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<br /> 813-780-Oq20 City of Z�phyrhills Permit Application Fax 613-780-q021 �
<br /> , Bultding Departrnent II
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<br /> Date Receiv�d phons Cantact�for`Permtttln
<br /> Owner's Name i ' Owner Phone Number _�
<br /> Owner's Address '�'"�1 Z. OwnerPhone Number � ,�
<br /> Fee Simple 71tleholder.Name (��,�c 1C.,,, �os�g� � Owner Phone Number �� -1 ,
<br /> . ,,'�
<br /> Fee Simple Titleholder Address °�°
<br /> JOB ADDRESS �'j � LOT# C��
<br /> SUB01VISiClN � � PARCEL ID# ` �
<br /> (OBTAINED FR4M PROPERTY TAX'NOTICE) -
<br /> W4RK PRQPOSED NEW COlvSTR ADDtAi:T � � SIGN Q ` C] DEMOGSH � -
<br /> y
<br /> � � INSTALL • 8� REP�►IR .
<br /> PROP03ED U3E Q SFR -[� COMM "� OTHEI2' s��e��� �•c�`r �`="``�
<br /> TYPE OF CONSTRUCTION � Q BLOCK "' Q -FRAME �'� STEEL [�, r�� L�y�-�
<br /> ,�a.. �.,. � ,�r ,
<br /> DESCRiPT14Ti O�WORK � �v [��(�J
<br /> BUil,O1NG SfZE �� � SiQ FOQTAGE���S�.�J ,,. HEIGHT (,� . „ �
<br />' QSUILDING $ �,....-�--... �...._....';. .
<br /> ��� VALUATiON OF TO`TAL CONS'i'RqCTIO1V
<br /> �J
<br />� Q � AMP SERtlICE [� PFtOGRESS ENERGY Q W.R.E.C.
<br /> EL�CTRICAi. $
<br /> �,
<br /> OFLUMBlNG $ .
<br /> „_,_, � .
<br /> QMECHANIGAI $ VACUATION OF MECHANICAL 1iVSTAlEAT10N ��t"
<br /> �. ��
<br /> Qc�s � E200FlIVG :[� sQ�c�a�.�nr 0 or��R `l '
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA C]YES: NO I �J 1 �
<br /> �
<br /> Bt![I.DEft CONIP/1NY „,.
<br /> SIGNAYURE REGI$TERED Y/ N �~ FEE CURREA Y./.N
<br /> Address L"lcense# � ��
<br /> E�ECTRiCtAN COMRAt�iY
<br /> SIGNATURE " REGISTERED Y/ N FEE CURREP Y/N
<br /> Address � � , : L•icense# �� ' ��
<br /> PLUMBER COMP.ANY • ,
<br /> SIGNATURE „ REGISTERED .,Y/.-N �: FeE cut�En 'Y/N.
<br /> Address " , ,License#.� - �
<br /> MECMAN1C�tt: , � ,GOMPANY - �
<br /> SIGNATURE � REOISTERED , .Y;/ N ,FEE CURRE� Y/N"-=
<br /> Add�ess , . , _ _ ' Llcsnse# �� �
<br /> OTHER ' = ` COMPANY � �
<br /> SIGNATURE � ' REGISTERED ��Y/ N � _ -FEE CURRE� . ?;e. Y�/:,N- . �
<br /> /�t�f688. _�•�4,t�. � . -._ °' 4` ' � '���C@I158# � �
<br /> ._,., �� ;.t ,
<br /> RESIt?E�ITIAL::_-�AttacEi.:{2}s;P1ot:P.,lans;�(2}'sets.of�8ult�ing�Rlans;;(1j'setof�Eriergy�For�ns;"R=0=1N;Feiniit:fti,�,neru;constriiction,
<br /> . .., ,�. =�-�: -�,
<br /> � �� ;Mlnimum�;ten�(:1A.),;worlttn�;days:aftet�'sutir�itfal`d"ate:�Requlred o'nsite,�ConsFnidtlon�Plans;rStormwater�Pians w/Silt Fence installed,
<br /> . . .... _ . �.,;�. ..;: ,.
<br /> , + . '$anftary FaGliUes,&:�lhdumpster-Slte;Work.Permitfior,.;sutidivisions/large`proJects`�:_>,;:*;:� � ' '
<br /> COMMERCIAL Attach{3}c6i»plete'sets'of Bu�ti�litg�Plaris�pttis a t.lfe Ss#eiy Page;(1}'set of Energy Forms.!2-C?-W Permit for new constructian.
<br /> Minimum ten(10)working days after submlttal date. Required onsite,Canstructlon Plans,Stormwater Plans,w/Sllt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit,for all`new`projects:All commarcial requl�ements must meet.compliance
<br /> SiGN PERtVIlT AttacFi{2)se[s of`E'ngi,`n,`"eeied�Platis:�,�:z:�,e:;�`' .. . ..� __. - >
<br /> •`""PROPERTY SURVEY reguired.for,all_NEW c;anstructlon. ,
<br /> �.
<br /> dlrectlons: , • _ _ , ` ,
<br /> Ftll out applicatlan completely. �
<br /> Gwner&Contractor stgn back.af applicaHan,notarized j
<br /> if aver�x500,a NotCca_at Commencemant i$raquired. �A/C upgractes over 575o4j , � 1
<br /> !► '�•1...�.r i,,tHG:a,�:f;." p ' ,� ,: ., x - . . I
<br /> Agent(for the cunVac4or)or:Power of Attairiey`(for the ciwner)would beFsomeone with notarized letter from owner authorizing same
<br /> D.Y.ER THE CiitlN'i'ER,P..ERMiTTiNG w.__. ,(Front-af APP1lcation On1Y)- _ , .. .- . ,
<br /> Reroofs if shingles Sewers Service Upgrades A/C - Eences(Plot/Survey/Footage) , ., `
<br /> DNvswrays-Not over Counter if an public roadways:needs ROW ' � , �
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