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a�s-�ao-oo2o City of Zephyrhills Permit Application x-813-780-0021
<br /> Building Department �/� n � � �"� �
<br /> 7 --'
<br /> Date Received
<br /> Phone Contact for Permittin � —
<br /> Owne�'s Name �O �*. �� �' J�� �` �� w`.� Owner Phone Number �� "° .i y ,� °� �
<br /> Owner's Address �e�'�.° ".; ��. �"�. e � � J :� �' �"'�.� �. .�� Owner Phone Number � �i,3— -ss � — ( �'/ Z
<br /> Fee Simple Tltleholder Name ��0� ✓G�,/ �!�� i� R j 1 /'"J,�h C`�. Owner Phone Number
<br /> Fee Simple Titleholder Address � �� �C../}��' �. ["'� , � ',�.._-
<br /> JOB ADDRESS / ,� ,�.� �'j �/ � 'L1I /L LOT # � ��
<br /> SUBDIVISION /� � �� hF- �t ;��,t{ ,e"" PARCEL ID# �.�". � ` "" ` "� � "~ �.`� -�.. ; : , •�:T � >;";�r :,;�`
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR � ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM 0 OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK S
<br /> �1Gs � .� �- � +� HEIGHT � ,
<br /> BUILDING SIZE ' • SQ FOOTAGE � .:� ,�. .�..
<br /> �BUILDING $� 7 D O VALUATION OF TOTAL CONSTRUCTION
<br /> J
<br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �� I
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION `� t�
<br /> QGAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER '�� � � , COMPANY G l��' L /e � d ✓�- /�1 �'S A1
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N
<br /> Address F16G6 /��� g�i. License #
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N
<br /> Address License #
<br /> PLUMBER � COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
<br /> Address License #
<br /> MECHANICAL � COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
<br /> Address License # �
<br /> OTHER � COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N
<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 8 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 52500, a Notice of Commencement is required. (A/C upgrades over;7500)
<br /> `* Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same
<br /> ./Ia�11.,++1w.t�,�it:..: ir,..«rr.
<br /> OVER THE COUNT R PERMITTING (Front of AppGcation nly) ;�..:�:., �..w..,aa..�..�s,.r�,.,.+•�u..n��
<br /> Reroofs if shingles Se`Wers' �" 3eriiFCe Upgrades AIC �Fences (PIoUSurvey/Foot e) �,� �,,, i ,�
<br /> ,,;,,,, i . � . . $
<br /> Driveways-No ver Counter if on public roadways..r►eeds RoW
<br /> ., q�r+.wn° , �r^�ww.* , q►..ws •w. ^� •+�wR« -�Yra.�^� 1 f' � -' •.,
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