���-a3�►�
<br /> sis-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 ���`�
<br /> Bwlding Department � J
<br /> Date Received � �/ tt a
<br /> ,� �r:��t�a�»,,.,.;.._,,.._....: •--'--�-� ...::,- ' - - - - - - - - - ° �;:� �9'rt ��..�. .-�."�"..^..�.T..",..�.�i,�Gs. 3 ...m-, - - - _ -, _ - ,r.'e
<br /> Phone Conta_ ct for Pertn �� � v
<br /> _ . . . .. ... o- �Hi�.ff}t�. sr . ...� -...... � n ..
<br /> . • .. =-..�n . n. .� . . -._..... ':r���..a.:f..n �
<br /> Owner's Name Owner Phone Number � ��(/�f v�
<br /> Owners Address �"1 � � Ownef Phone Numbef
<br /> Fee Simple Titleholder Name � Owner Phone Number f
<br /> Fee Simple 7itleholder Address
<br /> JOB ADDRESS � LOT # 4- to
<br /> SUBDIVISION �— PARCEL ID# II� 'p( .. 1 ��u
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NSTALONSTR � RDD/�A � SIGN � MOVE O DEMOLISH
<br /> PROPOSED USE � SFR � COMM � OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL � OTHER �--�
<br /> DESCRIPTION OF WORK � � �
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> :::ci?<::-i:q:::::.:n :5:e.m.-::n:;:yf1:-,ie:ARiF:F� m:Ni`r.isi11F6s�9�H?qa1�f3Np5�ieir'inNlii9fih'7!`r€Bimieii�:9i�:N911?!iC'm`Fiinn3k�il1.'si3lil:iiiFv`niik43e!iF4N#e:iriGiSi:3?is::a:3iSt:lir.ii��i;f:;i:i�ii�FineiF'v'smiii�hi#�'e?ri�-iFm`.�'i�iiRR,•iBii`v?69k�mel�f'ilr+.iini3i
<br /> � BUILDING $ ��'j VALUATION OF TOTAL CONSTRUCTION
<br /> .J
<br /> � ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W R E.C.
<br /> � PLUMBING $ /
<br /> �(1 V
<br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � v
<br /> � GAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES �NO
<br /> � .;;..::::::�.::: _......_�..._.. -.•-' ix=:: ;` - � �H�::�±3r@€�L^iba•E� - ��r- -
<br /> .: ...._`._'. ._. :.:Rr�:-�: .�� .,;:� :.. ..� .'n��'"r`.� . � �� � „ 63::� � Il.f� � .,: �lE9lE�:8�:,�S�v.B�E''���Si:E:�S�::s:::_�:E_33!�ESS�:s �i_!?;n t - r r,,,
<br /> �y' ._... . ��,_ S.SiE�tBirii�.� . :S�3S�ii?�e:�=tksr�..r..._n `�
<br /> BUILDER � COMPANY / .�� � OP�� SC�'� V� C�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y� N
<br /> Address K Ise � � Iff L 3 � License# � C
<br /> ELECTRICIAN COMPANY —�
<br /> SIGNATURE REGISTERED Y/ N FEECURRENT Y1N
<br /> Address License #
<br /> PLUMBER � COMPANY
<br /> SIGNATURE REGISiEREO Y/ N FEE CURRENT Y/ N
<br /> Add ress License 11
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y J N FEE CURRENT Y! N
<br /> Add ress License #
<br /> OTHER COMPANY �—
<br /> SIGNATURE REGISTERED Y/ N FEECURRENT Y/N
<br /> Address License #
<br /> .. ................ :.:::::::.::::�::::::r.::::�::_:::�c�::�:a:e:�::e::er.a3:=::ea�:::-•:e•:3: i �.,..� �
<br /> ... ............. f s�..���,.�.,,41.li�aFa3c3�4Jod.� M ..�:...:,...._.w�...... r .......�....
<br /> .... .,..�..� ..............._.... ._,............ ..
<br /> .. ... .... ... ... ... .....�. ........ .... ....... .....�,�.............�...... ....x;T•::a::::o3:r.r.oa?o:.^.uia;:r•?i:ai.:. k:� a::::.::::.::::�:: ::.;.:n:.v...�........_......... �..x.... ........ .,....:FY:•,s:E:7i^:: � ��ee°i!ii-i
<br /> ... .. . _•feL•. :f-x:r.:e: :::. �:.�.:::e:e:
<br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans, (1) set of Energy Forms
<br /> Minimum ten (10) wnrking days after submittal date. Required onsite, Construdion Plans, Sanitary Faalities & 1 dumpster
<br /> COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br /> Mmimum ten (10) working days after submittal date. Reqwred onsite, Construdion Plans, Sandary Facil�ties & 1 dumpster
<br /> Alt commeraal reqwrements must meet compliance
<br /> SIGN PERMIT Attach (2) sets of Engineered Plans.
<br /> ""PROPERTY SURVEY reqwred for all NEW construction.
<br /> -- ---,:�.-.:_:.:_, — .._
<br /> ... ... .... .... ..
<br /> :....:.�.::: - ::..::::�..;::�,::: .'. ...,.. : €ai?:K:li:€�i:iElik:S ���.i;i'�!Yi:i: i`� - , - �
<br /> _..__'_ _ ... .... :.:...... ...: -••m..,�..� ... , ��.�:E...:.: F,,; _ _ _ _ _ _ _ _ _
<br /> _. . .. _ _. _ ._ ._ , �.�.�..���3�9»:�I31it:t:lE�..:ld�g:�.�.»�.�..�...<„<,..5sii;iL.���.�..,.�.����._.»�a._�a� _ _ _ _ _ _
<br /> . m, ::.a:�g.��,r.:.,::: :. .'_
<br /> Directi on s: ,�._..r�_.,...�..---��.,...�.,.,�:s:.;.,.-'---.,_ ..............� .. .....c.�,.mi"s�i��.;..,..,__'.;:5
<br /> Fill out applica6on 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 Attomey (for the owner) would be someone wRh notar¢ed letter from owner author¢ing same
<br /> OVER THE COUNTER PERMITTING (Front of Application Onty)
<br /> Reroofs Sewers Service Upgrades A/C Fences (PIoUSurveylFootage)
<br /> �nveways-Not over Counter rf on public roadways. needs ROW
<br />
|