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8��aeo-oozo City of Zephyrhills Permit Application Fax-a�a-7so•ao2�
<br /> Building Department
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<br /> Date Recetved Phone ContacYfar"Permtttln � �
<br /> Owner's Name `� '�r- Owner Phone Number
<br /> Owner's Address OwnerPhone Number �� �
<br /> Fee Slmple Tltleholder Name Owner Phone Number �i � ,
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<br /> Fee Simple Titleholder Address 'a
<br /> JOB ADDRESS ' r � � ���� LOT# ��
<br /> SUBOMStON �i � PARCEL iD# ' -�
<br /> (OBTAINED FR4M PROPERTY TAX NOTICE),
<br /> WORK PRQPOSfD '� NEw CONST1t RDDIAI.T C� SIGN Q � Q DEMOI.ISN -
<br /> , e INSTALL R�PAIR
<br /> PROPOSED�USE [� SFR � CQN1M [� OTt{ER
<br /> TYPE OF CONSTRUCTION Q 'BLOCK " �[_] FRAME � STEEI. Q
<br /> DESCRIP7IQN OF WORK ' •b �
<br /> BUILDING SIZE - SQ FOtiT .HEIGHT. ,
<br /> �8���'�»�''� � , � VALUATiO�t�l t7�F T'tXi'AL CONSI'Rt7CTiON � -
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<br /> Q � � AMP�uERV{CE PRpGRE55 Et�lERGY
<br /> EE.ECTRICAL $ Q Q W.R.E.C.
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<br /> QP�UMBING ��
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<br /> �AftECHANiCRL $ VP+�UAT14N OF MECHAE�lICAI INS7ALIATION b
<br /> ��Jy �r
<br /> QGAS , RQQFIlVG Q SPEGIALTY_��- fJ'FHER .�" � �
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<br /> FINISHED FI.QOR ELEVATIONS FLOOD 20NE AREA C]YES. NO
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<br /> I BUILDEit COMPA�IY
<br /> �i SIGNATiIRE REGISTERED Y/ N FEE CURRE� Y./.N
<br /> Address License# � �
<br /> E�EGTRICIAN COMPANY
<br /> SIGNATURE y RE01$TERED Y/ N FEE CUFtRE� Y/N
<br /> Address + -.License# � � �:.
<br /> Pl.UMBER j� � COMPIWY� , .
<br /> SIGNATURE L ry . REGISTERED Y/:-N - FEE CURRE� Y/N.
<br /> Addre�s , lice #. .
<br /> MEC#iANtCAl. � CLIMPANY .�' . �
<br /> SIGNATURE / REGISTERED. Y/ N � FEE CURREP %N
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<br /> , ��/ / ,,��, r�
<br /> ' Address � �. Ltcense# ����/ ���1�'l�
<br /> O'iHER � � COIiRP'A1�tY � ' J .
<br /> SIGNI4TURE�:� REGISTeRE� ' Y/ N._ . �eE cuw�n Y�/-N .
<br /> Address , °t_- - ' „ ,, _ - Clcense#�� �
<br /> ..b, �:.r ,
<br /> ..,.., � - ' ;,��.::
<br /> RESIDENT1At::• Attach{2):�.P.Iot.P<tat�s;:(2}seEs:of'BuildingrPi�ts;(1)sef of�Energji�Fo`rm's;:R-O=WPemilt for new,.,,coi�struction,
<br /> . ,,.' _.rr.;y.. .;»„�:'� , .i. � F�.,,.....i
<br /> �-Minlmum;4tena(.1A);workfng,days.after",;.`sutimlftal dafe.=Required onstfe;�Constrticdon�Plans;�Stormwa4erPlans w/Stlt Fence installed,
<br /> � 'SanitaryFaciltties�&51�jdumpster�SitetWork,P.,,ermitforsutidivislo'ns/large'proJects� '='::.;�;::''` ' � = �
<br /> GOMMERCiAt,. At#ach{3}ooinplete sets of Biiildt�g Plaris plas a"�tfe Safety Page;{1}set of Energy Forms.R O-W Permtt for new construction.
<br /> Minimum ten(10)working days afker submittal dake. Requlred onsite,CansUucdon Plans,Stormwater Plans w!Silt Fence Instelled,
<br /> Sanitary Facili8es&1 dumpster.Site Work Permtt for all'newbprojects.All commercial requkements must meet compNance
<br /> SIGN PEFtMP7' Aftacti{2}"set's of�E�glneer,ed:P,l'atts:t:r,�,;:;�_,: . �
<br /> ""PROPERTY SURVEY reguireeii,forall NEW constructian.:, .
<br /> Dlreeilons: ;-, .- � _
<br /> Fill out applicatlan completely.
<br /> Qwner 8 Contractor slgn back-of applfcaUon,notanzed
<br /> !f vves S2S00,a Nottce aE Commencement is requited. (A/C upgrades over 57500j .,
<br /> YM �� ��'�C+��`N
<br /> Agent(for the�contracto�)`cr.Power�of qttomey(fo��tFie��owner)would be someone with notarized letter fram owner authodzing same
<br /> OVER'fHE'CCitlNTER.PERMITFiNG-.�.•:�•-�=�{Frontof-AppticaSonOrily)•;- '�
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage)
<br /> Driveways-Nat aver Counter if on pubtic roadways.:needs ROW � � ,
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