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81�3-780-0020 City of Zephyrhills Permit Application Fax-S'I3-7SU-Uv'L7
<br /> , - �' Bullding Department
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<br /> Date Received . _
<br /> �i • -• :�.Phone Contact:for-Permitting -
<br /> Owner's+Plaene ��£'�n ��<"e�� Ovuner Phone iVumber . `��7 S 1�S�� -,
<br /> . 3S�`? 2 5 �/ � ze b
<br /> Owner s Address . Ll I CA C� rc P �5 2 Owrner Phone Number
<br /> Fee SimpleiTitleholder Name � P Ovirner'Phone Nuenbe��
<br /> Fee Simple;Titleholder Addcess _�
<br /> JOB ADDRESS � ���-5 W�1 c�n C'i r 2 �' 335� 2 LOT# �
<br /> SUBDIVISION PARCEL ID#. d a"a�0-o����a�C —0 QQ d-" O� �'D
<br /> I (OBTAINED FROM PROPERTY:TAX iVOTICE)
<br /> 1fU0RK PROPOSED . PdEW:CONSTR ADD7ALT � SIGN Q Q DEMOLISH
<br /> a e INSTALL e �REPAIR
<br /> PROPOSEQ USE Q SFR Q 'COMM Q OTHER -
<br /> TYPE':OF CONS'FRUCTION Q� BLOCK - Q FRAME Q STEEL Q.
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<br /> DESCRIPTI`ON OF WORIC (S C� a�"�`p b� �� l��'Y�P✓1 fi
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<br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT ;
<br /> QB,UILDING $ VALUATION'OF TOTAL CONSTRUCT..ION
<br /> �ELECTRICAL $ �S O dQ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> o � �� ��y�
<br /> PLUMBING $
<br /> S
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<br /> QMECHAfVICAL $ � VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS Q, ROOFING Q SPECIALTY [� OTHER .
<br /> Y
<br />, FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> :BUILDER i COMPANY - �
<br /> SIGNATURE REGISTERED Y"7 N FEECURRE� Y�/N.
<br /> Address , License.# �
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<br /> �: ELEC,7RIGI�AN ;, �� . ���n�r�� :.COMPANY D�tv.�d Mo�'ord L�zct-nc dhq �=1rS�C��,�s E-� � �
<br /> �,'SIGNATURE V l� REGISTERED Y/ N• FEE�CURRE� 'Y/N
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<br /> ' Addres; - License# �����2 5�� �� ,
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<br /> PLUM�ER.;F , . , `CO�IPANY�. .
<br /> ,;. '�IGNATURE � � REGISTERED � Y/°N ' "� FEE CURRE� , Y/N I
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<br /> � Address � License#` �I
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<br /> .;` fNECHANICAL". � � j COMPANIf �
<br /> � SIGNATURE'' " � � ' "REGISTERED Y/ N FEE CURRE� Y/N � ,, I
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<br /> aaare�s��t License.#
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<br /> �c.•.OTHER'•' 's��, ,�. • . ' � � "COAflPARIY _ .
<br /> ';;�'SIGNATUREt,:�.v „•� - - • '� - REGISTERED ` . Y/N ` FEE CURREK Y/N
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<br /> � Address:�s..,�_ �::-�•- :;s=�.� _ - � - • License#
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<br /> '::RESIDEWTiNL�=:•: rAttacfi;`.'2s 4Rlot�plans•�"�2•�.s�ets`of:;Buil'dIn��:Plans^ 1%�'set'of=Ener �Forrris•R-0=1N Pery�"it J+�r.new,con"stiuction.� � " "
<br /> - -�,.,>.:-,,- , ,...___,v,.,(_�.). . „�� ). 9 �( ) 9Y. �,,; � �. :f° _
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<br /> -�:�.�=���=k�,.:�>>��:Minim.um�:terk:10,;:inrorkin'k'da"s;aftei�sutiriii�tal.;cJatie:�-'Re uired'onsite;'Cori`s"triiction�Plan"s,`S`tormwater'Plans�w/SiltFenceinstalled,
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<br /> �^-• Sanita,.ry,�Facilities�&�,1a,dwmpster_=;�Sites;Work:Fermit-for:?subdivisions/laige`p�ojects".;�= ` . "_.� � -
<br /> ;�.;�:GOII�RIIERCIi��,LL Attacli`�(2)�compiete'sets of Builiiing Plens�plus a L(fe Safery�Page;(1)set of Energy Forms.R-O-W Permit for'new construction: _ _
<br /> � , • Minimum'ten.(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence,installed,
<br /> ���:';_: Sanitary Facilttles 81 dumpster.Site VUork Permit fo��all°new-projects.All commercial requirements must meet compliance
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<br /> :.;SIGN°.PERNiIT "Attach=(�sets of;Enginee�ed;Plans:.t�:.e= ,,_ _ -� '
<br /> !'` ""FROPERTY S�1RVEY,required..for aII,NEW._construetion:_. _
<br /> ,,f.:
<br /> �.�=,�Directfons: ,. . .:v�, , , .
<br /> �;" �Fill�out�applicatlon completely. �
<br /> 0,wmer.B:Contraotor:siyn.tiack of_application,notarized
<br /> ;5j�� I�f over$2500;.a Notice:of:Commencement is required. (AIC upgrades over;7500j _
<br /> ��.,�. •,s,���;-
<br /> Agent:(fo�'the�con"tractoe)�o��Powerof�Aftomey(for`tFie owner)would tie someone with notarized.letterfrom owmer authorizing same
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<br /> �":�OVER=;YHE�COUNTER;yP�:FtMIT.T.ING.,. .(copy_of:contraetirequired) ' '`'' ' • �
<br /> �,:�.,...=._...,.., _.. . --
<br /> �'��Rerqofs if,sfiingles Sewers Service Upgrades A/C _ Fences(PIoUSurveylFootage)
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<br /> ` a.:'..+,;':n`.�i.�-. -:�::.. : , . �. . _ "� . . _"_ ,.1, '
<br /> - D�iv�ways-Not over Counter if on public roadways::needs ROW-� '
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