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813-780-0020 City af Zephyrhills Permit Application Fax-B13-780-0021
<br /> - a Buitding Departrneni
<br /> Data Received, ��tr"'��� Phone Gc�ntact`for:Penitltttn `' '.. ,._ ..._. .�-- ..� . ... , _ ,
<br /> Owner's Hame _ (�I . , - Owrner Phone Numtier .n � --�J ��`'�
<br /> Owne�'s Address � Yl(�• lOwner-Phone Number �.�J ,- �`�O c�C—J1�
<br /> Fee Simple Tltleholder Name � � Owner Phone Number �" �_ I
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<br /> Fee Simple-71tleholdar Addresa - - _ -
<br /> JOBADDRE3S / Y��(l� U�.,,,. r'l,� LOT# ���
<br /> SUBDIVISION , �I '• ' � � ,.PARCELID# " , '.' ". ',. . , � ,.. s'� -
<br /> . , _ _ „ , � .�-_. • - (QBTAINEDFROM�PROPER7YTAXNOTtCE}. :: � :
<br /> . WORK.PROPOSED ';r•NEW CONSTR �"-ADD/ALT ��� � 'SIGN�� -Q' '� " �Q � �'DEMOI.ISH -
<br /> , � INSTAtL � �' REPAIR
<br /> PROPOSER U8E ` �� �SFR ' '�' `COMM` "[,� ` '-OTHEF2 . � • -
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<br /> TYPE OF CONSTRUCTION 'Q' :6LOCK'`•. ;Q,� �FRAME Q.� $TEEL ,.-��, _.,.. - �:"
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<br /> DESCRIPTION OF WORK -• � x �O . p�.I'"�'Y CS'�'; ,�1� 1. �.��'�•...�•. �4�' 1�'IC3-
<br /> BUIGDING�SIZE- �' ' �� SQ.FOOTAGE���.,, - - �HEIGHT ���;�'�,��`,�����`'�1/G��
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<br /> UIL"DING ��'�:u"�"
<br /> '�" . � $: "' Q�� •VALUATION`�F TOTAL`CONS�'RUGTION'; �� �,,p
<br /> �, ' C�=� L.���f��d"��
<br /> QEt,ECTRICAC $ AMP'SERVICE ,Q, PRQGRESS ENERGY : W.R:�:C. �
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<br /> [�Pi:UMBlNG �� ` , , . ,. �.�'�/��C'L!.-7"'�1�� dt,l., a
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<br /> �NiECHANIGAL ' � _ � VALUATIOt+I pP MECF{ANfGALliti1STALLATlON.��f,1 '�;%�'�`-�- r�f�('/���
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<br /> Q�s 0.. Rao��N� _�. s�Ec��t.�nr 0- _ o-r�t��z �� jc�Y`i�t'��"'�G�t�i�=
<br /> FINISHED FLOOR ELEVATIQNS FLOOD ZONE AREA QYES NO �~ � `?�,
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<br /> S � � ��,� �vL.u� - i�iie r
<br /> BUILDER � �� COMPANY ,
<br /> SIGNATURE � � � ' r REC.,ISTEREQ Y/ FEE CURRE� :.Y/N�.:.� -
<br /> /�ddrea� � ' Lic�nse# � �
<br /> ELEGTitICIAN , COMPANY' `
<br /> SIGNATURE � REGISTERED Y/ N �cuRi��- � Y/N ...-
<br /> Addre�� ' � r '"L=lcense# � - �
<br /> PLUMBER y ' COMP.ANYa• -•`. ' . .. � � ._� .
<br /> SIGNATURE' „ �GISTERED - � ,•�>Y/�N � -. �FEE CURREA `Y/`N;
<br /> Address ,, :License# �� �
<br /> „-_._; -� _ .i� � , , , , , ..
<br /> MECHANICAL' ` :COMPJ4NY�
<br /> SIGNATURE ' � � � ' � , --REGIS7ERED ;,Y�/�`:.N:" ;�FEE�CURRED ••�Y�/�IV` •
<br /> Addres's � ` `i _ , . , -- .. Lfcense.#�.�� - I
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<br /> O'fHER � � ..COMPANX, . ��.;......;w. ,
<br /> SIGNATURE- � - `x "" - � REGIS'rERED �Y/.N:.. ,FEE:GURReK Y�%Nr:. .
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<br /> Address ry,<°i^;:. �:� - ` - . � ; ' 'License'# ( _ �
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<br /> RESlDENi'iAt;. =Att$cti:,�2)<Plcti?lans;(2}ysets.ofBiiildi"ng'-Pians,�,(1}set'of Energy�Formis;R=O=W.��Pemi'it,for neuv;constniction, -
<br /> -.-�.�.���.« .,,;..
<br /> - v;Minimum�tena(14),workingjd�ys=after;subinittal£date:.Requiced o'nsfte;f;opstrucdori=Plans;$3formwaterPlans w%.Stlt.Fence tnstiilled,
<br /> _ . „Sanitery:FadUtle,s,g���.,du�pst�r�Slte*Wortc's.P.,er�itE°tor:=sutidiirlsEoii��llazge-:proJects.:`;:=a:�:;',:`:`'''< ' , - . . ..
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<br /> COMMERCiAL Attach(3)''coinpte#e;sets ofBuitdin�',Pians.ptus�a,l:ife;Sefefy Page;(1}:setof Energy:Forms:R-Q-W Permltfor naw constnictlon:
<br /> Minimum ten(t`b)working days after submlttaF date. Required onsite,Ganstruckion Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Fadlitles�1_dumps#er.Site Wo�rk PermJt.far ali'new.prriJecfsrRll commerciai.reqult�ments must.meetcampitance �
<br /> SIGN PERMiY Attai�(2�'set's of'Engin",eered�Pla'n9:�;,:�;.�:-' ... ... • . -� -
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<br /> � •"'"PROPERTY SURVEYrequired for;all NEW�cons.huction.,. _ . -
<br /> - a � -
<br /> Direi:tlons: - ;�:.x:.. - . ..-. .... . . i:r • . .,,
<br /> FflLout applicaUan completely.-. F
<br /> Owner,;&Contractor stgn badc-of.appltcatton,notarized �
<br /> If over$�500,a Notice•af_Commencement,ia requlred. .(AlG,upgradea over 57500) ,
<br /> �R �F:i.''Z;"`Yl^Ctl.�:!`Kk}_`
<br /> Agent.(for ttie contractoz)o�'Power';of:Attoaiey�(far ttie owner)wouid be someone with natarized tetter.finm owner authotizirtg same
<br /> 'DVER THE'COUNTER�•PERMITTING-- - , (Front•af Applicatton Oniy)
<br /> Reroots.if shingles Sewers Service Upgrades A/G Fences(Plot/Survey/Foo#age)
<br /> Drivewsys-Not over Counter if an public roadways.:needs�ROW
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