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'h3 780-0020...,,.�....,._,..u�.��,�.b..,.w�,»...,.�,,.....:,...., M. �-•
<br /> �; - ., �� .- -� -� -.; - --�"" City of Zephyrhills Permit Application ;� ,� ,` ,�, ��F.az-8'13-780-002� �,�
<br /> :; � � , "`• . ,' , '� Buiiding Department � =z ,, , , ,, � ` ` ;
<br /> ,`<z: ..<:.ti: , . •. ., .��. �., tm ,{' ==k'•.� , ' ` ` '
<br /> s,����, �'� „ � !� ,::� ., ,�; �ir ,..•, , , , � ;�
<br /> � : . ,� ,s tt;' .
<br /> date Rece�yed'-�' - ; '�_ 'f i' `J•`!�'� ; 4� `' :, -__ .. ,... ,M . .
<br /> �: _ _ - . ° Phcne-Contact for Perrt►itfin <: - – _ _ ....
<br /> Owner's Name �'�h�b �'b(��' Owner Phone Numbsr ��3� ���J ����
<br /> I Owner's Addres '�����IP�e�a� Dr� pvyner Phone Number �:- �
<br />� . _ �
<br /> I
<br /> Fee Simple Titleholder Name r � Owner Rhane Number �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �t 2 35 flpp�.y'�c. t�f� , � ,-h ilts� �, �3 5�f� LOT# ��
<br /> suaa�visiart �Ip��. ��tlu��, Gg�s-��- PARCEL ID# 35�25-Z�-t����- C�� -oa�sc�
<br /> , (OBTAINED FR4M PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/A�T � SIGN Q Q DEMQt,ISH
<br /> ' e INSTAI,L REPAIR �( ��r�
<br /> PROPOSED USE Q SF12 Q COMM � OTHER
<br /> TYPE OF CONSTRUCTION [� BLOCK Q FRAME '�� STEEI. Q
<br /> DESCRIPTIdN OF WORK ��� a-�-� '�" rL�(bb� ��S • �!}�''� �U° 3d
<br /> BU1LpING SIZE � � SQ FOOTAGE C� HEIGHT C ,,, �
<br /> O�v������'' $ t�C�G�� VALUATION OF TOTAL COIVSTRUCTION
<br />� QEl.ECTRICA� �. � AMP SERVICE Q PRt3GRESS ENERGY Q W.R.E.C.
<br />� OPLUM811VG � � f
<br /> ��( �17
<br /> OMECHAt+iiGAL $ VALUATtON OF MECHANICAI INSTALtAT!{JN
<br /> . ,
<br /> QGAS [� ROQFING Q SPECtA�TY Q OTHER
<br /> I FINI5HED F1.00R ELEVATIONS �—� FLOOD 20NE AREA QYES NO
<br /> BUI�DER COMPANY
<br /> SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N
<br /> Address License# �� �
<br /> I
<br /> E�ECi'RtClAN COMPAAIY
<br /> I SIGNATURE REGISTEREp Y/ N FEE CUf'tRE� Y/N
<br /> Addre�s Ucense# � �
<br /> PlUl4�BER COl{�PA,NY
<br /> SIGNATURE REGI3TERED Y/ N FEE CURREA Y/N
<br /> Address License# f �i�
<br /> MECHANICAt. CCIMPANY
<br /> SiGNATURE REGISTERED Y/ N FEE CURREA Y/N
<br /> Addre88 � licenSe# � � i
<br /> o�ER . ��� con���r �.yn��.,�. �.o�-�-;n�} � .
<br /> SIGNATURE R6GISrertEn Y N . FEE CURRE� /N
<br /> Address ,�0`'{13� bY� �j�!c �t�p�s Y#�'t125� � 33��f� �Icense# ��G �32.������
<br /> RfS#DEN'�lAL Attach{2}Ptat R1ans,{2}sets of�Siiildii�g'Plans;(1}set of Enercrc�y Farms;R-Q-W Perinit for new constructian,
<br /> Minimum:ten(1,0)working d'ays after�submlttal date. Requtred onsite,Construo�on Plans,Stormwater'Pians w/Silt Fence instaifed,
<br /> Sanitary FaGlitles,81.dumpster;,SIte�Work�Permit for subdlvisionsAarge projects
<br /> COMMERCiAL Attach{3}campiete sefs of Builiiirig Plan`s plus a L�fe�Safety Page;(1}set of Energy Forms.R-t?-W Permit#or new canstruc�on.
<br /> Minimum ten(70)working days after submittal date. Required onsite,ConsUucdon Plans,Stormwater Plans w/Silt Fence instafled,
<br /> Sanitary Facilitles&1 dumpste�.Site Wurk Permit for all new projects.All commercial requlrements must meet compllance
<br /> S1GN PERMlT Attacfi{2)sets of Erigineered Plans. - �
<br /> """'PROPERTY SURVEY required for all NEW constn�ction.
<br /> Dlrections:
<br /> Ffll out applicatian completely.
<br /> Owner 8�Contractor sign back of applicallon,notarized
<br /> tf over$2500,a Notice af Commencement is requised. {AtC upgrades over b7500j
<br /> " Agent(for the contractor)or Power of Attomey(for the owner)would ba someone with notarized letter from owner authorizing same
<br /> DVER THE CQUN7ER PERMITTFNG (Front of Appllcation Only)
<br /> Reroafs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Driveways-Not over Counter if on public foadways..neecis ROW
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