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813-780-0020 City of Zephyrhills Permit Application F2
<br /> Building Department
<br /> Date Received �j 1
<br /> Phone Coritactfor`Permittin /
<br /> Owner's Name 't I 1 $ nor Phone Number
<br /> Owner's Address --c Owner-Phone Number F 1
<br /> Fee Simple Titleholder Name Owner.Phone Number
<br /> Fee Simple Titleholder Adrdpress
<br /> JOB ADDRESS ? 7Iol —3?74::;�7- 3 7?xo I np 97 TZ-7 zk LOT#:.��
<br /> SUBDIVISION PARCEL"ID# -�'2/I -06 c J�OG�'°" DC�1
<br /> o
<br /> : "" "(OBTAINED'FROM=PROPERTYTAX-NOTICE)_ '
<br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH
<br /> -INSTALL REPAIR
<br /> TYPE OF CONSTRUCTION:' BLOCK
<br /> A THER' ...
<br /> © ,.,..., FRAME
<br /> S
<br /> PROPOSED:USf,: SFR GOMM"` O
<br /> TEEL. .�.:.�,. . ,, ;
<br /> DESCRIPT10*0 WORK
<br /> BUILDING'S1ZE
<br /> SQ:FO,OTAGE 1� . . HEIGHT:
<br /> =BUILDING $ ,
<br /> VALUATION`'aTOTAL`C0N'STRUCTION
<br /> ELECTRICAL $. AMP SERVICE PROGRESS ENERGY W,R.E.C. .
<br /> =PLUMBING. $
<br /> =MECHANICAL $ VALUATION OF MECFiAi1l1CALINSTALLATION
<br /> =GAS Q-' ROOFING>. SPECIALTY 17-7 " OTHER.
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES. ,_NO ,
<br /> 7-7 BUILDER / , COMPANY
<br /> SIGNATURE �'�/ M REGISTERED Y/ N N . FEECURREA Y/_N.
<br /> Address License'#'1
<br /> ELECTRICIAN,, „ "`COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREN ':Y'/N ` `
<br /> Address r.Ll' nse;#
<br /> PLUMBER COMP..ANY"
<br /> SIGNATURE` REGISTE_RED;` s': :-:Y'/,..N FEECURRE+`''
<br /> Address
<br /> MECHANICAL:'~s' ., .. COM,{3kjNY, _
<br /> SIGNATURE REP!S7ERED;; Y/..N•-.- 'FEE CURREN
<br /> s..
<br /> Address"" " lJcense#;
<br /> OTHER CpMi?ANY`,
<br /> SIGNATURE, REGISTERED Y/,.',N.: FEB:CURREN Y:/:.N.
<br /> nse'
<br /> Address
<br /> Lice
<br /> t'm 1 =Er' Forrtis RA=W.;Permlt for.new•,00nstnicflon
<br /> REStDENT(AL_;�_�<`Attai�;;2 i�'lat°Puns, setsof;Buiidiii Piars•' sef'of. ,er�y",. . �.., .e.: , -, .,,
<br /> Minimum.ten(.1Q.)wor4ting days iter subjriittal'elate: Required,onsite�`ConstruotionPlans;tStoniiwater Plans;wL SIIf Fange.installed,
<br /> ter-SitezlNoili°Permft.fOrsiitikiv!stis8a "e`rb acts :..
<br /> COMMERCIAL Attach(3j'csoriiptete sets'tlfBuitdiiig Plans plus a life Safety Page;(i)set of Energy Forms.R-O-W Permit for new coristiuc ion:
<br /> Minimum ten(10)working days'after submittal date. Required,onsite,•,Construction Plans,Stormwater Plans w/Silt Fence installed,,,
<br /> Sanitary,FaciUtles: _1:dumpster...Siie-Work.Permlt for all'neuvprojecks:Ali'commerciai:requirements:must meet compliance
<br /> SIGN-PERMIT Attach(2)'setsaf`EngineiersdF!iatis ,;;:
<br /> ••"PROP!ERTY.SURVEYriaquired•fur,allNEW::rnspuctiotl;:..;. .
<br /> Fill.out application completely.
<br /> .Owner&Contractor sign back of application,notarized
<br /> If over$2500,a:Nottce,of 0 .req ammencement Is. uired. (AfC"upgra
<br /> Agent
<br /> ' ,�s,;..:;,W:.�....•.. ....,.,.._ ._. ...... '.... ..-_._.,... ._
<br /> '• contrac�r�'or°Power of Attomsy(for-Ilia ow owner)would be someone:with notarized letter from owner authorizing same
<br /> OVER THE'COU14TERcOIERMITTING :(Honk=af Application''niy)'
<br /> Reroofs'if shingles Sewers Service Upgrades A/C Fences.(Plot/Survey/F'ootage) _ - -
<br /> Driveways-Not over Counter if ompubllc road%wiys.:need§ROW
<br /> 0
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