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813-780 -0020 City of Zephyrhills Permit Application Fax- 813 -780 -0021
<br /> Building Department tf q4,2iev
<br /> Dati: Received ( 6- 0 q Phone Contact for Permitting a i/b -- ' t_›
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<br /> Owner's Name O/Z%cA ItIOq))/ / Fri Xiyi `
<br /> /,Ls Owner Phone Number 76 ' -- o - // //
<br /> Owner's Address ' 5/i ef9k•-- u�/ , I/ /4` vy
<br /> -a Owner Phone Number 72, 4 //
<br /> Fee Simple Titleholder Name T/-O2 ( /i3 i /, =g- Owner Phone Number
<br /> Fee Simple Titleholder Address / -'° 6 6 1,1 - 4 / L Lim 7 , . , ,,0A / ,,m /.0 ' ,/-1 sal. Y,3 t '/O
<br /> JOB ADDRESS /.3 /(() /J / 2 l/ I<�r?i� C / LOT #
<br /> SUBDIVISION ; PARCEL ID# 35 a`) -o / - ( , C 9 /(: , - 073O0 —O0 0
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE n SFR [ COMM I 1 OTHER I
<br /> TYPE OF CONSTRUCTION I I BLOCK n I I FRAME I I STEEL n OTHER' I
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<br /> DESCRIPTION OF WORK Vtg ;/z f=1- / / i 1�
<br /> BUILDING SIZE � SQ FOOTAGE HEIGHT
<br /> I I BUILDING $ VALUATION OF TOTAL CONSTRUCTION -
<br /> I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY n W.R.E.0
<br /> I I PLUMBING $
<br /> ill wet, eil ei
<br /> I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION t) / '
<br /> AL OTHER �( 1 10Y 4 � /4
<br /> I GAS I 1 ROOFING 1 1 SPECIALTY n (i 9 11 P
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I 'YES LINO (./
<br /> BUILDER �' �� X41 COMPANY CCdTra1.11,:c ciilL �Dn0f/2'•4LI c72 &./e -,
<br /> SIGNATURE 4, ,-- i�l t- ii. c' REGISTERED VV N 1 FEE CURRENT IAN N
<br /> Address ,3 :7 J a� n /? .2 ,4 yq✓g :5(3. 1-// License # C6U t") /- /k 9, I
<br /> ELECTRICIAN � W COMPANY I /9 PC', ; .(�j .�
<br /> SIGNATURE 4 ✓ , ` VYY7 ✓ REGISTERED I Y / N I FEE CURRENT I Y / N I
<br /> Address �/�2,5 / /I / 4 ,4), ( .4,,, , ,,4.fef2 337‘,,z_. License # I eC ©OOO 1/836
<br /> SLUMBER Lt/ COMPANY s > F C' URRENT z 1d c�i . SIGNATURE REGIST / N I FEE CURRENT N
<br /> Address 1 J 3c) 697Y7 ('N .,V- /4 / i L 3,3 5 // License # I C r✓pu_ 7
<br /> 3
<br /> MECHANICAL A li( COMPANY Y/ I � uR � Nr o � � Y/ N I
<br /> ^` y �/ ` C REGISTERED
<br /> Address 9 6 _ 2 UUU . !� i o p,L /74 6 z, 33R/9 License # C C_O 3 3 SAG,
<br /> OTHER T COMPANY
<br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I
<br /> Address • License #
<br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction,
<br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects
<br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction.
<br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br /> Sanitary Facilities & 1 dumpster. Site Work Permit 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 & Contractor sign back of application, notarized
<br /> If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000)
<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 /> Drivew• -- • • -'- 0 • n tifit , *. pu. ic r • t : , .n -ds ROW x9'3111113S l Malt' Malt' .
<br /> IOW - 311004 t1wsM • 4/ 81 ilM41 b t
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<br /> jai tMpttiii ipumtl? Irlt` ^B '' N MA ; - 'MOT 01100941 *.,
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