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���-►aU-�,��v Gity of Zephyrhills Permit Applicatian Fax-813-780-0021
<br /> Buitding Department
<br /> Date Received y'f'--��j�'i�j phone Cantact for Permittin �V �
<br /> Dwnar's Nam� Q � ' �- Clwner Phone Number " _ J�t �,,,
<br /> 7�'{rt y�'`i► sr � �
<br /> Ownec's Address �'!G �� � Qwner Phone Number
<br /> Fae Stmple Titlehoider Name �`� � Owner Phane Number �� �
<br /> Fee Simpie Titleholder Address ��� Ca tkl l ��, !r
<br /> J08 ADDRESS LOT# ��
<br /> 5U8DtViSiON � � PARCE!Id#
<br /> (QBTAlNED FROM PROFERTY TAX NOTiCE}
<br /> WORK PROPOSED • � New coNSTR� ADDlALT [� S1GN Q Q DEM0�18H
<br /> IPISTALL REPAIR
<br /> PROPOSED USE ' Q SFR COMM [� OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL Q
<br /> DESCRlPTiON OF WORK ✓t��r' �d�S �"'�
<br /> BUILDlN�SIZE �� i� SQ FOOTAGE HEIGHT ���
<br /> QBUILDING $ �� � VA[.UATION OF T,OTAI CONSTF2UCTION
<br /> QELECTRICAL �� AMP SERVlCE Q PROGRESS ENERGY Q W.R.E.� /'! ��,,�
<br /> � IlQ
<br /> QPLUMBING $ ` ������„�,,
<br /> i L ��JMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '�i �,,�5 /lQ� '
<br /> OGAS Q ROOFIMG Q SPECIAI.TY 0 OTHER ����
<br /> °INISHED FLOOR ELEVATIQNS FLOQD ZONE AREA QYES NO � ���`�� ��� S�
<br /> fi�Jner�r�'
<br /> 3UILDER ,� „� �L�"`_ _...,...�-���r COMPANY V f�'1<'•tr �V�`t� �317 L,p �"'�H'c%c�.lM+�`�
<br /> M,�
<br /> >IGNATURE REGISTERED Y/ N FEE CURREt� Y/N
<br /> Address ���� f'!��t S✓� �i�t t'�• ��f Z} License# �,�� C..�c3 �L��(1� �
<br /> cLECTRI�.''IAN �" �' � GQMPANY G G l�pLS ����"CJ�`L.� t,._
<br /> ➢IGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address
<br /> 'LUM ER cyi� � COMPANY
<br /> iIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � ((
<br /> v-�r�e
<br /> �Addeess license# �,���,�
<br /> (` v n+'Z
<br /> � C ANICAL ����,.� \(1 COMPANY �
<br /> ;GNATURE `�1 REGISTERED Y/ N FEE CURRE� Y/N
<br /> ��2
<br /> Address �
<br /> ►THER COMPANY �/���
<br /> ��`��
<br /> �lGNATURE REGISTERED Y J N FEE CURRE� Y/N � ""`�
<br /> Address i L�cense# � �
<br /> ;ESIDEN'TIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of EnergyForms;R-O-W Pertnit for new construction,
<br /> Mi�imum ten(10}worictng days after submittat date. Required onsite,Canstruction Plans,Storrnwater P{ans w/Sil#Fence Instalted,
<br /> Sanitary FaciliUes&1 dumpster,Site Work Permit far subdivisfonsllarge pro�ects
<br /> OMMERCIAL Attach(3)complete sets af Butlding Plans plus a Life Safety Page;(1)set of Energy Forrns.R-O-W Permit for new construction.
<br /> _____ Minimum ten('1 d}working days�after submittal date. Required onstte,Construction Ptans,Stortnwater Plans w!Silt Fence installed,
<br /> Santtary Fac!!(ties&1 dumpster.Site Work Permlt far ail new prajeots.AI!cammerciai requfrements must meet campitance
<br /> IGN PERMIT Attach(2)sets of Engineered Plans.
<br /> ""PROPERTY SURVEY required for ati NEW consttuc#ion.
<br /> Iractlons:
<br /> Fitl aut applicatian completely.
<br /> Owner 8�Contractor stgn back of appiicatlon,natarized
<br /> If over$2500,a Notice of Commencement is requ9red. (AIC upgrades over$�500j - _ ,. ;, . „
<br /> Agent(for the contractor)or Power af Attomey(for the nwner�wo.uld be someone v�it�<natarized�letter from owner autharizing same `
<br /> VER THE COUNTER PERMITTING {Front of Application,Only)._ - ' '��''"°` ` � � � .
<br /> eroofs if shingies Sewers Servlce�Upgrades'AJC ����Fences(PIotlSurvey/Fodtage);` ,`' '
<br /> >>. � , -
<br /> Driveways-Not over Counter if on public roadways..needs ROW i,,,.,.. , • ;Kt,,.;,�;,,�;
<br /> _
<br /> • .,.:r:�
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