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813-760-oozo City of Zephyrhills Permit Application Fau 613-7$0-0021
<br /> , • Suilding Department
<br /> Date Recelvsd -�1 , . Phone Coritact<for`�ermltEie ° .
<br /> Owner'a Name c� o _ � a uJ. Owner Phone Number
<br /> Owner's Address ��� � . � . OwnerPhane Number � �
<br /> Fee Slmple Tltlehalder Name � ' �� Owrner Phone Number ' � �
<br /> �'rT�' � +�
<br /> Fee Simple Titlehalder Add,res� 5 '"'
<br /> JOB ADDRESS f�s �S�''•e� LOT# ��
<br /> SUBDIVISION � � �. :'PARCEI:ID# - - .
<br /> . � • �(08T/UNED FROM-PROpERTY TAX NOTICE}
<br /> WORK PROPOSED NEw CONSTR ADD/AL-T C� SIGN �[� Q, DEMOLISH
<br /> ..- � � } INSTAI:L 8� �. :REPAIR� ' `
<br /> PROPOSED:tlSE: SFft � COMM �� OTIiEFt :
<br /> TYPE OF�QNSTRUCTION., �. '�`' �BLOCK�' ''L] " FRi4ME, � STEEL [�]-. "� . •� �
<br /> DESCRIP710N OF WORK ` b�� � ' /` ' , 4 '
<br /> BUILDII�G�SiZE.��� � SQ;FOOTAGE�, , , . .,HEIf3HT:,�_�.. ..
<br /> Ul�D1NG $ .� .,�_a. ..�� _:,._..` , . .. ' .
<br /> VALUATION OF'TC11'AL CQNSTRtlCTIOW
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<br /> QE�ECTRICA4. $ AMP SER\/iGE Q PROGFtESS ENER Y [� W.R.E.C,
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<br /> QPI;UMBlhlG $' ., , .., � ,`r , �---.,
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<br /> QMEGHANlGA� �` $ . VPiI..UATION;OF MECHANtCAL.INB'FA�tATlON �;�- � ����.�!�
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<br /> � [��s � �oQ�t��:;-t p S�Ec��rr--� -o���t�-= � ��� ,
<br /> FINISHED FL.00R ELEVATIONS FLOOD ZONE AREA �YES. NO
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<br /> I BU�I.a£R �1CiCiMPANY Ti
<br /> SIGNATURE Et31s7�a Y/ N. �e Cur�n' ' , J:'Y/.N : , _ ,
<br /> A►ddress '� ' � _ Lioense#�� -.+ ` .��
<br /> , EtECTRIClAPI�_,,, �s r`- COMPANY - , � . �' � .
<br /> ' SIGN/iTURE �' REGISTEREf1 Y/ N F�CURrtEn ' Y/N" .
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<br /> �i r4ddres� ��
<br /> , °Llcense:#.�
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<br /> , PtUMBER COMPANY� ,. , ,
<br /> ', SIGNATUIt� ' •' ;REGIaTeRED .:.Y/�N , .�e CUw� `Y/N:- • -
<br /> ' ,�ddress „ . � ' � ` . , . ..Wrsnse#�l . . �
<br /> AIlECH�1lCAL.. " . . -CQM�ANY , * , _ ' .-
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<br /> SIGNATURIc "�,. " , � .�
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<br /> ' ' . .-. REGIS7ERED�,. , Y:/�:N.-, . �,.,_�E:Cuwt�n � Y/�N:<�.:.
<br /> j �ddres�:`.` • . • . . , ` ' � Licspse.#,�. ��
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<br /> SIGNAYURE � .- . _ • ' " � " REGISTERED. � . . .
<br /> AYd�e� '..a-a r.'- .y.::i,i :`:?;3i'� :,s.r .v. ' �i .. •• ' r'"' < .. 4- ' �U�.A$e ff'� ., �
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<br /> RE3113EN11AL��:_:.,=:Aittaah;;(2):,�?�0�:'PIBfi$;.(2)sets`=of;B�t'Idi`ng�Ptans,.(3j�sef'oftErien,g`y�Forms;�.R=O=VU�Pemtit for";neu�r,':consMic�bn;.. - .
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<br /> .�Mlnlmum{;ten�(:10.);working�;days�aftet,sudiolttsl�d'ate;�Requlred.onslte;��onsirucHon�Plans;-Stbrinwater"Plan's_w/Sllt Fence.lnstalled,
<br /> �$8R123T�t F6C��4�65�n1 l�URZPstBJ;'.�3t6 V11GE�C��9f.tCl�t�O�filladlifl§fOt1S/�8fgQ�Qf4j8C�SS�r,':'#;'i�;:�''.;.-.,:;; `• _ - �.= _ _ .
<br /> COMWtERCtAi. Attach(S�'coinptete sets"of Bu`Itidlrig`Plans p}as a'L1fe Safetyr Page;(1}set of Energy Farms.R-t3 W Permit for neW const�uctlon.
<br /> Mtnlmum ten(1 Q)wo�lcing days'after submlttal date. Requlred onslte,ConsUuctlon Plans,Stormwater Plans w/Sllt Fence Installed; .
<br /> Santtary Fadt�les�1_dumpster.Site,Work Rermlt for all new'prdject's��Alt c;ommerclal:reqt�trements must meek compllance
<br /> SIGN PERMiT Attar�i(2)"s'ets cif'Engiii+�eied;'pian�;,;.,:.�,;-s-��-• `.. . - . - • `
<br /> "`"PROPERTY..SURVEY�requlred;fqr aJI�NE.W..,constructlon:.,�~ ;', •
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<br /> �1f6G'�Oti�: �.:,- -:< , -' __ . -- - .,.. _ . ' ' "
<br /> ', Fill out appBcallon completely.
<br /> t3wner 6�Contr�ctor slgn badc�af appllcaSon,nata[iz�!
<br /> tf over 52500,a Nottce.of_Commencement is requlrc�d. (AIC upgrades over t7500)_ _. � � '
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<br /> Agent(for ttie contraatbr):pr:P"6wer of Attiortiey(for`the�owne�)wauld be saineane with noMarized,lstter from owner authorizing same�;
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<br /> °DVER�THE�COUNTER.iPERMIYTING�`--:{Fiont�of=ApPllcation�Qnly)�",' ••�-� . •.- - . ' � � , .
<br /> Reroafs If shingles Sewers Servlce Upgredes A/C , Fences.(Plot%Survey/Footage) ,.` , ' = -- ' •
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<br /> Drlveways-Not over Counter If on publlc roadvuays::neeif§ROViI-;,� , ; �
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