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813-780-aozo City of Zephyrhills Permit Application Fax 813-7$0-0021
<br /> 4 � Bullding Department
<br /> Date Received :.. ,_ �— �., Phone Contac!<for�Pannittin :'' '� ". � �
<br /> �Owner's Name �.. � Owrn,er Phone Number -�V ��� !
<br /> �xraePs Address V �l� • �� .�"T t/'e.. � h l^�i����� �� t3�rner�Phone Number ( f �
<br /> Fee Simple Tlkleholder Name� � � Ownec Pfions Numl�er -
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<br /> Fee 3impl�Titlaholder Addr+�sss k - ` '
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<br /> .�'�J08�DDRESS ��j� �7� 'E. 5 . .�7'�5–�f I LOT# �� .
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<br /> SUBD1VtS10Ai I .�4� r pAftCEG 1�# . . .. ,. . ._ � ,_ ,,,
<br /> - �'� ,.. ;. �(OBiA1NED FROt�!PROPERTY TAX Et0'(ICE} , ,,
<br /> WORK PROPOSEt7 NEWCONS'TR ADDIAG'T ��' ' SlGN [� ��: ..DEMOLtSH• -
<br /> � .• � INSTALL ��� ~ •REPAIR � � _
<br /> PRQPOSED:USE � � SFR ' Q COMM'ry :�] •OTHER ' ' "
<br /> TYPE OF CONSTFCUCTION_ '[� `'BI;OCK�'" '� ," �' FRAME, � STEEL. Q.
<br /> DEBCRIPTION'OF WGRK �" '� � hCI� . � '� t�' � �
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<br /> BUIi.DlNG°8lZE � ' -`� l`� ���, SQ FOOTAGE.�_:�. �: . ,:N�IGHT., :::. ; - � .
<br /> `YC"�;ti::.,., ,.7.�t� ,
<br /> BUILQING �. � +—�. VAL:UATiON`�.1�`Tt3'i`AL•'Gt�NSTFtClC'i'tON , ����j'' a� „-
<br /> � �S'� 1�.... �� - _ , : .
<br /> , ELECTRICAL �� AMP SERVtCE Q` PROGFtESS EN�RGY [�. ' ,W.R.E,C...
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<br /> OPL•UMBING $ � �
<br /> QMECHANICAL' ' $ �'— VALUATION�OE MECHANICAL:INSTALLATION �� �
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<br /> QGAS [� , RQOFING,,; Q SPECIALTY '� OTHER4� �' �yy"`'���-g.�'�� �
<br /> FINISHED FLOOR ELEVATIONS FL.00Q ZONE AREA �YES. !VO � ��
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<br /> BUILDER (� � � � � MPANlY �'(�!l Lp�..
<br /> SIG�1�►7UR� ��'�.r.� �- R6GISTERED Y/ N. � �e cuttRFn', _Y/N_._-;; . ; .
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<br /> Astdress .- . .Llcense# ( � ��
<br /> �LECTRlCUW.:;� ,,: ,s �.'' CONtP�tNll� , � -, . �. . �
<br /> SIGN�►TURE - �' REGISTERED Y/ N t�cti�ittet+ Y!N
<br /> Addres� , , ,�• . ..�.Licerise#-��� �
<br /> PLUMBER + � . C,OMPANY._ ,�';� ' � �� '
<br /> SIGNATURE �' . _ ., ,. REGisT�tEa:, K�s; �_�Y/��N.-. � �e Guwte�' • Y/N,
<br /> Actdres� . F� M1 � I tJcense#.�(� ._...: � - ' �
<br /> MECHAPIICAL'� ' . � . , ' { _.GQMpANY:. ' . � ,.. . _ �
<br /> S1GNI�TURE . � , '} . REOIS7ERED�., Y:/�N: - f,FEE CURRE� : -Y./•N�- �
<br /> Addes$s: - _ .'. .. • .. . .. , '; � � « . . � ,� � llcense#-�- -,�,— ,. r.� .
<br /> OTHER . _.: � . � r . ,. ' .GOMPANX � >,_ :, u. � ,.�,Y . ,
<br /> SIGAiAYURE. `:z�: ` .. , " '� ,� � - ,� t �� , t.REGIStERED .. , , Y/.N,.e, +FE�GURRE�.� ,Y L f!i:._ .
<br /> Atldres� '� `i� - �.�: - -'-ih�:�:t�;;•�`.. - a .. , ' ' `Lic�rise#�( -. ' I
<br /> �. _ -- ';t .ca.., �:..;;_� .,,.,, �;,:, _'�:;'.; ;3'•: =fif��`- >;c; , ... . ., � ,
<br /> RESIDEWTIAL;:.�`:Attacli,(2):;Plot;Plans,.(2)'sets:of#'Bulldrng'Rlans;=(1,j`set',of�Energy�Forins:R=�O=_V,Y-Permlt.fcii��eyrricoristru.r.tton,..... -� �
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<br /> _ Minimum{tene(',10);woritl�g da�ys,�aiter sutimittal date}�Requlred onslte;-Construictlon�Plans;Starmwater.Plans w%Silt Fence Installed,
<br /> . 'SaoftarjrFacllitlpsr&s�;IPdur�Pster;,Sile�:Vl�ork�Per,m�t;�q_r:`subdivi`sltltieRsr+gerprojectis,::;.':�;�6::>=°'_;=t <.� . _ ,;- , -_-:.;. •- .:_ _.
<br /> COMMERCWL Attach(3)�oomplete'sets`of BulCdtrig"Plans plus a Life Safety Page;(1}set af Energy Farms.R O-W Pemtit for new caaswctlan:
<br /> MlNmum ten(10)wa►king days aRer submlttal date. Requtred qnsite,.Constructlon Plans,Starmwater Plans w/SUt Fence Installed,
<br /> Sanitary�Faciti�es:&;1,dumpster...Sits:W.ork,Fermith?r,all�new:priojects:�►llcommatciai:requlrements�mus#meeYcampllanca ,
<br /> SIGN:PERMlIT Attacti"(2):sefs=o`f"E'riglne�eteil;P(a[�,:,a;--�=r�'�-_:;,:.`,.<. ;. , _ - , _.
<br /> •""PROR..ERT]_SURVEY reguired,f�qraU:NEW;cons,trucyon.,.. -.� ' " - ., ,, �
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<br /> Dlrec!lons: , .. :, -- � � ; ..._. _._. _ _ . • '.
<br /> FIII out appBcadon completely.
<br /> Owner&Cantractor sign back of applicaUon,natarized
<br /> If over;��504,��Nottce of.Commencemsnt ta rec�ulred.;{AtC up$rades over:�i7500) . _. <�. ,. ... '
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<br /> Agent(for tfie conttactar•)°'Orfawer of;Attomiey.{to�..##�e.awner.}woutd be,somenne,x+ntii.notari-ted letter from owner suthorizing same. •� �
<br /> '.QYER THE COUIVT�R:PEi�MlTi7NG�'--:�:(Front=of�Aj�Pflaattan Oii{p}��, � �,_� ^.. -_ _ . . .
<br /> ..... � .,�..._._. ,� . •.. ..-.,_ ces(PlotlSurveylFootage) , _. _ __ ,
<br /> Reroofs If shingles Sewers ServiCa Upgrades A/C 'Fen ,
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<br /> Orivewaya-Not aver Countar if on public.roadway&.:needs,EtOW_..,,....,�".,,. , ,... n .. s . _.-.. - -
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