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a�s-�eaoo2o City af Zephyrhills Permit Application Fax 613asaoo2�
<br /> � � � Bullding Deparftnent �
<br /> Date Recelved / 1 Q
<br /> �--t�.=( Ftions�Contact;forPe'ei�t#ti� _ g� Q jt� 0 7`�
<br /> Owner"a Name ��t"""� �n � r Owner Fhone Number
<br /> Owner's Address - Owner Phone Number 'r- �
<br /> Fee Simple Titleholder Name �� � � Owner Phone Number � �
<br /> ',ii , �.
<br /> Fee Simple Titleholder Addre�s v
<br /> JOBI4DDRESB � � �G �T LOT# C___�
<br /> SUBDiVISiON ��'e� ��"� PARCEL ID#
<br /> - (OBTAINEO FROM�pROPERTYJAX NQTlCE)�
<br /> WORK PROFOSED '•NEW CONSTR - ` .� ADDIALT 0 S1GRt�� Q �Q 'DEMOUSH
<br /> INSTALL i, REPAIR
<br /> PROPOSED=USE Q SFF? Q COMM � OTHER .
<br /> TYPE OF CONSTRUCTION : Q BLOCK "` Q FRAME � S'TEEL `Q
<br /> i) .
<br /> DE3CRIPTION OF WORK 1�� �� d��� � � �"""' �'
<br /> BUILDING Si2E'~� � 8Q.FOOTAGE'��, HEIGHT., �� .
<br /> ,. QBUI�pING ' �_� -�;=�--�;�,_ t:m. . Y
<br /> -VALUAT�ON.OF'TOTAL CONSTRUGTION
<br /> �EE-EC7RtCAl. �. $ M� o v� AMP SERVlCE 'Q° PRCIGRESS ENERGY Q W.R.E.C.
<br /> C���������„_,,, , _
<br /> �PLUMBtNG �' �
<br /> OMECHANtCA� $ VN.UATtON OF MECHANIGAI.INSTPP1t.LAT10N
<br /> , • �_�'
<br /> QGAS Q ROOFING [� SPECIAITY-O- " OTHER.
<br /> FINISHED FLOOR ELEVATIONS ��� FI.00D ZONE AREA [�YES NO
<br /> BUtLDER COMpANY
<br /> SIGNATURE REGISTERED Y/ N FEE cuRREn Y l N"
<br /> Address � Licanse#-r� �
<br /> �� � �, �.�.� St.�c.d--cS.� t vc.'c
<br /> Ei.ECTRIClAN � '' �'`F ��"—`� COMPANY ' � �" t -�j�`"
<br /> SIGNATURE � REGIS'TERED Y/ N FEE'CURRE� Y/N
<br /> Address 1 �'3�' `�- C�S�` c.t.' �-� �D.r' � ( t��3�'--�-��£?ucense#��e �,�� �J{�a"�G I
<br /> (, P1.UM8ER �GOMPAMt ' .
<br /> $IGNATURE � � .REGIS,TERED - Y/-N . F6E CURRE� Y/N �
<br /> .: ,, ,F . .
<br /> Address llcense#,� �
<br /> MECHAt+tttCAl.' , COMPANY .. -
<br /> SIGNATURE , i�cisrERe� Y./_.N _ �e cu�n Y/N .
<br /> Address � - ' , . Llcense# �, �
<br /> OTNER . � ' �COMPANY �
<br /> SIGNATURE�r � ' " "REG�STERE�' Y/ N: FEE CURRE� Y/N
<br /> Address - °,�:�„� - , . ' . Cicense# �, �
<br /> ,.:. ..� . - �. ;._, . . y - .
<br /> RESIDEN'�IAt:'�::�Attacht2}iPC6t:Plansr.(2}s�s=of�8iilldfrtg"P.lans;`{'f)�setofEnergy.Fartns;:12=0-Vit�Permitfarnewconstiuctit,an,, 1 �
<br /> : Minimum,ten:(:1.0)�,working days;aRer�submlttal:date:;:Requl�ed-onsfte;�ConsGuodon Plans;Storrtiwater Plans w/Sllt Fence Installed,
<br /> " � Sanitary FaciliUss�&�.1;dumpste_r,:SIte;Work:Permlt�for subdiVislons/large pro=ects °�•- '" , � .'`
<br /> COMMERCiAt. Attach{3)�cbmplete sets'of Buitding Rlans ptus a Ufe'Safa#y Page;(1}set af Enetgy Focros.#2-O-W Pertnit for naw canstruction.
<br /> Minimum ten(10)woricing days after submittal dake. Required onsite,ConsUucUon Plans,Stormwater Plans w/311t Fence Installed,
<br /> Santtary Fac111Bes&1 dumpster.Stte Work Pertnit far aU new'projects:All"cammeretai requlrements must meet complfance
<br /> SiGN PERMt7 AftacFi(2)sats of Engineerecf;Ptans:;,.,r;Y;R`�'� - . � ° ' . ,
<br /> """PROPERTY SURVEY reguired for all NEW qonstrucdon.
<br /> Diractlans: - .. , -
<br /> Flll out applicatlon completely.
<br /> Owner 8 Contrac�r stgn back of applicatEan,notarized
<br /> tf over 52540,a Natice of Commencsment is required. (A!C upgrades over?oT500)
<br /> ;� ,;;�r. �
<br /> " qqent(for tlia contractoi)'or`Power of i4ttoiney(fo�Uie owner)would be someone with notadzed letter fram owner authorizing same
<br /> G1V,ER THE COUNTER:pERMiTiING•� �--- (Front of:Appltcatlon�Only)� -•
<br /> Reraofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> _ ,a ... . ....... . __.. . -� r - '
<br /> Drtveways-Not over Counter if on pubflc roedweys..needs ROW
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