<br /> �"E'r1�1"P�P"7�1'-y"�-tY9"F�i"'7'YT�I�TG'TP�
<br /> �S I LD I N G $ � �� r-e�-u-rP-�-Q-fl-�-g-g-�_�
<br /> '� VALUATION OF TOTAL CONSTRUCTION
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<br /> �ELECTRICAL $ AMP SERVICE
<br /> ��l'J 0 PROGRESS ENERGY � W R.E.C.
<br /> �LUMBING � �
<br /> , � � ��j '
<br /> �MECHANICAL $ � (� ��
<br /> 4' G2�,�..� VALUATION OF MECHANICAL INSTALLATION
<br /> �V
<br /> �GAS C� ROOFING � SPECIALTY
<br /> FINISHED FLOOR ELEVATIONS � OTHER �
<br /> ( � C� i" FLOOD ZONE AREA �YES NO
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<br /> BUILDER � ���
<br /> 31GNATURE - •'��_ COMPANY �.. � „ �,-, ��;.�_�.�,,.� �-J,L�
<br /> REGISTERED Y/ N FEE CURRE�
<br /> Address ����� %_/�. Y/N
<br /> Cb.� .� r^ l�r}� c..
<br /> License# ���.C���-j p (, ;�
<br /> _�LECTRICIA�1 �/� '
<br /> 51C,NATURE � ��'�^� COMPANY ��G�,"`l"-,+�C,pn�,,,S"',�',�`T ��i`''t,,°,C�,lll�� �,.
<br /> ' ,r REGISI"ERED Y/ N F.EE CURRE� Y/N
<br /> Address ���y,QjA,a����+"�'�^ �,�' ,/
<br /> �""� � '?�,F��
<br /> d License# ���,������,��
<br /> PLUMBEki
<br /> 51GNATURE � �"'� _... .. . — COMPANY ' °��';���.,(�,f. ..���•G"s�s�',��:t�-,�:.� ����,�;�?�,�a ,�
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address f �7��� � -
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<br /> F License# ����,�' �F�, . "i �
<br /> MECHANICAL `�
<br /> SIGNATURE �,a'���;_�„�.�.�„-��_�____ COMPANY I'.�A�i(`..���,�,1'���{l�' �'r�- ,�:� ,i7��'e'?.JJ`_
<br /> �REGISTERED Y�/ N FEE CURRE�
<br /> Address •��K-7� �F-�.-,��� Y/N
<br /> _ �"'� ��,�a.��^,�,•�,�'J`�,�,
<br /> OTHER _ ,{� F
<br /> License# ������j��
<br /> SIGNATURE ^ �(.�'-
<br /> � ^. '�,,./'�-----.`-,.�-'-„ COMPANY UO('t%f"�'� � � -rA � . �.;� '`
<br /> �' ��.y;�,/�f1,�/�F .—i✓{.(��rA-�'
<br /> REGISTERED Y/ N �
<br /> FEE CURRE� Y/N �"
<br /> Address ������ ��"'",�/ � ,
<br /> �J�� ��,��;�'
<br /> � � Ai � � � � i � � � � o � � � � � oo � � � o � � � � � o � i � aaee � oai � ioi � oa � .� ooae ¢ aaaBBo
<br /> License#
<br /> RESIDENTIAL Attach (2) Plot Plans; (2)sets of Build(ng Plans; (7)set of Energy Forms; R-O-W Permit for new construction,
<br /> � 9 9 B 7
<br /> inimum ten (10)working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster;Site Work�Permit for subdivisions/large proJects
<br /> COMMERCIqL Attach (2)complete sefs of Buiiding Pians plus a Lffe Safety Page; (1)set of Energy Forms. R-O-W Permit for new c
<br /> Minimum ten (70)worl<ing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanftary Facllities&7 dumpster Slte 1Nork Permit for all new projects.All commercial requirements must meet compl'ancectfon.
<br /> SfGN PERMIT Attach (2)sets of Engineered Plans.
<br /> *"'`'4PROPERTY•SURVEY required for all NEW construction.
<br /> '�--4_d__s_�-4--0--�_4--4-a-�.-�,_ - --
<br /> D i recti o n s: 4'�-�--a-8-8-{�_
<br /> Ffll out appllcation completely. �����������-��'�@"�-�-a�'-�-�--�:o�n `n �g_�q���
<br /> Owner�Contractor sign back of applicatfon, notarized
<br /> If over$250D,a Notioe of Commencement is required.
<br /> "' Agent(for the contractor)or Power of Attorney(for the owne�ou d9be someone wrth�n)otarized letter from owner aut
<br /> �VEA THE COUNTER PERMITTING (copy of contract required)
<br /> 3eroofs•if shingles Sewers �� horizing same
<br /> ,ervice Upgrades A/C Fences (Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on�ublic roadways..rieeds ROW ' � �
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