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a�s-�eo-oozo City of Zephyrhills Permit Application Fax-813-7tfU-UUZ1
<br /> • Bu(Iding Department
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<br /> Date Received � �,��` �1�c �- �� 6�� _� �,�
<br /> 6�./ - �.Phone ContacYforPermitting p C� " �
<br /> Owner's Name C���'y'� �����`�' Owner Phone Number , y�� �� ��
<br /> Owner's Address . ��0� a'� � Owrner Phone Number �
<br /> Fee Simple+,Titleholder Name ' Owner�Phone Number
<br /> Fee Simple�Titlehoider Address _
<br /> � ��lX� p� i��� 4 LOT# � �
<br /> JOB ADDRESS
<br /> SUBDIVISIOPV� �`�L ����. PARCEL ID#. \Z ��2 � 2� ��j�U "� �C�'����
<br /> � (OBTAINED FROM PROPERTYSAX NOTICE)
<br /> WORK PROPOSED e . NEW.CONSTR'e ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> INSTALL ��REPi41R
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE'.OF CONSTRUCTION Q BLOCK • 'Q �'FRi4ME Q STEEL Q
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<br /> DESCRIPTION OF WORK ' �e-"� `���'��-�- ��
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<br /> BUILDING'SIZE ` SQ FOOTAGE�• HEIGHT : ��
<br /> BUILDING $ / � � VALUATIOIV'OF TOTAL CONSTRUCTION
<br /> lQ
<br /> �,ELEC7'RICAL $ AMP SERVICE Q PROGRESS EfVERGY Q W.R.E.C.
<br /> Q,P,LUMBING $
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<br /> �]MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
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<br />' OGAS � ROOFING Q SPECIALTY Q OTHER •
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDER � COMPANY ��
<br /> SIGNATURE REGISTERED Y'7 N ' FEE CURRE� Y/N
<br /> Address �3� ���� 1sP� ��G�� , License# -: �e-���3 ��j�
<br /> ;. ELECTRI,CI�4A1 , ..COMPANY '
<br /> :SIGNATURE REGISTERED Y/ N • FEE CURRE� . Y/N
<br /> � ,�aa�ess ' - l:icense#" '�
<br /> �.:-;�:.:; �
<br /> 'PLUMBER.; , . "COMPANY�
<br /> ,.-SIGN�ITURE ` REGISTERED Y/ N ' FEE CURRE� Y/N
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<br /> Address License# :�
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<br /> ;' MECHANIGAL� � COMPANY �
<br />' `';�SIG{VATURE'` � � ` � " ' REGISTERED , Y/ N FEE CURRE� .' Y/N . - ,
<br /> � �aaress'�r� = ° � �> - � � License.#. '
<br /> „}:�.:�, : ... _. .. . ,
<br /> :;.OTHER`..: ._:,: �.�'�. , ; . , - - ' �°COMPANY -
<br /> ��`SIGNATUREss:u ;a - � " - � ' REGISTERED ' . Y/.N FEE CURREK Y/N ,
<br /> "% .-��..it:';�_:st:, , , .. ` , ... _ ' f
<br /> �:__ Address��. �:,i: = License#
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<br /> ;:.ti,- :::•, .,. , . . .. .s -. .e :¢4,.,;:r::,-. , .. r.w ,,, ... . .
<br /> .;RESIDENTIAI:c?:;;; ;Attach.(Z,);FIot:P:lans;tj2•)>sefs'ofBuilding�Flaris;(1)�'s,e4�of�Energy:Fomis;R:0=1NPerrrijt�ornew.constiuction, "
<br /> ;,a.<=;.�:��:,�-;:fVlinimum,Ften�1Q:,workin �„da':5':afte�TsutirraitEal�'date�:"Be ui�ed`onsite°�Coristruction'Plan's'StormwaterSPlan's w%�Silt Fence installetl
<br /> .x�,..). ... .9, .Y. q � �
<br /> w.,� >,�.:,w.�� ,:•:;.,,.,.;,,,.:-_ , r_ �
<br /> Sanitary.�Facilities�&+,1ti;dwmpster;?SifeY,.W_.oric�,Permit:for;subdi5is'ions/la[gerprojecfs'-° , , - _
<br /> "-`�COMMERCIAI. Attach�'�2)�compiete sets of"Buildi"n"g'Flans plus a Life Safery Page;(1)set of Energy Forms.R-O-W Permit for'new construcdon.
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<br /> • - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed,
<br /> �=�>.-' Sanitary Facilides 8�.1 dumpster.Site Work Permit fo�all<new projects.All commercial requlrements must meet compliance
<br /> ���SIGPI'PERMIT ""AttaoFf=(2)sets�of;Enginee�ed;Plans;;?,:,::�.•�� - ' �
<br /> :'FN~ •'••FROPERI'Y SURVEY_required for.all,NEW consttuction..- -
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<br /> ;Di�ectlons: ,.: ,.... _ _�;� . - -- -
<br /> "���Fill.out`application completely.` �.y _
<br /> O,inrne[i8 CanVactor sign back of application,n.otarized -
<br /> << If ovee;$2500;.a Notice�of:Comm�ncement is requi�ed. (AIC upgrades over 57500)
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<br /> r•;',.:�i• �' �.�.'�..����-
<br /> _. Agent�(fo'r�the�cont�acto�)'or.Power•of�Attomey(for'tFie owner)would`tie someone with notarized letterfrom owner authorizing same
<br />' =;rOVER:7HE�COUNTER;PERMITTIN.G,.._ ,(copy_of,contraetarequired) ' - - -
<br /> ;;'Re�oofs�if;sliingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) .
<br /> .. :.-<: . :_._-: - . .. , .:., .: ,.._ , ..
<br />' -,.�..�' ',.�!'i-:t:��"Y.1: .�..--... .. .. . . "
<br /> - D�Iveways-Not over Counter if'on public roadways::needs,ROW : ��
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