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813aeo-oo2a City af Zephyrhills Permit Application Fax-813-780-0021
<br /> _ � Bullding Department
<br /> Date Recsived phone�Gantaat for Permtttin —
<br /> Owner's Name �Y10.� C. LI.YG{LL.. ; 4wner Phane Number
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<br /> Owner's Address u�aaa s�I veY �A.�.S b r'• }'�1���j, 33�Owner Phone Number �= �
<br /> Fee Simple Titleholder Name � ' � Owner Rhone Number � �
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<br /> Fee Simple Titleholder Address �
<br /> JOB ADDRESS �aD� �11vev (}�,�s t�r, h r.�►1�I�� �-�.. 3� LOT# ��
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<br /> SUBDIViSION S I IJe✓ �Q F-�� PARCEL ID# �3�2�`a����'���bpOC� -^ 00$Q
<br /> ! (OBTAINED FRdM PROPERTY TAX NOTICE)
<br /> WORK PROPt3SED , e NEW CONSTR 8 ADDlALT �J StGN Q Q DEMOI.ISH
<br /> INSTALL REPAIR �
<br /> PROPOSED t1SE � 9FR [� CON1M C� � OTFiEFi �,�Y} °: ,, ...,, ��
<br /> TYPE QF CONSTRUCTION Q BLOCK Q FRAME [,� STEEI. Q �,_,, �
<br /> DESCRIPTION OF WORK E� ��Ol � �< j'"
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<br /> BUiLD1NGSiZE �u ^� SQFOOTAGE l�P`f� HEIGHT � �
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<br /> OB���'��'' I"' � VALUATION OF TOTAL CONSTRUCTION
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<br /> QEI.�CTRICAL �� AMP SEFtVICE Q PROGF2ES5 ENERGY Q W.R.E.C.
<br /> OPLUMBINC'a �� �
<br /> ' �� �
<br /> I QMECHANtCAL $ VAt.UAT10N t3F MECHAN1CAl tNSTALtAT10N �! �,
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<br /> ' QGAS � RQOFii+fG Q SPECIAI,TY �� QTHER
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<br /> FINISHED FLOOR ELEVATIONS �_� - FLOOD ZOfVE AFtEA �YES NO
<br /> - - �
<br /> � BU��DER COMRANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> � Addres$ Gcense# � �
<br /> ELECTRICiAi+1 COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/.N
<br /> Address License# � �
<br /> PLUMBER COMP�
<br /> SIGNATURE � REG�STERED Y/ N FEE CURRE� Y/N
<br /> _ �
<br /> Address License# � � �
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<br /> MECFIANICAl. C{�MPAN'�Y �' �
<br /> SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N ,.,,.,,.,.,,_
<br /> Address i Llcense# �� �
<br /> OTHER COMP� . -1'� n'tLt+1 �o o�/» -
<br /> '� SIGNATURE RECaISTEREb Y/ N . FEE CURRE� Y/N
<br /> �
<br /> Address h �h1j �'t 335:1 � Llcense# ���/,3���3 �
<br /> _ R�SlOtEN'11�4l; _=Attach{2}Plot Flans;{2}sets.bf BiilEding Placzs;{1}set of Et��rgy�Forms;Ft-O-1+4t Petm�t fae new c��sttc�ction,°� - —- _ - — - —- -_ —�--
<br /> Minimum.tem(10)�working'days after.subriilttal date. Requiretl onslte,ConstrucBon Plans;�Stormwater Plans w/Siit Fence installed,
<br /> Sanitary EaclllUes.&.1 dumpste_r,.Site Woric�Perrnit for su6diyislonstlarge proJects
<br /> COMMERCIAL Attach{3}complete sets of Beiildirig Plan`s plus a Life Safety Page;{1}set af Energy Forms.R-O-W Pennit#or new construction.
<br /> Minimum�ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater P.lans w/Silt Fence installed,
<br /> Sanitary Facllitles&1 dumpster:Site 1Nork Permtt for al!new proJects.All commercial rec�uirements must meet compllance ,
<br /> SIGN PERMIT Attach{2}sets af Engineered-Plans.. � , . : � , • - � ' , -
<br /> , ..««PROPERTY SURVEY requireil for ali'NEW canstructian.� � � � _ _ ___._ , _,_
<br /> Dlreatfons: {
<br /> Ffll out applicaUon completely. �
<br /> Qwner&Gontractar slgn back of app4ication,natarfzed '
<br /> If over$2508,a Notice of Commencement is required. (AtC upgrades�ver ST500j
<br /> " Agent(for the contractor)or Power of Attamey(for the owner)would be someone with�otarized letter from owner authurizing same
<br /> DVER THE GOUNTER PERMi'iTiNG (FronEof Application Only}
<br /> Reroafs if shingles Sewer� Service Upgrades A/C Fences(I'IoNSurvey/Foo�ag
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