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a�3aaa-oazo City of Zephyrhills Pecmit Application Fax 813-�so-ooa�
<br /> Bui(d'mg Department
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<br /> Date Rea'alved '� , ` '. . � ' ' ` �7 �'":.
<br /> Phone Cantactfor Permittfn r1,:,1'� Y t�n�' —.��/'3
<br /> Ownar'a Name � a'2!�� �O �,,,� `'s Ov�'tner Phone N'umber'`` �'.L' '.
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<br /> Owner's Address ���� 2� .✓1'"'" 00� Ouvner Phone Number y �. � �
<br /> Fee Simpte TlNeho(der Name �� � Owner Phone Number �� �
<br /> Fee Simple Titlehoider Addre�s
<br /> .lOS ADDRES8 _ S,-!��� " _ L,OT# ._C___^�
<br /> SUSDIVIStOtt �.\s�` 4 � _��*'�� ~�:��
<br /> PARCEI tD# '�.�
<br /> " i (OBTAINED FROM PROPER7Y 7AX NOTICE)
<br /> WORiC PROPOSED NEW CONSTR ADQtA�T C� SIGN Q Q DEMOLI54i
<br /> INSTALL 8 REPAIR
<br /> PROPOSED USE � SFR [� COMM � OTHER
<br /> TYPE OF CONS'TRUCTION Q BLOCK Q. FRAME � STEEL [�
<br /> DESCRiPT10N OF WOFtK �C Q,� �
<br /> BUILDING StZE � � SQ FQOTAGE��� � HEIC,HT ��..�
<br /> QBU{!OlNG �� �
<br /> VA�.UA7'lOhl OF TOT II.C0IUSTRUCTIOIV
<br /> �,]ELECTRICAL r?y� AMP SERVIGE � Q PROGRESS EIdERGY Q W.R.E.C.
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<br /> QPLUMBING (y','��
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<br /> QMECHANICAI. $ �,/��� od � VALUATlON OF MECHANIGA�INlSTALIATION
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<br /> QGAS [� ROOFING �] SPECIALTY �I �] OTHER
<br /> Ft1�i1SHED FI�QR ELEVATIONB FLOOD ZONE AR�EA QYES NQ
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<br /> 8UlLDER GOMPANI(
<br /> $!GFlATlJ12E REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address i.icense# �� _�
<br /> BI.EGTRICIAN GOMPANY i
<br /> SIGNATURE ,, ,, REGiSTERED Y! N FEE CURRE� Y J N
<br /> Add�ess �.Icense# � �
<br /> PL.UMBER � � COMPAII�lY
<br /> SIGNATt1RE REGtSTERED Y/ RI FEE CURREh Y�N
<br /> Address lEc�ense# � �
<br /> MECHANICAL COMPANY l.3rrjM'rG,s �Ito /rf�e/� L�-t S C
<br /> SIGNATURE R��ts7ERSO Y/ N FEE CuRREn Y J N
<br /> Addre� Y �i'�Y/ -4/'i.� � �—h��ff,f°,� �Icense# /Q� Q���� �
<br /> O'THER COMPANY '
<br /> Sf GNA7URE „ REfisISTEREd Y 1 N ��cuR�t�R Y/At.
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<br /> Addre�s � ltcense# � `� ,
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<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Pla�s;(1)set of Energy Forms;R-O-W Permit for�ew construc�on, '
<br /> Minimum ten{10)warking.days after_submitta4 date. Reqalred ansite,Conshvc�on P1ans,Starmwa#er Plans wl Slit Fence installed,.
<br /> Sanitery Facifitles.&1.dumpster SRe Work Permit for subdivisionsflarge proJects
<br /> COMMEFtC1A1. Attach(3)•camplete sets of Building Plans plus a Llfe Safety Page;{1)set of Energy Forms.R-O-W Pem►it for new construcUon.
<br /> Minimum ten{1 Q}wocking days aft�r submlttal date. Requtred anslte,Gons#tucNon Plans,Stormwater Plans w!Sitt Fence Instafled, �
<br /> �Sanitary FacillHes&1 dumpster.Sfte Work PermR fur all newr projects.All cammerclal requlrements must meet compliance - - � -
<br /> SIGN PERMIT Attach(2)sets of Englneered Flans.� ,
<br /> ""PROPERTY SURttEY requlred fcr att NEW c�nstructlan. j
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<br /> Directlons: �
<br /> Fill aut applica�ar�c�mpietely.
<br /> Owner 8 Cantractor sign back of applfcatlan,notarixed
<br /> !f aver 325Q0,a Notice of Gommencement la required. (A►C upgrade$over�T50Q)
<br /> " Agent(for the contractorj or Power of Attomey(for the owner)wouid be someone with notarized letter from owner authorizing same
<br /> OYER THE COUNTER PERMITTING {Front of ApplicaUar►Qrely)
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fenaes{PlotlSuroeylfoatage)
<br /> Drivewaya-Not over Counter lf on public roadways..nesds ROW
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