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813-780-0020 � City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Bullding Departrnent
<br /> �• .
<br /> Da#e i2ecelved "Fhone Coritacffor`Pernntttin � —
<br /> Owner's Name � S ��1 � Owner Phane Number Z�l '���- r ��
<br /> Owner's Address ����"� �✓��� ��l� OwnerPhone Number �f� '�'�� �f 6Q
<br /> Fee Simple 7"Itleholder Name � � Owner Phone Number � �
<br />� '-,_� - �-
<br /> Fee 8lmple Tltleholder Address °'°
<br /> JOB ADDRE3S `7'�z.� G�-rr ��(J Z^�j jl S �� �3 S`�{r LOT# ��
<br /> SUBD{VISION � � PARCEl.ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORKPROPOSED �� NEwCOiYSTR ADD/ALT � S1GN Q [� DEMOL.ISH -
<br /> e INSTAI:L 12EPAIR
<br /> PROPOSED USE � SFR � COMM Q OTHER"
<br /> TYPE QF CQNSTRUGTION [� BLOCK �' Q -�FRAME '[� STEEL Q,
<br /> .,. ,
<br /> DESGRIPTION OF WORK s: �)I`'�C.�Z��� �� �T � J(� ��
<br /> BttlLptNG S12E � �� SQ FOGITAGE�� HEIGHT' ���_�
<br /> �r�;s-.:-._ -.�.�,.... �.�
<br /> � �(�(`},d� VALUATION OF TOTAL CONSTRUCTION
<br /> BUI�DING $
<br /> I� QE�EGTRiCA� � AMP$ERVICE Q PROGi�ESS EMERGY Q W.R.E.C.
<br /> .,._._ , � "
<br />' C]Pl.t1(u18iNt3 � � �
<br /> �� " ��
<br /> � QMECHI�RlICAL $ `VA�UATION OF NIECHANICAI INSTA�[ATION- '� � �
<br /> I '�
<br /> ' OC�AB Q RQOFING Q SPECIAI.TY-C� OTHER
<br /> FINI$HED FLQOR ELEVATIONS ��� FLOOD ZONE AREA �YE$: IVO
<br /> i BUi1.DER � COMPANY
<br /> SIGNATURE � � REGISTEREp Y/ N ' FEE CURREA Y./.N_
<br /> �4ddre$s Licerise# �� �
<br /> ��ECTRtC1At�! COMPANY`
<br /> SIGNATURE � REGISTERED Y/ N �e cutt�n Y/N
<br /> AHdre�s . , �L•icense#' i �
<br /> PLUM�El2 CdMP.1WY� •,' �
<br /> SIGNATURE � RECiISTERED J ; ,Y/,-N ; FEE CURRE� Y/N:
<br /> Address , Ucense# �� �
<br /> i MECHAN1Cl�t. COMPANY, .,
<br /> SIGNATURE REGISTERED Y;/ N F�cuRRen Y/N �
<br /> � _. , , � �'�''�'`
<br /> Address � . . � Ucense# (. � �
<br /> OTHER Ct1MPANlt�� ;_
<br /> SIGNATURE ' ` REGISTERED Y/ N..� . FEE CURREP _ :` Y/:N' .
<br /> Addrees ~�`i;=- ,_�� ' -., � , `Ucense#�� �
<br /> � . d . _ -i , . . . _.... . . .� ��.r.,: .. -� ,.-a�C";.�_o;�.�� : 4 ,�.� . . .
<br /> RESIDEP1TiAL,� �=Atkach:{2),Ptoti:P.,lans;.{2}:se(s:of'Bu3lding:Rlans;(1}=set of Ener�y�Forms;`R-O=Nt Permitfor new.,consttuct3an,.v
<br /> ,:,: Mlnimum;cten�(1A):working;days;after,:.'subinlEtal'd"ate:=Requlred ans(te;�Construction<Plans;}Sfornnwate�`Plans'w/Silt Fenoe tnstalled,
<br /> � �§anitery FaGlities,&�1t,dumpster-Site�Worlc:yPermit,for sutidivtsions/large'piajeats� "__.':;"...'� , , :
<br /> COMMERCtAi. At#ach{3)'coirt3plete seEs of 8ii11ding"Pl ns plus a Cife Sa#efy Fage;(#}se#of Energy Fotins.R-O•W Permit for new constructEon.
<br /> Mlnimum ten(70)working days�after submlttal date. Required onstte,CansUuctlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facliitlas&1 dumpster.Site Work Permit for all`new.proJe(:ts.All commercia►.requfrements must meet compllance
<br /> SlGNPERMlT Attacti{2)"setsbf'Engiri,eei:eil�Plans;�aE,;�;r'w�� ... •- .
<br /> """PROPERTY SUR1/EY required,for;ail NEW constructian..
<br /> Dlieattons: , r -- ` -
<br /> Fil)out applicatlon completely.
<br /> Owaer&ContraaMr sign back•ot appilcaUon,nctarized
<br /> if aver 52500,a Notice af Commencement is required. (NC upgrade�ovar 57500)
<br /> �f ..�G=�ti�..i'�j"'
<br /> Agent(for th'e`cantractor)or:Power of Attamey(fo�the ciwner)would be someone with notarized letter from owner suthorizing same
<br /> OVER THE CUUNTERwP_ERMITTiNG�- -{Front of Application Only}-
<br /> Reroofs if shingles Sewers Service Upgrades AIC Fences(PIoUSurvey/Foatage)
<br /> Drivsways-Not over Counter if on public roadways.:needs ROW
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