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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ' Building Department
<br /> Date Received „��;��.�_r�� "
<br /> -�--r-�--y-n-�- Phone Contactfor Permitting `"� ���`���� � � �`� G�������
<br /> _ r
<br /> Owner's Name �, � � �. a � €� Owner Phone Num6er } �� �L���', L r',?(a �
<br /> Owner's Address ���4���1� cra ,r f�,..� '�'��^����� '�'�<-
<br /> � �Owner Phone Number
<br /> Fee 5imple Titleholder Name c,.,�. ,�
<br /> Owner Phone Number
<br /> Fee Simple Titleholder Address '
<br /> JOB ADDRESS .� � �� `� ^'j ' � I�;,� �,�( ( LOT# �,I,
<br /> SUBDIVI510N ��l U•Gr'� �� �
<br /> PARCELID# ��' ''�-��-���--r ,� - _ ��
<br /> � (OBTAINED FROM PROPEATY TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN
<br /> ' 'INSTALL REPAIR � 0 DEMOLISH
<br /> FROPOSED U5E �� SFR � COMM � OTHER
<br /> TYPE OF CONSTRUCTION ��' BLOCK � FRAME � STEEL � •
<br /> DESCRIPTIOIV OF WORK On�L'� J��/]�� 1 ) -�
<br /> 1�c•�'��-�-►_5 '1.--�., B/� (� ]
<br /> � 7 li 1'��b ����'Z� �"'.J C�Y����.':"L��'^L --��'G"'L.ti.
<br /> BUILDING SIZE SQ FOOTAGE ���
<br /> � � � HEIGHT
<br /> "r-e-rr-t-�-r-rmr-r�-e��-r�-�r-�e-r�-r-rt-rrQ'�r-e-y-r-r-yvr-ru--rv�-
<br /> ��UI,LDING � �-���°�°�"��`��'$-e-�-Q-u-r-
<br /> ( t7��. ���J VALUATION OF TOTAL CONSTRUCTION
<br /> ��LECTRICAL $ AMP SERVICE
<br /> � �`77�. 0 PROGRESS ENERGY � W R.E.0
<br /> V`J
<br /> �PLUMBING � .� 9 � ,.� �
<br /> � L—C�/V
<br /> [�IECHANICAL $ � � \ ' VALUATION OF MECHANICAL INSTALLATION
<br /> f� �l q3�3
<br /> �GAS �' ROOFING � SPECIALTY � OTHER •
<br /> FINISHED FLOOR ELEVATIONS �• � �
<br /> , ( r��� FLOOD ZONE AREA YES NO
<br /> (..C7
<br /> --a—¢—a--a�.-o—�--a—a—a-�—.a—�—a—a—�-c—�—o--i—a—o—a—a--rr—:—a�e—�--a—�a—�--a—��:-�—�—:—a�a--s—�a�-;—s—��c-�--�—�—,9--e..,e—z_
<br /> BUILDER
<br /> SIGNATURE � � -''� COMPANY �. � _ �;-, �J,.��-��,..-� �"�,L�
<br /> , REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address %c��[�rr� l���<o.� � r^ )�i}� � � a
<br /> License# �������� � ;�-
<br /> �LECTRICIA�1 � �s��,^ ,
<br /> SIGNATURE �� ��� � COMPANY ��,�'l;,C�n�7,,,�"�,Q',� �������, �
<br /> . REGISl'ERED Y/ N FEE CURRE� Y/N
<br /> Address 4°'"�-�y QJA�'�,p'O,/'"�s' �'`f,,,� � � ;�,� License# ���,��J��,1����
<br /> PLUMBER v /� � �+ / '
<br /> SIGNATURE ���'`('✓✓8" _.. .._. — COMPANY ' I''"' /r-����` •.�8,�•G"s�',�3:'4-,�� �,��,��;��,��r� �
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � f��� T r�i^rn��c- ���.���,� �' �' �O'� �
<br /> '� Lfcense# ��,�^'� �i �, r r
<br /> MECHANICAL ��� � ,r
<br /> SIGNA7l'JRE f,,..�'r�,"`.�.'_�-^r.��..��..-.��COMPANY "�'1A'".�t,(',,,�%L��;,�,j��,{1�" �d� ,� , ,a7�e�'"�,.fi
<br /> REGISTERED Yf/ N FEE CURAE� Y/N
<br /> Address • ����� ��%-�'"��.�- �� fi�ca.,a�"�.•t��/`��
<br /> - j� License# ������j�� �
<br /> OTHER ,
<br /> SIGNATURE r ��F� - _..-,.Y----. COMPANY I�AF't%f".I.� . ..�� � ,/).. ,�>. ,F�
<br /> a ,( �;
<br /> F � '-��� =/� :.�/,��F�'1_�,�a•�''
<br /> �-^ � Y/N. /'
<br /> ' � REGISTERED Y/ N FEE CURRE�
<br /> Address l��c�����`3 �f`/n� �'j�����
<br /> 1 1 L 1 1 1 1 1 1 1 1 1 1 i 1 1 1 1 1 1 0 I 1 I 1 1 1 I 1 I 7 1 1 7 B 0 1 B 1 1 9 1 1 1 1 1 IICO B p#O p i p 1 g B 9 9 B 0 0@ 9 1 p 7
<br /> RESIDENTIAL Attach (2) Plot Plans; (2)sets of Build(ng Plans; (1)set of Energy Forms; R-0-W Permit for new construction,
<br /> Minimum ten (10)working days after submittal date. Required onsite, Constructiori Pians,Stormwater Plans w/Silt Fence installed,
<br /> 5anitary Facilities &1 dumpster;Site Work�Permit for subdivisions/large proJects
<br /> COMMERCIAL Attach (2)complete sets of Building Plans plus a Life Safety Page; (1)set of Energy Forms. R-O-W Permit for new construction.
<br /> Minimum ten (10)workfng days after submittai date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, ,
<br /> Sanitary Facllities&1 dumpster 51te 1Nork Permit for all new projects.All Cbmmercial requirements must meet comPliance ����� `
<br /> SIGN PERMIT Attach (2)sets of Engineered Plans. �
<br /> '`***PROPERIY�SURVEY required for all NEW construct(on.
<br /> -�--F-l�-¢-�.-�-.g.-0_p„� • �..�,_p_�����--E�-1-,f-8-6-1-�8--8_C--d�B'►L.p-B-'A...g.-d-�-s--�-4--�-�@-�-�--L+�@-�.�&,�-,g_ ` -- --- I
<br /> Directions: '� I
<br /> FIII out application completely. �"`���'�'��0"'��-�e-- I
<br /> Owner�Contractor sign back of applicatfon, notarized
<br /> If over$2500,a Notice ot Commencement is required. (A/C upgr.ades over$7500)
<br /> "` Agent(for tF1e contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
<br /> �VER THE COUNTEFI PERMITTING
<br /> 3eroofs ff shingles Sewers (copy of contract required) ,
<br /> Serv(ce Upgrades A/C Fences (Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on�ublic roadways,.rieeds ROW - . .
<br /> , ` , �
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