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e�s-�ao-oo2o City af Zephyrhills Permit Applica#ion FaX-s�a-�saooz�
<br />, Building Depafinent
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<br /> Date� ce{vec{�,�v ; �;'S,£ '.� ,',s ' � - { [ � _ '" t` ! � �
<br /> M� ,�:�,� :.�: °PhoneCantactforPermttEin� =t�� .��titJ�'
<br /> ti �.,.. -,- �i,;' - ::•..;.,, ;' ^�:J.:" r �,�,,�,,��;1�` ,
<br /> Owne�'�Name ? ' U�- " �...Qwi�ec.Pho»e Number-- � , , °
<br /> Owner's Address Owner Phone Num6er r� �
<br />` Fee Simple Titleholder Name �— � Owner Phone Number � �
<br /> Fee Simple Tltleholder Address
<br /> JOB AGDRESS l!1 I � �1�cl "� LOT# �_���
<br /> SUBDIViSION � � PARCEL IQ#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) '�
<br /> WORif PROPOSED } e NEW tON5T#�8 ADDlALT � SIGN [� Q DEMOLISH I
<br /> INSTALL FtEPAIR
<br /> RROPOSED USE Q SFR Q COMM Q t}THEi2
<br /> 7YPE OF CONSTRUCTION Q BLOCK � Q FRAME � STEEL Q
<br /> DESCR�PTION OF WORK 4���Ch.�\ � C�J - R�y{�1 u���.(^
<br /> BU1LDtNG SIZE � � SQ FOOTAGE HEIGNT �_�
<br /> ���1�'�i��' 'w � VALUATtON QF TOTAL CONSTRUCTION
<br /> �
<br /> QEIECTRICAl. $�'�� AMP SERVICB Q PROGRES5 ENERGY Q W.R.E.C.
<br /> �
<br /> �Lt3MBING $ �j
<br /> � �
<br /> QMECHANlGAL $ � �� VALUATION OF MECNANICAI.INSTAILATION
<br /> � � �`:
<br /> QGAS [� RQQFiNG Q 3PECIALTY �] OiHER
<br /> FIIVISHED FLOOR ELEVATIONS �-� FLOOD ZQNE AF2EA [�YES NO
<br /> � � � �.��� . _ ,. � . _ . ,
<br /> �
<br /> BUi�DER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> I, Addre�$ _ ' License# �— �
<br /> E�ECTR[CtA[+! COMPANY
<br /> $IGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �— �
<br /> PLUMBER � CONIPANY
<br /> SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N
<br /> Address License# �— —�
<br /> � MECHANICAI. CONIPAfiIY
<br /> , SIGNATURE REGI$TERED Y/ N FEE CURRE� _ Y/N �I
<br /> Addre�s License# � �
<br /> OTFtEl2 /y COMPANIt �.�� � � YY 1 C��)O�'� .
<br /> SIGNATURE „_�S:? � cQ rC REGISTERED Y/ N FEE CURR � Y/
<br /> Address ���� a� � �� License# �� / �c��"�}�
<br /> �—�
<br /> IZESIDENTIAt: Attach{2}Plot Plans;(2}sets of Bu3lding'Plans;{1}se#of Energy�Forms;R-Q-W Permlt for new construc#on,
<br /> Minimum ten(10)working:days aftec submittal date. Requlred onsite,ConstrucHon Pians,Stormwater Plans w/Siit Fence instelled,
<br /> Sanitary FacillUes&.1,dumpster 5ite Work•Permit for subdivislons/large projects -
<br /> - COMMERCIAL Attach{3)camplete sets of Bullcl3rig Plans plus a(.It`e Safeiy Page;{1}set of Energy Fotms.R Q-W Permtt far new constructioa.
<br /> Minimum ken(10)working days after submittal date. Required onsite,Cbnstructfan Plans,Stormwater Plans w!Silt Fence installed,
<br /> Sanitary Facilides&1 dumpster.Site Wark Pertnit for all new proJects.All commercial requirements must meet campliance
<br /> SIGN PERMIT AftacF�{2}sets of Englneefed Plans.
<br /> � ""'PROPERTY SURVEY required for all NEW constniction.
<br /> Dlrections:
<br /> Fill out applicaUon completely.
<br /> Owner&Contractor sign back of applicatlon,natarized
<br /> If over�25d0,a Notice of Camrnenaement is requlred. {A/C upgrades over E750Q)
<br /> " Agent(fo�the contractor)or Power of Attoi'ney(far the owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER PERMI'iT1EtG {Fmnt of Application Only}
<br /> � Reroofs if shingles Sewers Service Upgrades A/G Fences(PIoUSurvey/Foatage)
<br /> , Driveways-Nat over Counter if an pubtic roadways..needs ROW
<br /> f"e� � �7
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