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<br /> 813-�so-oo2o City of Zephyrhills'Permit Application Fax 813-780-0021
<br /> Bullding Depattment
<br /> D,�te Rscetved . -� Z-� .. �Phone-Cantact:far PennttNn :� ,
<br /> , y . . ..
<br /> Owner"s Name �tt,.� � � '6�-�1`� Owner Phone Number
<br /> Owner's Address � �� !v .Ut,-+�l�s~� \ �- Ow�er Phoae Number � �
<br /> Fee Slmple Titleholder Name ��' - � `Owner Phone Number �— �
<br /> �J� . �
<br /> Fee 3imple Tltleholdar Address -^' � •--� ""^ '—" i "" 1`
<br /> JOB ADDRESS �Il�i ,. �'^ OG�-. ��, ' � -- 2,. LOT# ���
<br /> suenivisior� C�1�`jZv�.�r� �' paRCE�.ia� �- �`�S - a1 �--c�o oo3vo 01�o
<br /> - • (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WflRK PROPOSED � NEW CONSTR ADD/ALT � SIGN' [� [� pEMOLISH�
<br /> e *-INSTALL ,. REPAIR : •
<br /> PRflPOSED tlSE . Q SFR � COMNI � OTHEF2
<br /> TYPE OF CQNSTRUCTION�'� Q BLOCK ~ C] FRAME C,� STEEL [,��'
<br /> DE3CRIPTION OF WQRK �dJ�` � � V���
<br /> BUILDING S#ZE ��� � �.
<br /> � � ; FOOTAGE�, HEI(3HT C�_,�
<br /> � � 3Q
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<br /> �BlJtl.D1NG $�o'�bt� `�� - � _---
<br /> VALUATION�'OF 1'OTAL CONSTRUCTION �
<br /> QE�.ECTRICAI $ AMP SERVICE Q PRt3GRE3S ENERGY W.R.E.C.
<br /> �y, � . � a
<br /> QPl:tlMBtNG � ,� ` S y
<br /> QMECHANiCAI $ `VALUATION Of MECHANIGAC IRISTALLATtON �����
<br /> C-. �� �,�'� :.
<br /> QGAS . Q ROQFING •;Q SPECIAI.TY Q � OTHER f
<br /> FINISHED FLQOR ELEVATIONS ��� FL.00D ZONE AREA QYES NO
<br /> �utc.o�tt _.."` ----�—�-�_� o�P�Y ��� �C��j�; f�v,� .. �
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<br /> , �.�_. _— .
<br /> SIGNATUR _._---- -- - - REGISTERED Y/ N FEE CURREK " Y/N
<br /> Addres� � � �� ��� , L''icense# L_ �
<br /> EI.ECTRtC1AN . �°. - CCIMPANY= .= _
<br /> SIGNATURE �' REGI87ERED Y/ N FEE'CURRE� Y/N '
<br /> � . i� . , : .
<br /> Address . License#:�� �
<br /> P�tJMBER . COMPANY � �
<br /> SIGNA7URE � �ReGIS.TeReg = , Y/ N. Fee;cut�te� Y/N
<br /> Addre�s = Ucense#��� �
<br /> MECHANlCAI: ` ' � _ COMPANY _ �
<br /> SIGNATURE � ' � ; FtEGISTERED , Y/_.N . � FEE CURRE� Y/N�.
<br /> Address�' ' License# l �
<br /> t?'fHER � � � CO,M,PANY. :� ,
<br /> $IGNATURE - � ' �� REGIBTERED Y/�N . FEE CURREA Y/N
<br /> Address � . _ Ucense# �` _... ��
<br /> RESIDENi'IA1:, :�Attach(2}.P:.totPtains;..{2}:seis{ofiBuiicl3ng';Plans;(1)'set'af Energy�Form's;�R=0-W Peimif for'new constiucHort, _ , .
<br /> - Minimum,ten;(1:0)aworking;days;after_su6mittal-date: Requlred_onslte;<�Gqnstniod'on Plans;Stormwater Plans w/SUCFence installed,
<br /> �Sanitary Facilitles;&�.1�dumpster.Site.lNork;Percnit.for'sukidiv.istonsllarge�iro]ects ` -
<br /> GOMMERCiAL Attach{3}campleEejsets of-Bullclirig'Plaris`plus a t�fe'3afeiy Page;('!j set af Energy Forms.R-O W Permit for new canstruction.
<br /> Minimum ten(10)woricing days�af#er submlttal date. Required onsite;Constructlon Plans,Stormwater Plans wl Silt Fence Installed,
<br /> Sanitary Facflitles&1 dumpster.81te Work Permtt for aU new'pro�ects:Alt commerctat requirements must mest campilance
<br /> SIGN PERMFT Attacti{2)sets of Eiigi�,ieered�,Alans.,�.,.;r,-���; �� . . � � � �
<br /> ••«"PROPERTY SURVEY reguired for aII,fVEW.canstrucdon.
<br /> Direi:tioas: ,, ' .. - , .. ,
<br /> FIII out application completely.
<br /> Owner&Contractor sign.badc of applicatlon,notatized
<br /> If cver$2500,a.NoUcs of Commencemant t�required. (A!C upgrades over 57500)
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<br /> Agent(for the i�ntraoto�)ar Power of"Attomey(fo�the�owner)would be somaone.with notadzed letter from owner authodzing same
<br /> t3V.ER TtiE CQUNTER PERMITiiNG- �---��(Front�of AppticaUon�Onty)� '. �
<br /> Reroots if shingles Sewers Service Upgrades A/C ' Fences(PIoUSurvey/Footage)
<br /> . ..y «._`i;� ..
<br /> Drivswaya-Not over Counter if on public raadways..ne.`eds ROW „ _ �
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