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813 -780 -0020 City of Zephyrhills Permit Application Fax - 813 - 780.0021
<br /> Building Department
<br /> Date Received (5 '--.0 Q
<br /> 1 Phc ne Contact for oerm!ttm 9
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<br /> 'Owners Ndme I ts, " � k Owner Phone Number I Q.15‘3)2) iajR 1bte
<br /> Owner's Address - 7 A x rj h ' 'd t ) 1 Owner Phone Number I 1
<br /> Fee Simple Titleholder Name " -"'t I Owner Phone Number I 1111
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ( • 3 � 3 w ©© (�� t ( o I LOT # I
<br /> SUBDIVISION L M �
<br /> ..LI� I PARCEL ID#I64
<br /> GO s - aI -01pV ( „ A D j - -00k Q I
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR t/ ADD /ALT r I SIGN I I MOVE I 1 DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE I ✓I SFR COMM I-T I I OTHER
<br /> TYPE OF CONSTRUCTION I BLOCK I 1 FRAME r I STEEL 1 . 1 OTHER 1
<br /> DESCRIPTION OF WORK fpptCLC!,p il l l.vtndCA S► O ;sae,
<br /> BUILDING SIZE 1 I SG FOOTAGE { 1 HEIGHT
<br /> Y raj' r e . muam 3iR!Efi:M =Ri .a [.n, - nua,mnu.iiei ucr!!i'z " "v:!!ui`v i [naeus
<br /> I/1 BUILDING $ -1 9J ( `J ;m�,..[..,,:
<br /> VALUATION OF TOTAL CONSTRUCTION
<br /> 1 ELECTRICAL I$ AMP SERVICE 1 1 PROGRESS ENERGY 1 1 W.R.E.C.
<br /> 1 PLUMBING
<br /> I
<br /> I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> I GAS .%i
<br /> 1 ROOFING 1 1 SPECIALTY 1 1 OTHER l
<br /> FINISHED FLOOR ELEVATIONS 1 1 FLOOD ZONE AREA I IYES 1 INO
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<br /> BUILDER % Z , • ' COMPANY 4me beper 1 ko Ae ✓Ase
<br /> SIGNATURE REGISTERED I Y / N I F E E CURR I Y/N I /►
<br /> Address 6 11,0U ttA/ // Si/lj e 4 16y10). f l , License # I C/Zc O D J 1 g ie ' , A1
<br /> ELECTRICIAN /// COMPANY
<br /> SIGNATURE /I /�� REGISTERED Y/ N
<br /> /• ( I I FEE CURRENT I Y/ N 1
<br /> Address ( I License # I
<br /> PLUMBER I
<br /> I COMPANY I
<br /> SIGNATURE �/ / REGISTERED I Y/ N I FEE CURRENT I Y/ N I
<br /> Address I /•!////111 I License # I
<br /> MECHANICAL I 1 COMPANY I
<br /> SIGNATURE �� REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
<br /> Address I V I I
<br /> License #
<br /> OTHER I I COMPANY 1
<br /> SIGNATURE REGISTERED I Y/ N
<br /> I FEE CURRENT I Y/ N I
<br /> Address
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<br /> (1) set t.. of Energy , y:iF or rrm s :.:ism.L:,: f:: i'.:isW;::.:iG:N: 1 F':iEi:.' >':,3:i:.:vi:'.iiXi::, :6: mn .ml m....len.. .a .....
<br /> 1) e of Eerg Forms
<br /> 3 . „:
<br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (
<br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
<br /> COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br /> Minimum ten (10) working days after submittal date. Required on'site, Construction Plans, Sanitary Facilities & 1 dumpster
<br /> All commercial requirements must meet compliance.
<br /> SIGN PERMIT Attach (2) sets of Engineered Plans.
<br /> ” *PROPERTY SURVEY required for all NEW construction.
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<br /> tDirections: �i71t!! ?f':i:r!tGf. ^... .??: Y' IB;; isi?!: 8 .?!! it@` h?.": ?'I::i ?!;i!:37;1?t:i ?.,,�;1!? . .S!li?!n;;A:Ri -, !!EsiR'• :,� ,,. .
<br /> !R? t � _ IIiA: i; 1. ?i ?!;N. ?t::i!.p?i ?7;a!g ? °
<br /> Fill out application completely.
<br /> Owner & Contractor sign back of application, notarized
<br /> If over S2500, a Notice of Commencement is required. (A /C upgrades over S5000)
<br /> Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (Front of Application Only)
<br /> Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage)
<br /> Driveways -Not over Counter if on public roadways needs ROW
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