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' s�s-�eo-oo2o City of Zephyrhills Permit Application FaX e�sa8aao2�
<br /> Buliding Qepartment
<br /> Date R�€►celved Phone Coirttacffor Penrttttin •
<br /> �----
<br /> Owner's Name � cA � GzJ , �^ / � Owner Phone Num6ar
<br /> xwner's Address . l� --' ..S f �z G'I •�-S Owrner-Phone Number �— �
<br /> Fee Simple Titleholder Name �— �� Owner Phone Number � , �
<br /> ,_t .
<br /> Fee 3lmple Tltleholder Address "°
<br /> -�JOB 14DDRESS �� LOT# ��
<br /> SUBDIVISION �— � PARCEL IR# -
<br /> �(OBTAINBDFROM'PROPERTVTAXNOTICE�, -
<br /> WQRK PROPOSED `• NEW CONSTR : ADD/AlT � SIGN -Q Q pEMOL.ISH -
<br /> INSTALL �, REPAIR
<br /> PROPOSED-U3E � SFR Q COMM C,] OTHER"
<br /> TYPE QF CONSTRUCTION � BLOCK " Q FRAME � STEEI. Q,
<br /> DESCRIPTI4N OF WORK�
<br /> BU��Ci1NG S�z� � � S4 FOCiTAGE��� HEIGHT ��y�
<br /> QBUI�QING �:, $ � o�T �...v_��, �-. _ ' .
<br /> ���� � VALUATION`�FTO`fAt CONSTRUGTION
<br /> QELECTRICAL � � AMP SERVECE � [� PROGRf55 ENERGY Q W.R.E.C.
<br /> QPLtlMBIfYCa �$��
<br /> ��
<br /> QMECHANICAI � � Vi4�UATlOt�i OF MECHA(�lICAI tNSTfU.LAi'lOiV � i
<br /> _ .7 z,:�- ,
<br /> [�Gms o �o���N� .o SPEClAI.TY � QTHER ����
<br /> FINISHED FI.QOR ELEVATIONS FLOOD ZQNE AREA C]YES. NO
<br /> , BUt�DER '`�, Y y�, �_/,� COMPAt�tY ����1"!�.�.
<br /> SIGNATURE l�`� REGISTERED Y/ N FeE cu�te� Y/.N•
<br /> , Address LiCense# I �
<br /> E�ECTRICIAN CBMPANY
<br /> SIGNATUItE � REGI$TERED Y/ N FEE CUFtRE� Y/N
<br /> Address • -.License# �—� �
<br /> PLUMBER , Cp�pqHy -
<br /> SIGN�ITURE , REGIST.ERED ,Y/.N � FEE CURREA Y/N.
<br /> Address " License# j �
<br /> MECHA,I+flCAI: � , .,COMPANY _
<br /> SIGNATURE � � , REGI37ERED .Y;/ N FEE CURRE� Y/N •
<br /> Address ` � ` t ' License# � �
<br /> OTHEl2 � . COMPAPlY ,�
<br /> SIGNA7URE - ' - REGISTERED '�Y 7 N,. � FEE CURRE� < Y L-N�..
<br /> Address , . _ . `r.t`;- � - . : ' -"Cicense#"� �
<br /> ,,... , ,�, , �.,.,
<br /> -��c- ���:< .
<br /> RESIDENT�AI: -Attach{2).P1ot•P.<lans;.(2)sets.of=Bultdtng�Riaits;-(1)•sef af�Erieigy`�Faiiiis;'R-0=W_Permit:for nev+r;canstriic�on,
<br /> ; MinimumF.ten:(.10);working�;days,afte�;'submittal:dafe:�:Requlred onsite;Ginstruc�ori�Plans;�Storrnwafe�Plans w/Sflt Fence tnstalled,
<br /> � '8anitary�Facillyes���l:dumpster,t�Ite,Work:Permltfor.sutidi4lslonsllarge'proJects; , . .�. _ � - " �
<br /> ,_.:,,. ..:_.�. . _���..._.�: :,:w- ;.-
<br /> COMMERCIAL Attach{3}eonnplete sets'of Sulldin'g"'P1ans ptt�s a L.ife Safety Page;(4}set of Energy Fatrns.R-C?-W Permit for neW construction:
<br /> Minimum ten(10)working days after submittal date. Requlred onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permtt for alPnew°proJects:All commercial.requiremenGs must meet complfance
<br /> SIGN FERMlT Attacli{2)"set"s of°Etigineer,ed:,P.iaris;;�:�;:'s�'� ... .� - , � _
<br /> ••`"PROPERTY SURVEY regulred forall WE1N construction..
<br /> � Dlrectlo�s: ..,.z-. _ � ,
<br /> Fill out appflcatlon compietely.
<br /> Owaer&Cantractor stgn back-of appltcatton,notatized
<br /> if aver S2S00,a Notice raf Gommencement Is required. (A/C upgrades over;�so0)
<br /> •-;�r�;z>r;:_,
<br /> `• Agent(for the�contiractor)'ar:Power of Attortiey(fo��tFie owner)wauld be someone with natarized letter from owner autharizing same
<br /> t}VER THE CCIUNTER.PERMi'fTING-�- �- jFront.af Applica#ion Onty}
<br /> Reroofs lf shingles Sewers Serolce Upgrades A/C Fences(Plat/Survey/Foatage) �
<br /> DNveways-Not over Counter if on pubflc roadwrays.:needs ROW
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