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e�saao-ooxo City of Zephy�hills Permit Application Fax 813-T80-0021
<br /> Building Departrnent
<br /> Date�eceived' --- � phone-Cantact far Permittln
<br /> Ownar's Name Owner Phane Number
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<br /> Owner's Address � 4wner Phone Number � �
<br /> � Owner Phone Number � �
<br /> Fee Simple Tltleholder N e �
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<br /> Fee Simple Titleholder Address i
<br /> Jo8 AaDRESS 3'��►I� t»�i NQ 1 S V� �.aT# ���
<br /> sua��v�sEOH ��4 hltt'IUZ�� par�iE�,�o# �y• Z'S�� Zi - 0 a`�o �po Co� -� C'9 60
<br /> � � {Q8TAINED FROM PROPER7Y TAX HO'flCE)
<br /> WORK PROPOSED NEw CQN5TR ADDI�tT [� SIGN Q Q DEMOi.lSH
<br /> e INSTALL � REPAIR '
<br /> PROPOSED:USE �] SFR � COMRA ' [„� OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK [� FRAME C� STEEL Q
<br /> DESCRtPT10N OF WORiC ���4� M� rA'L
<br /> BUILDING SIZE 3Q FQOi'AGE i ' HElGH7 �—��
<br /> QBUILDING � � V�ALUpTIiN t?F TOTAL CONSTRUG'i'RON
<br /> QELECTRICAL $ AMP SERVICE Q PRC?GRES3 ENEf�GY Q W.R.E.C.
<br /> [�PLUMBING $ �11Q�,�
<br /> MECHANICAL $ ��— ( `-'`
<br /> Q VALUATION OF MECHANICAC INSTALLATION �
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<br /> QGAS Q ROOFING Q SPECIALTY � OTHER
<br /> F�IVISHED FLOOFt ELEVATIQNS � FLOOD ZONE AREA QYES NO
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<br /> BUILDER �QMpp�y
<br /> StGNATURE REGISTERED Y/ N FE�CURRE� Y!N
<br /> Address ( License# � ��
<br /> ELEC7"RICIAN � " COMPANY
<br /> StGNATURE REGISTERED Y/ N FEE CURREt� Y/N
<br /> Address 1 License# � ��
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<br /> PLUMBER COMPANY
<br /> SIGNATiIRE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address I i.icense# �'� �
<br /> MECHANICAL . COMPANY
<br /> stGNATURE �EGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address i . �i e#
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<br /> OTHER COMPANY
<br /> Slt3NATU12E P REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address """� � ' l.Icense# ��_���� +
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<br /> RESIDENTIAI: Attach(2)Rlot Plans;.(2)sets of Buflding'Plans;(1)set of Energy�Forms;R-O-W Permit for new constructlon,
<br /> Minimum.tem(10)warlcing:days aftet.subnitiittai date. �Required onsite,Canstruc�on�Pians;Stortnwater Plans wJ Silt Fence installed, �
<br /> Sanitary FaciNtles&1 dumpste.r,$fte Wortc=Perrnii for su6divlslansilarge,proJects � � ;
<br /> COMMERCIAI. Attach(3)complete sets of Building�Plans plus a life Safety Page;{1)set of Energy Fortns.R-O-W Parmit for new construcUon.
<br /> Minimum ten(10)working days after submittai date. �Required onsite,CanstrucUon Pians,Stormwater Plans w/Silt Fence InstaUed,
<br /> Sanftary Fac�liUes&i dumpstar.,Site Work Perm{t for ali new projects.Ail cammerc3at requlrements must meet compllance
<br /> SIGN PERIIAIT Attach"(2)sets ofEngineer.ed Plans.,, ° I
<br /> *'*"PROPERTY SURVEY required for all NEW construction. .
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<br /> Directions: !
<br /> Fiil out application completely.
<br /> Owner&Contraotor sign badc of app!{catton,notarized
<br /> !f over 52500,a Notice of Commencement Is reqcalrsd. (AfG upgrac9es aver a7540} ".°... " �. :�;..,..r,.;„....>.«.,..,.�,,._.,.�•.,. -...:..�..
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<br /> " Agank(far the contractor)'or,Power of A4tomey(fior,ttie.owner);woutd tie sameone with notarized letter from ownenaufhoriztng same� .,° >
<br /> : ., .,.. _ ,. -• : ;... `-;
<br /> DYER THE COUNTER P_ERMl7�'aNG •,:`� (Front of APPAcation�Ori{y}„r;� „ ._ _, ." �;,�(�,._..� .. -+,. _. ^
<br /> Reroofs If shingles Sewers Ser`vi'c�a Up'g'�ades A%G ,'+:Fences(PIoUSurvey/Footage) „ ,._.-e. , .. __ � � " '
<br /> ., , . _ � .. j " ,_<,-....�.>,., a, _....,_,- . ..
<br /> :.�,:-��,.<,�..,�r,.,..,:� �
<br /> Driveways-Not over Countec if ori'pubfic roadways..daeds RQW i
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