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e�saso-oazo City of Zephyrhills Permit Application FaX e�3aeaooz�
<br /> Buitding Departmant �
<br /> Date Recstvad , �. � � � Q
<br /> _ ,Phone�Con#act;for Parmlttln .� ,
<br /> Owner's Name �' .r1 L.� � �f d'j"y� Owrner Phone Number �I G'`����tv�j
<br /> Owner's Addre�s � t1'1' l�/. Ctwner Phone Number '�� �
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<br /> Fee Simple Tideholder Name � )�`.,� �2 ��'� pwner phone Number
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<br /> Fee Slmple Tltleholder Address °°
<br /> JOB ADDRESS �� � .-vC� ��i''�. LQT# C�
<br /> SUBD{VISIOtd �� � � PARCEL ID# - `
<br /> . (OB7AINED FROM PROPERTY TAX NOTICE��
<br /> WORK PROPOSED � ^n[Ew cONSTR' , ADD/At,'T C�' StGM' � [� DEMOLISH
<br /> - INSTA4L , REPAIR
<br /> PROPOSED=tlSE SFR Q. C4MM � OTIIER
<br /> TYPE OF CON3TRUCTiON> • Q BLOCK "` Q FRAME � STEEI. [�
<br /> DESCRIPTIOPI-OF WORK � ��d�/ � 1 Z�� ' �
<br /> BUltD1NG SiZE � —� SQ FOOTAGE C�, , HEIGHT'���
<br /> �ClICDING $ �j ��`'"�'�� '-�;=�_.._.. �.,-...._
<br /> Z C��J�✓ VAU7ATION OF 7bTAL CONSTRUGTION
<br /> [�E�ECTRiGA� $ � AMP SERViCE r �Q PROGRESS ENERGY Q W.Ft.E.C.
<br /> QPl:UMBtNG (�$— � �
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<br /> OMECHAh3tCAL $ VALUATIQt3 OF M�CFlA(�tICAC EI�iSTA�tAT10N
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<br /> QCtiAS Q ROOFINtG Q SPECIALTY � OTHER. -
<br /> FINISHED F1,00R ELEVATIONS � ff� FLOOD ZONE AREA QYES NO
<br /> BUt[.DER �_M1 �C MRANY � .,,�
<br /> SIGNATURE c� REGISTEREd Y/ N FEE CURRE� Y/N.
<br /> Address '°� Llcense#-� �
<br /> E�ECTRtC1AN � COMPANY ` - -
<br /> SIGNATURE �' ReGisreR�a Y/ N FEE CURRE� Y/N
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<br /> Address . License:#:(� I
<br /> PLUi1I1BER . � . , ,CGIMPANY
<br /> SIGNATURE � � .REGIS.TEREp Y/ N. - FEE CURREK- Y/N
<br /> Address tJcense# ( � - �
<br /> MEGtiAt�lICA!' ` CCIMPAGlY � .
<br /> -SI(3NATURE ' ' , R€�I§reREa . Y./.N . ' �E cuwtEn Y/N
<br /> Address '� . , � _ License# I . I
<br /> OTHER , . , CtlMFANY
<br /> SIGNATURE�- � " ~ - ' � 'REGISTERED Y/ N .. ' FEE.CURRE� Y/N
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<br /> Address �..;, :�.�_,:.-_ �� �;;_<..i:° . .- , , „ , ' License#
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<br /> RESIDENTIAL. : �At#ad�{2}:P„16t.Plans;-.(2)sefszof.Bulldt`r'ig"Plaits;'(1)"'sef'af Energp�Famis;`:R=t}�1N�Femiitfornew cons#iuc�tlan;
<br /> Minimumtten;(•10);,woricfng;days;;afte�.subiriiftal d'ate:'=Requlreii,onsite;=f�on§Viiahon Plan's;Stormwater Plans w/Silt`Fence instailed,
<br /> �Sanitary Facilitles;&�-1,clumpste.r,_�Si,te`Work:Permit for subdiVisiorisllarge prbjects `' �' - � " � '`
<br /> COMMERClA! Attach(3}cbmplete sets of Bulldiiig Plans�plus a ltfe 8afety Page;{1)set of Energy Forms.R-O-W Permlt for new car�struc�tton.
<br /> Minimum ten(10)woricfng days'after submittal date. Requlred onsite,ConsUucUon Plans,Starmwater Plans w!Silt Fence installed,
<br /> SaNta►y Facllides&7 dumpster.Site Work Permtt for all new�proJectsr�All commercial requ(rements must meet compflance
<br /> SI�N PERMIT Attacti{Zjsets of�Englnesred•P.lans::�c�:�::�: :. .. - .
<br /> k�A�PROPERTY SURVEY reguired for all„WEW..consWcUon. -
<br /> D1rei;tions: .
<br /> Fill out appiicaNan completely.
<br /> Qwner&Contractar stgn badc of appilcattan,notarized
<br /> if ovet 52500�a Natice,of Commencsmsnt is required. (A/C upgrades over S750o) , ,
<br /> " Agent(for the�contrackar.)or'Power'`of Attortiey(fo��tFie�owner)would be�someone wikh nota�ixed letter from owner authorizing same
<br /> OVERTHECt3UN'tER:PERMi7'TING�•�-� ----(FrontofAppBcatton�Ontyp•
<br /> Reroofs If shingles Sewers Service Upgradas A/C Fences(PIoUSurvey/Footage)
<br /> Drivewaya-Not over Caunter if an public roadways.:neeids ROW
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