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813-780-002Q City of Zephyrhills Permit Application Fax 813-780-aa2�
<br /> j Building Degartment
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<br /> Qate Recelved -��-� _
<br /> s Phon��.Contact;for Paimttti �
<br /> Owner's Name � . . . Owner Phone Namber ���`'��
<br /> Owner's Address 7 �c� Owner Phone Number �
<br />' � y,. . � �x � �
<br /> Fee Simple Titleholder Name � Owner Phone Number
<br /> , ,�. --�—
<br /> Fee 3lmple Titleholder Address �a
<br /> JOB ADDRESS 7 �. o � ;� , �' 33,�`G' LOT# `� �
<br />' SUBDiVIS10N ��aG6�,���� PARCEL ID# ,.�v�('a� 'CY�U '"C��'`C�
<br />' - (OBTAINEO FROM PROPERTYTAX NOTICE� '
<br /> WORK PROPt}SED NEW CONStR' ADD/AlT [�' SIGN" Q ' �[� pEMOI.ISH
<br /> � ��INSTALL 8 - REPAIR � '
<br /> I� PROPOSED=USE Q 8FR [�. CONIM C,� OTHER
<br /> TYPE OF CONSTRUCTION � Q BLOCK ~ �] FRAME ��] STEEI. �]
<br /> DESCRIPTION OF WORK Gf.c/ � �� r.,/
<br /> BUItD1NG SiZE -� � SQ FOOTAGE � . HEIGHT [�� .,
<br /> ����'d�N�' � � � YALUA710N�C1'F'TO'I'AL GONSTRUGTION ��
<br /> C.��� �� (
<br /> [�El6CTRICAI: $ � AMP SER1/iGE Q PRCIGRESS ENERGY Q W.R.E.C.
<br /> � '� -
<br /> [�PLUMBING $ ,
<br /> �M, � �� �= �
<br /> �MEGHANICRL $ tIA�UATION OF MEGHANiCAl.INSTA�ILATtON LQ��'.(;tr2
<br /> ���
<br /> ( QGAS , Q ROOFlNCa ;Q SPEGIAI.TY-C]. � OTHER: t �j �y��,� ��������"-
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZQNE AREA QYEB NO S�
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<br /> BUIlDER - -�'--- � e �
<br /> cvM�,e►r�„r �} s �l.s
<br /> � SIGN/ATURE � � REGISTERED Y N FEE CURREN ` .Y/N'
<br /> I
<br /> Addresa ,,� ?�� . ����' � License#`���.1, �,�"`�-1 . �
<br /> �.. � �l.�
<br /> EIECTRICIAFI ,..:� �-.-`'_� .- �� COMPANY" �f.� ��r^ i c
<br /> "' " ��°°' REGISTERED Y/ N FEE CURRE� Y/N
<br /> SIG�A7URE �,
<br /> Address � ,..5" %v�F'UJ � � i� 2'i5 . -License#� _C l�Oa�°3k�( ~ I
<br /> P�t�MBER _ r .� GOMPANY • � c�,S " � 5. ,
<br /> SIGNATURE � .REGISTERED Y L N. �E cu�tEn= Y/N
<br /> Addre�s �-�"� � 1j�s' � f�� License# ���f��c�s'
<br /> MEGNRl+tICAt.' � COMPANY _
<br /> 31GNATURE � � � REGISTERED X L.N FEE CURREA Y/N .
<br /> Addreas� , , License# � �
<br /> O'FFtER ' , COtUIPAt!�Y '
<br /> SIGy�TURE�, ' � - � � REGISTEREn Y/ N.. FEe CURRE� Y/N
<br /> Add�es� . .'� . � . � _ ` LiC811Se# � �
<br /> -RESIDENTIAL, :,Attac:�{2};pCat Pians,•'..�2).sets.ofiBt�llding"Plaiis;`{=1:}"set`af Enargyr�Forrri's';R=0-W`Pemiif for•new�cxirtsfiuc4tart. .
<br /> � Minimum,ten�(1,0)�working;days,after,.sutimlttal;d'ate::Requlred.onsite;Gonst'rucNan�Plans;3tomnwater'Plans w/Sllt Fence instelled,
<br /> ��Sanftary Facilitles;&��1;dumpster Site;VNork:Permitfor:subdlVtsionsflarga:proJects ' ' `
<br /> COI:'�M�d?CtA�. Attach{3}'complete sets�tsf�Bultdiag Plaris�plus a 1.lfe�Safety Page;{1)set af Energy Forms.R-C)W Petmit for naw cansttuctlon.
<br /> Minimum ten(10)worktng days�after submittal date. Requl�ed onsite,Construckian Plans,Stortnwater Plans w/Silt Fence Installed,
<br /> Sanitary Facllttles 8 7 dumpster.Site Work Permit for aQ newproJecfs:=i411 commerclal requirements must meet comp!lance
<br /> StGN PERMIT AttacFi�{2)sets ofEiigineered;Plaris.,4�,z�:�=.�f,°-:.�:;�. = - . ` - _
<br /> •••"PROPERTY SURVEY reguired for aI1�NEW qon.structlon..
<br /> . DirectFons: ... . � .
<br /> Flil out applicatlon campletely.
<br /> Owner 8 Contraotoc sign back af appticatton,natarized
<br /> if avar S2S00,a Notics:af CommencemeM is requlred. (A/G upgrades over;T500)
<br /> , �-r,,:,._,. ���r:
<br /> '" Agent(for the�aontractor.)o�Power of"Attomey(fo�ttie owner)would be�someone wikh natarized letter fram owner authodzing same
<br /> OYER THE COUNTER;PERMITFtNG�:- ----{Front of�AppBcation Only) " `
<br /> Reroofs if shingles Sewers Service Upgrades A/G Fences(PlodSurvey/Footage)
<br /> Driveways-Not over Counter if on pubiic roadways..ne`eds ROW '
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