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- 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Buflding Departrnent
<br /> D�te Received . _ �=phone�Contact�for'PermttHn �` . �_ � � — � � °
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<br /> Owner's Name ���/f�f� �d �_ � �-�-���r Owner Phone Number "
<br /> ' �Owner's Address ���cx��J ' ��j'= ��i - � OwnerPhone Number '
<br /> Fee Slmple TltleholderName��� � ' � ' � OwnerPhone Number ' �
<br /> : _ ;:;�. . .. , . . - � r ' .
<br /> Fee Simple Titleholder Address . � �' •• � .. - �
<br /> JOB ADDItESS � �� l�, � c� � . _ LOT#, �
<br /> SUBDIVISION PARCEL•ID# II-�' '-� �v v l p -c��ll�0 - am/ �D�` �
<br /> - � ` �•(OBTAINEDFROM'PROPERTYTAX�NOTICE), � �
<br /> WORK PROPOSED � NHW CONSTR :' ADD/ALT 'Q' SIGN Q ' � [� `_ � DEMOLISH - ,
<br /> ,. , -. INSTi4LL e,'. REP�41R ' '
<br /> PROPOSED�USE 'L�= '�SFR ''Q .,COMM 1 Q OTHER' ` "' � "�
<br /> TYPE OF COWSTRUCTION•. �"Q ''BLOCK'�' 'Q;_ `FRAMEa � STEEL. Q_.
<br /> DE3CRIPTIOPI''OF WORK � / L �/t/ � /—G S1/(�i� �
<br /> BUILDINGSIZE - ` � �SQ:FOOTAGE ,:_ P .;.HEIGHT:`. . ... -
<br /> .,� •, -
<br /> .- �BUILDING $ -x��.;.-�;:;:..4 . :.=;,4_.,.._.�..' . . . _.
<br /> � G� � �`Q : VAI:UATION°b�TOTAt�CONSTRUCTION
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<br /> QELECTRICAL $ - AMP SERVICE �[� PRO'GRESS ENERGY �]. W.R.E.C.
<br /> QPLUMBING �'$' � - �
<br /> F � -
<br /> OMECHANICAL $ ' VALUATION OF.MECHANICAL INSTALLATION ��
<br /> QGAS Q , ROOFING.,::Q SP.ECIALTY:[� OTHER� ' �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES. . NO
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<br /> �UILDER / / . COMPANY � �% J /�C G�C�� .�G` �' C
<br /> SIGNATURE � GZ/ - �, REGISTERED Y N. FEe Cuw�e�' /.N,;-
<br /> l�ddress - � � '�License#'
<br /> ELECTRICIAN=,-: ,- „ ` COMP�INY � ' � ` �
<br /> SIGNATURE � ' REGISTERED Y/ N FEE GURRE� '.Y/N �
<br /> Addres� . . � 4 �L•Icense.#' - . , .
<br />, PLUMBER � , , • C.OMP.,ANY-_ :�'.:;�� - . ,
<br /> SIGNATURE , - .., °REGIS.TERED _ ?+., :;:Y/r.N % , ��e cq�e�• 'Y/'N:
<br /> Addres� . : �. , . : _
<br /> . ....
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<br /> � _ : ycense# , - •
<br /> : . . .. - . -.:. .. .. ._
<br /> INECHANICAL , . , . � „ . -.COMPqNY,' . . . ,
<br /> SIGFIATURE " ' �" ` ` ' � REGISTERED:� .: „ .Y,/'N r= .FEE'.CUw2E� �Y Y-N�. • '
<br /> Address;. , .. . . . .. „ . ,.,, .. •� ,. < M � _ , License# � _ . . .
<br /> OTHER � • ,-- : _ .. � . , . � � _ :.COMPANY - _;., .. : � : ,... .. . ,
<br /> SIGNAYURE, , � . - � . ;- , .` , _ ,, � � - T.REGI§TERED ,. Y/,N , FE�GURRE�L :Y�/•.NL. � , , ,
<br /> �4ddr�as . .�,,., , � r��: . . , „ ,� .. ,,. .., , _�License#�'
<br /> RESIDENTIAL�;:���-Attach„2�:P._,lot;Plans�:2 ;sets:of.B'uildln���Rlans•::1-�s'�.o-�En• _ "� `� � '�'� - � . . . .
<br /> .., _ " ; ,.. .�� ,. ..
<br /> ` (..)- _ ,( )..,. ... . ,_, .9.. . ,_( ), et f. ergy�Fortns;=R=O=W;Pertnit:fornevy,conshuction;_:,. _ ,
<br /> - . , ... �,. ....._.,..., ...,��.:-
<br /> �;. ,Minimum�:teny(;1�0.);vVorlting;days�aiter„sutimUtsl�ifafe.w Requlred"ons(te,Cons'tnicUon�Plans;�Stortnwater'.Pla�s w1.�Silt Fenc,e instelled,.
<br /> �Sanitary FedltUes 8���rc�umpster,Site�WoiksPemi�'t.fQr sub'dtvislonsllarge proJe"cis: :�`:� '�:� ;� °�' � �• ' �-"� '' ' ' � _
<br /> COINYYiERCIAL Attach(3j complete'sets'of Bullilirig'Plans plus a Life Safety�Page;(1)set of Energy Forms.R-O-W Permit for new construation:
<br /> Minimum ten(10)working days'aRer subm(ttal date. Requlred onslte,Copstructlon Plans,Stormwater Plans w/Sllt Fence Installed, �
<br /> SaNtary FadlfUas&�1_dumRster._Site Work.Permit,for all new�project's:`All commercial:oequlrements must meet compllance
<br /> �...�„_ i. -
<br /> SIGN:PERINIT Attacti"(2)`set"s of'Englneered:Plaps:R�,;;xflrr_=�. . -
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<br /> ""PROPERTY..SIIRVEY:reguired,fior all_NEW constcuction.,. .� . � �
<br /> Dl�ctlons: : ,.:i�.;�..:.__; �� � _. _ , .. _.. ._ • .
<br /> Flll.out applicatlon completely.
<br /> Owner 8.Contractor sign.back of appltcatlon,notarized
<br /> If'over 52500,�:Notice,of..Commencement is.requlred. (AlC upg►ades over 57500) , ..
<br /> " Agent(for the�contractor)"'Or'-Powe�of Attomey(fo�the�owner)would be someone with notarized letter from owner authorizing same
<br /> `OVER'THE"COUNTER�.P.ERMITTING�----==-(Frontofi�Applicetlon Only)�� � _ �
<br /> Reroofs if shingles Sewers Service Upgredes A/C Fences(Plot/Survey/Footage) . �. . -
<br /> " .__"'- i s . ..i _w_..1`5.:W�n :i}.�.ry n_ ' ..- .K:..yr ` . ,. - ., ' .. .. � ., . ..
<br /> Driveways-Not over Counter if on.public-rnadwpy&�:needs ROW ,
<br /> . �' < ".'i �il�'i'ci.i� ,
<br /> . i .1• .- `�'!, _ ,
<br /> � ,.r�-..� -... �. -:- _. . �. - I
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