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s�aasao4za C9ty af Zephyrhills Permit Applicaiian Fax-813-784-QQ21
<br /> , Suilding Departmen!
<br /> Date Raceiv�d Phana Coatact for Perm�tting –
<br /> Owner's Name C � �-S��r� ��d,2.. yy'p Z'-- Owner Phone Number
<br /> Owner's Address �� � G�a � �!-"�'-�' Owner Phone Number � �
<br /> Fee Simple Tltlehoider Name � � Owner Phone Number ��l�
<br /> Fee Slmple Tittaholder Address
<br /> JOS ADDRESS LOT# �_��
<br /> SUBDIVISION � � PARCEI.ID#
<br /> (OBTAINED FROM PROPERTY TAX N01'ICE)
<br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q Q QEMOLISH
<br /> tNSTALL REPAIR
<br /> PROPOSED USH Q SFR Q COMM 0 OTHER
<br /> TYFE OF CONSTF2UCTION [� BLOCK [� FRAME � STEEL Q
<br /> DESCRIPTIQN bF WORK -� V � r"�J• . �r SZ- �
<br /> BUILDING SI2E �` � SQ FOOTAGE� HEIGN7 �`�
<br /> QBUILDING I$ � VALUATIQN QF TOTAL GONSTF2UCTION
<br /> �,,..,_,_,,.._,
<br /> Q � _i—� AMP SERVICE Q PRQGRESS ENERGY Q W.R.E.C.
<br /> ELECTRICAL $
<br /> CJP�UMBtN� $ ���
<br /> C_,.._,�� �t�
<br /> QMECHANlCAI. $ � VALUATION OF MECHANtCAI INSTAt[.ATION �
<br /> �C � �{�.
<br /> QGAS Q RQOF(NG Q SPECtALTY � OTHER
<br /> FfNtSHED FLOOF2 EL.EVATtONS ��� FLOQD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y/N
<br /> Address License# �_ '�
<br /> ELECTRtCtAN COMPANY
<br /> SIGNATURE „__^ REGiSTERED Y I N FEE CURRE� Y/N
<br /> Address �icense# �— �
<br /> PLUMBER COMPANY
<br /> SIGNATURE �. REG1STSRED Y I N �E CURREn Y/N
<br /> Address l.icense# r� i �
<br /> MECHANtCAE. �""�� COMPANY t�S C9,,..��
<br /> SIGNATURE `-��"z--�– R�czsre�teo Y/ N FEE CURRE� Y/N
<br /> Address l.icense# � C �� �- i �
<br /> Q7HER COMPANY
<br /> SlGNATURE RE�ISTERED Y/ N FEE CURRE� Y J N
<br /> Address l.icense# �—� � �
<br /> RESlDENTlAL Attach{2)Plat Plans;{2)sets of Buiiding Plans;(1}set of Energy Forms;R-O-W Perrnit for new construation,
<br /> Minimum ten(10)working days after submittaf date. Requfred onsite,ConsWction P1ans,Starmwater Plans wt Silt Fence instatled,
<br /> Sanitary Facilfties&1 dumpster;Site Work Permit for subdivisionsAarge projects
<br /> GOMMERCIAi. Attach{3)camptete sets of 8uitding Plans ptus a Life Safeiy Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten{1Q)working days after submlttal date. F2equlred ansite,Construction Fians,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities 8�1 dumpstec Site Work Permit for all new praJects.AA commercia!requlrements must meet compiPance
<br /> 51GN RERMtT Attach(2}sets of Engineered Pians. -
<br /> """PRQPERTY SURVEY required itar a(!NEW canstruction.
<br /> Directions:
<br /> Fii!out appiication compietefy.
<br /> Owner&Contractor sfgn kaack of applicadon,notarized "
<br /> If over$2500,a Notlae of Ccmmenaement is required. (A/C upgrades over$7500)
<br /> '* Agent(for the contractor)or Power of Attomey(for the owner)would be someone with nota�ized letter from owner authorizing same
<br /> .,�.,...,.. <_...�:.. _� ..�..,�. ..,_.
<br /> DVER THE COUNTER PERMITTING Front of A, licatioo.Qnl ,.�„�• - ''`'�'- _ `'""'�'
<br /> ,•:,�-�....,.:.. PP Y) , H
<br /> Rerootslfshingles Sewers � �Service.Upgrades,AlG , ,,FencestPtot/SurveyiFoo#a9e) ,.';; .. - , ., ,� , ,` f
<br /> 1` ,. ,. ._
<br /> Driveways-Not over Counte�if on publ(c.roadway,s..needs.R01N, " . , _ .,� - „ . � ;
<br /> ,. . . ... ,. ` � _ .._...,_ .,. :- > -..-, ._,.._.F._. . _�:.v ,;;
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