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813aeo-ao2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> r ' Bullding Department
<br /> Qate Received = -� �Phone.Coiitact'for'PerrrtEttln `
<br /> Qwee�"s Name � ��� Q�nrner Phoae Number
<br /> Owner's Address �� '� Cl O`vunerPhone-Number � �
<br /> Fee 81mple TltleholderName �,_ � � � Owner Phone'Number A I -�
<br /> . . , ""�;7'�, :
<br /> Fee 3tmple TltleholderlRddress �" " � �
<br /> JOB ADDRESS / �p �R(� �U� LOT# ��
<br /> suaawisio� � �� P�c�t:�io# ��I- :2�-'Z --"D/�' t�3j�--�D 7d
<br /> ,. � , . � � (OBTAINED EROM PROPEFiTY TAX`NOTICEj � �
<br /> V{tORK PRGPOSED , NEW CONSTR •', ADDIALT '� SiGN Q ' - Q�, DEMOLISH �, ,
<br /> . .- , e INSTAl;4. - .8=' = REPAIR' �
<br /> PROPQSED�iJ38. [��� `SFR ""�] COMM� :`[�„� O'THEFt' ' � <
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<br /> TYP6 OF CON3TRUCTION;, '�' :�BLOCK�' ;[�` FRAME. � � STEEL [,�]: �.�.
<br /> DESCRIPTIQN OF WORK .L •�7 t � c , � 1'� � � -
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<br /> BCliLDIFIG$tZE�'�— � �FOOTAGE .��-� ., . : ,:HEIGHT'� , .
<br /> , OBll{CQING $ , _�;�,:.;:r_-�. :-i-:�=.-,. _�.'.. . < , , ,
<br /> ,�QQ, �'�: VACUATION�`G�"TOTAGCONSTRUGTION .
<br /> QEI.ECTRICA! $ �� � ���� , ,
<br /> AMP SERVICE [� PR�GRESS ENEI2GY Q W.R.E.C.
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<br /> QPl:UNIBING $' _ ,
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<br /> Q NIECHANIGAI $ �VAt.Ui4TtO1V.OF MECHANlCA�,IPt3Tl�t.lAT10lV �� �
<br /> QGAS [,� � ROOFlNG��...Q SFECIA�TY C� 07HEFL , , ,
<br /> FIPVI$HED FLOOR EI.EVATIONS FLOOD ZONE ARE�► �YE$. NO
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<br /> ' BUIi.DER CQMPANY �' C��L'�.
<br /> SIGNATURE REC31S7E�tED Y/ N. �ecuRRe�' Y/.N,_.-
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<br /> �,d�.a� S�sr� r� L�v � . . , u��se#°�� � �
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<br /> EIECTRICIAN�;.:�: : � , � COMPAi�1Y= ' - � .
<br /> SIGNMTURE �"' REGISTERED Y J N F�cuR�n Y./N :'
<br /> Address , , ,.•.Ucense'#=f'� ' � � �'' I
<br /> �LUMBER � GOMBItNY; , - - ' _ .
<br /> SIGN�►TURE ` � �REGIS,TEREp� -e< '�Y.'/-�N':` • -F.EE.6URRE�' , 'Y/`N:•- -
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<br /> MECHAN1GAl: � - . . . � - � ;GQMPANY:. , . : :�.., r - -
<br /> SIGNATURE ' " ` , � � ' '' REGI'�TERED �..Y./N—,. %:,FEE CURREA '-Y/N>% '
<br /> �ddress',.;- �. . . .,: � - - ;:_ - ' ._ ° `Y � Ucense# �. ,. - I .
<br /> OTHEF� � ;:,,.. 1, . , . . .- � . _ _ , „ . . , __ .
<br /> :EO PANY :�
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<br /> SIGNATURE.� ' . � - , r` ' . . � R V_,.REGISTERED , -.Y/ N,� � ��FEE GURRE� ,rYJ=N;.: ,
<br /> . . ... ...� -.� ii?n::.."1 fi Ir`4 � - . . . �' '..� . . , . ���.
<br /> �lL1L�P8�S _ ' �:£: ..c;. i, n•} , . '- UC�IflS9#'�
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<br /> RESIt}ENTIAL:- �`--Attaati j2{#?to<P.,lans��`2�1�.sets�of8uildtn�''y;;Flan§�,11.\�se't''iif°Eiie��/��{�/:Fornis�.R-0=1tU�Perm1#`:for ner�u�:�nstruc#ion. ,
<br /> . _�... _- ,1 /.,.3_� 1� J -i7 � . 1\,I,�.. �t. . 'i77;. I .. . . � ._ .. _�..�„iy,, ?�,� I � *�'
<br /> ��,,.,:�Miqlmum,�, m(�10,)2woriting}clay§�atter,;'sua�iilttalidate:�Requlred.onslte-ConstrucNon Plans:�Stormwate�::P.lansw%;Sllt Fence tnstalled,
<br /> ...� Sanitary�$�14ties;&,�;���t�mpster,ySlte�tiNorkKPertnit.�or.subdivlstonsltaige.projects�;..?�;t;�;'�';-�' .� . - . � . ". .
<br /> COMMERCIAL Attach(3)Ycoinptete sets af Bsiltding Plans"ptus a'C.`�fe Safeiy Page;(1}set of Energy Farms.R-CI W Permit for new constnsction.
<br /> Minimum ten(10)working days after submittal date. Requ(red onsite,,ConsUucUon Plans,Stormwater Plans w/Silt Fence installed, ,
<br /> Sanitary Factl�las��1 dumpster..Sife,Wortc Permit foc ati,`newiprojecfs_:Aii�commerda�cequEcements-must meet compllance
<br /> 3tGN F�ERMIT Attach:(2)set§of'�ngineeired;.Pians::•�Y;�:~�:'r' �� ., . . ,,.' , .
<br /> •`""PROPERT_Y..SUR'V,EY r�equired�for�all NEW.ccns.tructlan..:� _ ,. ; - _ � ,
<br /> Dlrectlon�: '`.'.>.�:;�., ..: _ __. ,.. ..,._�. . . ,
<br /> FIII out applicatlan complekely.
<br /> Glwner 8�Confractor stgn Etack:of appltcatlon,notarized
<br /> if'over�2500,a Notice af Commencement ta requtre�l. (AIC upgrades over S750p) _ _ - �
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<br /> .. -::t.�a-°v:s:C�r,;;��:.r.. _ .. .
<br /> Agent.(for ttie conttaetorj`or`Po`irirer of Attoiney(fiir#tie:owner)woutd be someone with natarized letter fmm owrner authadzfng same
<br /> O.Y,ER THE GQUNTER.PERMITTING�=- ={Front of�Application Only)`+_ � � �
<br /> Reroofs'if shingles Sewers Service Upgrades.A/C � � Fences(Plot/Surv_ey/Footage) -`� -- -,
<br /> - � _-��--:. .- . � -..�. __r.;-�r,::: :,,t�; - �- . .. ,
<br /> Drlveways-Not over Counter if on public roadways.:neecis ROW , ,
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