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813-780-0020 D y Fax-813-780-0021
<br /> City of Zephyrhills Permit Application �,jj. q
<br /> Building Department �rhN
<br /> Date Received Phone Contact for,Permitting. —
<br /> Owner's-Name Owner'Phon®Number; t .
<br /> Owner's Address- _ -
<br /> �" S� Z" J 1- Owner.P-hone Number° �"
<br /> Fee SfinpleT(tleholder Name ,' OiivnerPhone'Numti'®r. '
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ?:, ;•
<br /> ��• -�- G.-c'. `I.l' •"��lii S. `.I LOT:#
<br /> SUBDIVISION PARCEL ID#i`} .y: :Z(�:Z C. COt.�;o, ,.
<br /> (OBTAINED FROM P,ROPERTJ!TAX NOTICE); ,
<br /> WORK PROPOSED NEW CONSTR' ADD/ALr 0 SIGN : Q Q . .DEMOLISH :•- ""
<br /> e INSTALL REPAIR"
<br /> PROPOSED USE- 0 .SFR ' 0 COMM :• .::,0; .OTHER'
<br /> TYPEOF CONSTRUCTION' BLOCK FRAME $TEFL`'."
<br /> 0 0} o, o.
<br /> DESCRIPTION OF WORK YA i
<br /> ,. . . - - ��9cQ.aYiq, �. •ex�5��rcf.
<br /> BUILDING„ ZE, SQ FO.OTAGE :3. / ! HEIGHT` _ :�bjC
<br /> ." JBUILDING $. •�� VALUATION:OF'TOTAL,CONSTRUCTION.7
<br /> =ELECTRICAL '. $". AMP SERVICE 0 PROGRESS ENERGY- 0. W.R E.C;.
<br /> PLUMBING'." $
<br /> MECHANICAL $.,: VALUATION.OF.MECHANICAL INSTALLATION'.;
<br /> =GAS = ROOFING ASPECIALTY'0- OTHER::
<br /> FINISHED'FLOOR ELEVATIONS FLOOD ZbNe AREA =YES ' NO
<br /> BUILDER COMPANY`"
<br /> SIGNATURE '"=:REGISTERED. - : "Y./.N ' : "` FEE',CURREP Y'L`N«
<br /> Address License'"# .
<br /> ELECTRICIAN 777 .
<br /> COMPANY
<br /> SIGNATURE :REGISTERED Y/_N ;
<br /> Address ,License
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED : . .-" Y:/'N: F,EE'CURREr::;
<br /> Address. License:#:_ - -
<br /> MECHANICAL: <.COMPANY _
<br /> SIGNATURE. REGISTERED " :Y/_N. FEE;CURREI%
<br /> Address
<br /> ,
<br /> ense Uc #'.
<br /> OTHER. • ' -COMPANY'.:
<br /> SIGNATURE %'� :' REGISTERED:' `': Yr/ N t`' FEE CURREf� Y^/N"-'''
<br /> Aaaress . ; SSS�3, �� ^'S►- zephyr ha s 1 33 : License#.:`
<br /> -"
<br /> B•"ild' d0,Plans;'=1: ,setof`Ene Forms•,R=O_-.WA P..ertnit:fo
<br /> RESIDENTIAL Attach(2)PIoYPiaris;(2),sets of u dI 9,-. " (.) rgy.
<br /> Minimum.ten(10).working.days"after submittatdate. Required onsite;Con'structionPlans,Stormwater:Plans..w/Slit Fenceinstalled:"
<br /> Sanitary Facilities&I-dumpster,Site Work Permit for_subdivisIpns8arge projects
<br /> ja .q,,...
<br /> COMMERCIAL Attach(2)complete sets of B'uilding,P,.laps;,plus_a Life`Safety Page';(1)set of Energy Forms.R-O-W Permit-for-.new.Consttuction.'"=`
<br /> Minimum ten(10)working;days after'submittd:We'Required'onbite,Construction Plans'Storinii4afe�-Pianslw/`Silf Fence`instalied",'
<br /> Sanitary:Facilities&1:dumpster,Site•Work P, rmI!for all,new projects.All-commercial;requirements must meet compliance
<br /> SIGN PERMIT Attach(2):sets,:of Engineered Plans: '
<br /> ••..PROPERTY SURVEY"required for•all NEW construction:
<br /> Directions:
<br /> Fill out application completely.
<br /> Owner&Contractorsign:back of application,notarized
<br /> If over$2500,.a Notice of Commencement is required. (A/C upgrades over$7500)
<br /> •" Agent(for the contractor)or Power of Aftomey(for the owner)would be someone-with notarizedlefter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (copy,,of-contracUequired)
<br /> Reroofs if shingles *�Sdwers- "".,—Service-Upgrades,AIQ--.,,,,Fences(Plot/Survey/Footage). k ,
<br /> ' ail:,"•.r.f'J�i;j,i i(':"..y1 ::"'c�i:'
<br /> Driveways-Not over Counter,if:on:pubiic.roadways:needs:RO
<br /> ,:!ail;,.,,._� ".�.,• (7 •:)�`,' ..q * •
<br />
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