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<br /> "`"�"'�.�"�e��-�eo=oo�o ^� City of Zephyrhills Permit. pp °...,-'`���y`' _ .a --�:°. °� Fax-813-78aao2�
<br /> >>�„�°. ,., ,-,� ,.�:�.. ,,:r,,,�. =,>,: ,i �;�:,,:� A lication�.
<br /> i ,'.''s`�'f�`'�= z'''��iS�i�b;#.,e r t�. ;r�{?�?: ti Bu�lding £p531t1YS6i1t`��.., -. � _ v �.�Ii'' s.t.i:£_? t, ` Lri :'
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<br /> ' ^��'f' y'v>":F .,t!^I;{�, •:f'1 ¢� rt`.Y r� , a . �,y5 tl�. j 1 . :1;�] yr
<br /> Date '•�~ ;: ",�:. �` ;.�^•J :� �'`_; . . � ., .�:.• ,;�.�,. ... •• , r,F.
<br /> `t'2ei�eived �' t' '•�s� r;f� Phone Coritact for P,ermi#in�: :��_� S���,� ,,
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<br /> Ovrnar's Mame � Y �O��Q,,}�1S �Q Owner Phane Number V� ✓� �O� '3��
<br />' Owner's Address ��3aZc.� $� � �'}�, � Clwner Phane Num6er �, �
<br />' � �
<br /> Fee Slmple Tltleholder Name � Owner_Rhone Number
<br /> , . �
<br /> Fee Simple Tltleholder Addr�ss � ' '"''
<br /> .....:....:.:...... �
<br />� �os�wuR�ss 3Gi 3aa' ��'` ��G�:.1,,,, � , 3 3'�'tl a- �or# ��
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<br /> SUBDIVISION ou,�.ri 5.�.��' ��'� PARCEI.ID
<br /> � - � (OBTAINED FROM PROPERTY TAX NOTIGE)
<br /> WORK PROPOSED NEW CONSTR . ' , ADD/A1.T [� SiGN [� DEMOLISH
<br /> e INSTALI:' �'''8�.+ REPAIR ����� .
<br /> PROP4SED�USE Q SFR � [� GOMNI � flTHER _
<br /> TYPE OF CONSTRUCTION Q BLOCK [� FRAME � � STEEL Q
<br /> DESCRIPTI4N OF WORK � 1�,, "' S �1�-
<br /> � -
<br /> BUtLDING S12E �-- T,,. � 5Q F007AGE I� HEIGHT � �
<br /> �$�������''� �' � VALUATION OF�TOTAL CONSTRUCTION
<br /> L_..,_, �J
<br /> �ELECTRICAL ($ � AMP SERViCE Q PROGRESS ENERGY Q W.R.E.C.
<br /> L.�
<br /> i �PI.UMBING �$� � � � 1�1� J f� ��
<br /> L... -- ��� �(��
<br /> QMECHA�tICAI $ VA�I}ATIflN a MECHANICAC INSTALlAT10N ��
<br /> QGAS [�1 ROOFING Q 8PECIAL � OTHER
<br /> FIIVISHED FI.00R ELEVATIQNS FLOOD ZONE AREA YES NO
<br /> BUIl.DER • .. • - - ` ,F����� � CQMP
<br /> SIGNATURE REGIST RED Y/ N. FEE CURRE� Y/N
<br /> �►ddress � ' License# I �
<br /> ..��. .
<br /> E�ECTRIClAN . `,.� ` ,.: , COMP��►Nlf
<br /> SIGNATURE REGIST�RED Y/ N FEE CURRE� Y/N
<br /> Address - ", - ,' , I l.faense# � �
<br /> P�UMBER COMPATIY
<br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N
<br /> Address � LPcense# � `�
<br /> MECHANFCAI. � Ct1M�ANY
<br /> SIGNATURE REGISTIERED Y/ N FEE CURRE� Y/N
<br /> Address � I.icense# � �
<br /> OTHER C{SM�ANY � YYi&.Yt �O�-C l .
<br /> SIGNATURE REGISTERED / N = • FEE CURRE� Y/N
<br /> _ _Address Sti2 j� �� 3 � License# C�, i3aZ5�,'�'�_ I -
<br /> �
<br /> RESIDENTIAl. 'Attach{2)'Ptat Plans;{2}sets_o#Bui[ding Plans;(1)set af Energy�Forms;R-O-V1!Fec�rtit for new cons#ruction,
<br /> Minimum ten(1Q)working days•after submittal date. Requlred qnsite,Constnucdon Plans;Stonnwater Plans w/Silt F'ence installed,
<br /> Santtary'Faciilyes.&1 dumpster;.Site Work�Perrnit for sub�livislonsAarge proJects
<br /> GOMMERCIAL Atkech{3}c:amplete sets af Buildirig Plans ptus a Life Sa€ety Page;{1)set of Energy Forms.F2-t?-W Permit for new canstruction.
<br /> Minimum ten(10)working days after submittal'date. Req�ired onsite,ConsVuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> SaMtary Facillties&1 dumpster.Site Wark Permit for alf ew pro]eots.Att cammerclai requlrements mus#meet compl3ance `
<br /> SIGN PERMIT Attach(2)sats of Engineered Plans.�
<br /> •`"•PROPERTY SURVEY required for a11.NEW constnacti n.
<br /> , Df�ec#tons:. . � , ; . ,;,,
<br /> ,; ,
<br /> Ffll ouk appiicaUan completely.' . � "� `'� - _ ''
<br /> :;:.;-�
<br /> _ Uv�mer&Contractar s{gn back of..appiicatton,notar�z'sd � .
<br /> tf avar S250d,a Notice of Commsnaement is'required:� �(A/C upgradI s over a7500)
<br /> '" Agent(for the cantractor)er Power of Attomey`°(for the�bwner)would be�omeone with notarixad letter from owner authorizing same
<br /> •, ?'
<br /> dVER THE COUNTER PERMITTIfitG (F.ront of Llpplication Oniy}
<br /> Reroofs If shingles Sewers ' Service Upgrades.A!C:,- Fences(PlodSurvey/Footage)
<br /> pNveways-Not over Counter if on�pubtic roadways.:need§RQW
<br /> - , . •- .:;;i� i.y , �
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