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s�s-780-0020 City af Zephyrhills Permit Application Fax 813-780-0021
<br /> Buliding Department
<br /> Date Received � . .,•� . =Phone=Coetact,for Pe'tittttEn :_
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<br /> Owner'a Name ��-�'�- -Yl T'1 Owner Phone Number ��l�U�"0��y
<br /> Owne�"s Address ��« �� �'�.Ze h rl�i��S,�C- • �"j��per Phone=Number ' 3��' �t�O- (���---�
<br /> Fee Simple Titleholder Name P h.����� �"E�"�^ �"�'��� Owner Phane Number '� �. I
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<br /> Fee Simple Tltleholder Addrass J 3�y�� 1��' �v� � .� �'i- ����S � �(.- �'�S``�2-- ,
<br />' JOB AbDRESS �J�2�� ��h �'� , 'h rL"r�5, �� "��`-l'Z LOT# �_y�
<br /> SUBDiN1310N �t t`{Y �-�-ei��'1� ��"�H�.� PARCEL ID# f 2�2Lo"2 t- O!�{G��U c:1/r�0- d{p t�,
<br /> —T_T (OBTAIN6D FRfJM PROPERTYTAX NOTICE)•
<br /> WORK PROP03ED � '*NEW CONSTR ADDtALT `�� S1GN" Q Q DEMC11.iSH
<br /> . ,INSTALL � - REPAIR �
<br /> PROPOSED USE � SFR [�. CQMM Q OTF{ER
<br /> TYPE OF CONSTRUGTION : �� BLOCK �' [� FRAME [� STEEL Q
<br /> DESCRIPTION`OF WORK ♦ I�e�� �2 - '(�U
<br /> BUILOING SIZE ��� � SQ FOOTAGE 7��7 . HEIGHT ���'���� ,
<br /> w. .
<br />' BC11l.DING $ � a� � � --�;.:-�,__. �,t�_�..
<br /> � j�. ff' VALUATtON QF 70TAL GONSTRUCTION
<br /> 1 .
<br /> QELECTRICA� _ �� AMP$ERVICE 'Q FROGRESS ENERGY Q W.R.E.C.
<br /> QPf:t1M81NG g - ,
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<br /> , [,,�MECHANICAL $ _ ��~ 1/ALUATIQN t1F MECHANICAL#t+iS7ALLATION �J �,��
<br /> � � � �� �� 1 ,
<br /> [�GAS Q RC'�OFING :Q SPECIAt.TY C]. - OTHER.
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO
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<br /> BUIi.DER 7� � ��(,/� �/�� t� COMPA�IY e�����
<br /> SIGNI�TURH �lrJ��" ' � `G REGI3TERED Y/ N FEE CURREA Y/N
<br /> Address License#'t � ��
<br /> EIECTRIClAIrl. . - COMPANY- � - `
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address , �� � _Ltcense# � �
<br /> P�UM8E3t , , ; COMPANY
<br /> SIGNATURE ' ' .REGIS.TeRED ,Y l.-N, FEE CURRE�- Y/N -
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<br /> Address License# � �
<br /> MECHAt�tICAt. +' � � COMPANY � �
<br /> SIGNATURE ' � ' � r REGISTERED � Y./_,N F�e Curtt��. Y/N-.
<br /> Address• � ' � � Ucense.# � �
<br /> O'iHER � . � COMPANY.,.'
<br /> SIGNATURE�� • • `REGIs7E� Y f N'. ' Fee.CURr�K Y/N.
<br /> Address � , � - ` � � Cicense# �1 . �
<br /> . . �..;. .. , �..r� .
<br /> -.RESlDEHTIAI:. �'�Attach{2};PlotPlans;..{2}.sets°of ButlilingVP..lans;(1}'set of Eneigy Porms;`f2=0-W Permif for'neinr ccnstiuc�#1an,
<br /> :- Minimum�ten;(1,0)�working;d.ays�.after.su6inittal:d'ate::Requlred,onslte;rConstnioNan-Pla'ns;Storrriwater`Pians w/SIIt Fence installed,
<br /> �� �Sanflery�Facllltles�&1,dumpste_r,_-Site.VUorksPertnitfor',sutidiVistonsflargaprb�ects '� '` ' `
<br /> COMMERCIAi. Attach{3}cornplete sets'of Bultifiiig Plans ptus a E:tf��Safe#yr Page;{1j set of Energy Forms.R-O-W Petmit for naw cansVuctlan.
<br /> Minfmum ten(10)working days after submittal date. Requfred onsite,Construckian Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facflitles&7 dumpster.Site Worlc Pemrtt for al!new projiacts.All commercial requirements must meet compliance
<br /> SIGN PERMti' Attacti{2}sets of�Engi�eered;Plans.,,.�,�ti�:q;� . �-> �°. . ° - � ` '
<br /> ""'PROPERTY SURVEY required for all NEW_construction.
<br /> Diret�tions: �_, _ `. � . .
<br /> Fil)aut appUcatlon completely.
<br /> Owner&Contractor slgn back of applicatlon,notarized
<br /> tf over�2500,a Notice of Commencament ls requlred. (A!C upgrades over 57508) ' ' ;�� .• , .. , y .
<br /> ,�:�.,,.�:;,�. ., ,....
<br /> " Agent(for the�oontracto'r)�ar Powe'r of`Attorriey(fo�:tt►e owner)would�be'someone wlth notarizad letter fram owner.authodzing same
<br /> dV,ERTHECOUNtER,FERMITiiNGw••-�- •(Front-of�Appilcatton.Only}�• ' � -
<br /> Reroafs If shingles Sewers� , Service Upgrades A/C' Fences(PlodSurvay/Footage) ,
<br /> �. r �:,. � � . - - .
<br /> Qrlvewaya-Not aver Counter if dn,pubfic roadways..oeeds RONV
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