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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax -813 -780 -0021
<br /> Building Department
<br /> Date Received -2,1 0 7 Phone Contact for Permitting FEE A nd- - ) v
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<br /> Owner's Address t4—O 4-5 Sr g- . & I r - . , - Owner Phone Number [_ --
<br /> Fee Simple Titleholder Name 0 C MMC445, I,L.G Owner Phone Numbe' [_
<br /> Fee Simple Titleholder Address 317 -R IvtAce.3-0 4 , T'pA- Ft. � ?
<br /> JOB ADDRESS 1 t M. glueyQ. 4- b -5 LOT#
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<br /> SUBDIVISION PARCEL
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<br /> (OBTAINED FROM PROPER Y TA) NOTICE)
<br /> WORK PROPOSED NEW CONSTR I I r`. 7 AD 1 I 1 SIGN I I MOVE � DEMOLISH
<br /> INSTALL REP
<br /> PROPOSED USE I J SFR f COMM 1 I OTHER I I
<br /> TYPE OF CONSTRUCTION BLOCK 1:11. FRAME STEEL I I OTHER
<br /> DESCRIPTION OF WORK ' T
<br /> K 1•io(- Ft-WISH 8 c.
<br /> NIS OF kt t 1st e t?e pMt
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<br /> BUILDING SIZE w n - 6U SQ FOOTAGE ( 2-0 ID HEIGHT
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<br /> I BUILDING $ j / p ` `o 0 VALUATION OF TOTAL CONSTRUCTION
<br /> I— ELECTRICAL $ AMP SERVICE I 1 PROGRESS ENERGY I I W.R.E.C.
<br /> I ( PLUMBING $ A.,,tri
<br /> re MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION /� i
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<br /> I0- GAS I 1 ROOFING 1 1 SPECIALTY I I OTHER 'O Pb } .� (1 :. f-4zi 2
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES 11/5NO f , is Oh CA
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<br /> BUILDER COMPANY e,/l,7(Vri ryr"N rt : X '
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<br /> SIGNATURE /� / REGISTERED I Y/ N I FEE- CURFIENT I 'lll
<br /> Address (O MSC Pe. ,T�RQt(4$f' 1S 3°I License# 0 .0 IS �� A
<br /> ELECTRICIAN COMPANY �(5el ,_ f, �' ��i'� ; .1 ( r`��
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<br /> SIGNATURE r l I/V et, A1 v‘. /� REGISTERED ® FEE' CURFIENT 1 Y / N
<br /> Address 11...1. // 1 ca,...‘„,- 4. �41/� c,...- M.41 License # {: 11 i,) 0 t 1-4i.-11 PLUMBER y/A{` C- COMPANY I ' x l410191 y I 6 IL
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<br /> SIGNATURE / REGISTERED FEE. CURF:ENTJ 1 Y / N
<br /> Address 12Al) EiGl(mot/►/S! Elvd, tin if- # l, x,
<br /> 3 Delar�3 37 >y License # C- FC 0S713i
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<br /> MECHANICAL / / /�'� COMPANY .B N/ � 2 - S 'v v 1-
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<br /> SIGNATURE / V /5 0_ REGISTERED ® FEECXRF'ENT I YIN I
<br /> Address 75 f ? i i t . ( } % t J i / C / , X /V 3 x . 6 5 , S ' License # IEA C13 .6 - 43 0 '{
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED I Y/ N I FEE CURFIENT I Y/ N I
<br /> Address License #
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<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, Stornrwater 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, Stomtwater 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.
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<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 NC Fences (Plot/Survey /Footage)
<br /> Driveways -Not over Counter if on public roadways..needs ROW
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