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s�s-�se:�oa�o City af Zephyrhills Permit Application Fax 813-780-002�
<br />� s Bufld�ng Qepartment
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<br /> Date Received pFtone-Cantaet'for Permtttin � ��� - ��� - �� 1�
<br /> Qwnar's Namer �E-C�l��a �/�.�G'GS . Owner Phone Number g��" �4 +a�' c� 7��
<br />� Owner's Address � a ! �,1 � /"�'� OwnerPhone.Number � �
<br />, Fee Simple Titlehold�ar Name �� � Owner Phane Number �� �
<br />� . '�� �
<br /> Fee 8tmple Tltleholder Address �
<br /> I JOB ADDRESS ���! �� I�G�..- LOT# C�
<br /> suso�vis�a� PARCEL ID# � " � -- l9���'f���-�j �
<br /> (OBTAINED FROM PROPERTY TAX NOTICB) �
<br /> WORK PROPQSfO NEW CONSTR ADQIALT � SIGN Q [� DEMOI:ISH -
<br /> , � INSTAI:L REPAIR
<br /> PROP4SED-USE Q SFR. Q COMM � QTHER"
<br />', TYPE OF CONSTRUGTION � [� E3LOCK '" [� FRAME [� STEEI. Q,
<br /> i dE3GR1PTION OF WORK ` � Gt ���/V �-�}j�,"7"' � 6 d�/ S G!� o� $�/,h ,� .
<br /> BUIE»DING 31ZE �� � SQ FOOTAGE ifE1GHT ,
<br /> QBUI�DING � � -...a,...�„-_t,. .-,, `
<br /> VALUATION CIF TO'I'AL CON$TRt1CTION
<br /> C�����ZR��� � � AMP SERVECE � PF20GRE55 ENEF2GY Q W.R.E.C.
<br /> QPLUMBfNG ($�' �
<br /> L
<br /> QMECHANtCRL �� VACUA'CION OF MECNANICAL INS7Rl�AT10N -
<br /> QGAS Q ROQFING Q SPEGIP�lTY � pTHER
<br /> ' FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA �YES.. NO
<br /> BUi1.DER COMPANY "
<br /> SIGNATUFtE REGIS7ERED Y/ N Fee cuttRe� .Y/N_
<br /> A���� License# � �
<br /> ELECTRtC1AN CflMFANY
<br /> , SIGNATUi3E �' REa13TERED Y/ N �ee cutiRen Y/N -
<br /> ��re$$ Ltcense#, � �
<br /> PLUMBER , COMP.ANY
<br /> SIGNATURE � , REGISTERED Y./-N •. FEE.CURRE� Y/N.
<br /> Addn@8S . LiCenS9# �_— �
<br /> MECNANtGAt. � GOMP�4N1` ,�..� . F}fi1G� �' �L� � �--
<br /> SIGNATURE REGISTERED Y:/ N. FEE CURRE� Y/N�.
<br /> Address �� l • /fe�tl� '` " ;�h��LLS 335�1 , ucense# C��A �`�q��' �
<br /> O'fliER CQMPANY � _
<br /> ' SiGN�iTURE ' " � - REGISTEREo Y/ N:_ � ,FEE CURRE� ;4 Y:/�N�._.
<br /> Addr888 . -, •;t- , - , . _ � ,LicEiitS6# � �
<br /> . �,,,..�.;;.-, .__. . ,. ._;:=- . ;� . ._. , ;_:,,_,.:.: . .
<br /> . . .: - �� � • _� , . �
<br /> RESIpEN'f4At. �Attach{2);.P:.lot,P..lans;:(2}sets.of 8uitcllitg".Ptans:(1}�sef af.�nergy`Forms;:R-0=WPermlt.for'nerii�coris#ruc�on,
<br /> , Minlmum�ten;(1,0);working�;cJays�after,�'sutiinittal�date.=.Requ�red onsite;Constriic�an�Plans;sStormwate��Plans w/SOt Fence instailed,
<br /> . ,. .
<br /> Sanitary`FaGlltles:,&�1t`dumpster,,,.Site�,Workf,P.ermit for-:suticliqislons/large�:proJeots.`-.:�,:`b;'r;'`� '' ' �
<br /> COMNtERCtA1. Attach(3}°cainplete sets'of Bullditig`Plan§�plas aY�.ife Safety Page;{1)set of Energ}r Focros.R-f�-W Permit for new canstruction.
<br /> Minimum ten(10)working days'after submittal date. Requlred onsite,Constructian Plans,Stormwater Plans w/Silt Fence installed,
<br /> Santtary Facilides&1 dumpstar.Slte Work Permit fior ail'new proJe"cts.-�All commercial requirements must.mesi.complfance
<br /> � S[GN PERMlT Attac#i{2}"sets of�Eiiglneer,+ed.Plaris:,���:;��_ � �. . � - . -
<br /> •"'PROPERTY SURVEY reguired,for,all NEW_constructlon.. ,
<br /> Dlrectlons: . .,. . �
<br /> Fill out epplicatlon complotely.
<br /> Clwner 8 Contrackar stgn bacic�of.appi(ca8on,notadzed
<br /> if over 52500,a Notice of Gomntencement is reqaired. (AIC upgrades over;750d)
<br /> r. �, , -,1c:::.r: -
<br /> Agent(for the contractor)ar-Power of Attamey"(1`o�4he owner)would be someone with notarized letter from owner authorizing same
<br /> QVER THE COU1+!'i'ER..P_El2MITfING� - {Front-cf{ApplEcat�on Only}
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plat/Survey/Foatage)
<br /> Drlveways-Nat over Counter If ort public roadvuays.:neecls ROW
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