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<br />� � e��-7eo-oo20� City of Zephyrhills Permit Application Fax 813aaaooz�
<br /> Buitding Depattment
<br /> Date Eteceived ��- ,. �� — ��
<br /> Phone Contact for Percnittin
<br />�� Qweer's Name f3� �< 4 .� i C� t�� �1c• t!y� Owner Phone Nunnber oZC?� r�r�r.� g(�/ G�? �
<br />� � �� .� ,
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<br /> Owner's Address 505 A'� �ma�,►.�. �- Ownar Phane Num er e�?O� � �'�J
<br /> Fee Simple Titleholder Name Own�r Phone Number
<br /> Fee Simple Titleholder Address ��� • 4 �'� `° '�'�
<br /> JOB ACIDRE$S , �r'��'Z'I.C. rcS ��'lOU� LOT# �� + �"'
<br /> SUBDIVISION c.�+n'!�+'aj�- �""�'�- f`� �E�� PARCEL ID#
<br /> (OBTAfNEQ FROM PROPERTY T/UC NQTICE)
<br /> WORK PROPOSfD NEW CONSTR ADD/ALT � S1GN� Q Q DEMOLISH �
<br /> INSTALL � REPAIR
<br /> PROPOSED USE SFR � CQMM � OTHER v'Y-P�
<br /> TYPE OF CONSTRUCI'ION BLOCK � Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORK �� a ' �
<br /> BUILDING S1ZE ���t���t � 3Q FOOTAGE C� HEIGH7' C��
<br /> ���t�'d���' � ,���4y��" 1/ALUATION QF TOTAL CONSTF2UCTION ��cS�� � _
<br /> QElECTRICAL �� AMP SERVICE Q PRQGi�ESS ENERGY Q W.R.E.C.
<br /> QPUIMBING � �
<br /> QMECHAfi11CAl $ VA�UATlON OF MECHANICAt,ttVSTAtLATlOt�l j��V �
<br /> �
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<br /> , QGAS Q Rt30FiNG Q SPECIAt,'TY [� OTHER
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZQNE AREA QYES NO
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<br /> ��'G r ; � r
<br /> BUtCDER � � , O�/�c..��f1 t �OMPAI�IY '��W��-'�
<br /> SIGNATURE ,/ O/d'r /�/ �� REGI$TERED Y/ N FEE CURREA Y/N
<br /> Address �'��5 �re'�cCcr+�CL���e. (,t,�,c," License# r— �
<br /> �
<br /> ' ELECTRtCiAN � COMPANY
<br /> SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N
<br /> Address �License# � �
<br /> F'LUMBER COMPANY
<br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �� � ,
<br /> MECtiANICAL ° - COMPAI�iY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �� �
<br /> 07H8R .COMPANI( �
<br /> SIGNATURE rtE�ISTE�o Y/ N FEE CURRE� Y/N
<br /> Address • license# � ��
<br /> RESIDENTtAL'_, �Attach{2}Rtat Plat�s;_{2}sets of�8ialtding'Plans;{1)set af Etiergy�Farms;R-O-W Permit for neur c�nstruction,
<br /> Minlmum;ten,(.10);working;days.after_subrriittal date. Requlred onsite,Constructian Plans;Stortnwater Pians w/Silt Fence installed,
<br /> Sanitary FactliUes.&�1,dumpster,Slte:Work�Permit#or subdldistonsAarge projects =_ _.
<br /> CORr7MEi2�lA1. Attach(3)ibmplete set"s of Buit�ing Plans ptus a l.tfe Safety Page;{1}set of Energy Farms.R-4-W Permit for new consttvotion,
<br /> Minimum ten(10)working days afte�submittal date. Reguired onsite,CanstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> SaNtary Facilities&1 dumpsfer.Site Work Permit for all ne+er proJecks.All cammercfal_requtrements must meet comp!lance
<br /> StGN PERMIT AttaCh'{2}sets of Erigineered F(ans.;;•�'",� �
<br /> "**PROPERTY SUR1/EY required for all NEW canstructfan._ �
<br /> Directlon�:
<br /> Fill out applica8an completely. ,
<br /> Owner&Contractor sign back of appEicaUan,notarized
<br /> If ave�$2500,a Notice of Comrnsncement ts required. (I4►C upgrades over�TSdOj
<br /> '" Agent(for'the contractor)or Power of Attamey(fci�the owner)would be someone with notarized letter from owner authorizing�same•°-��_�� �,:.��--
<br /> �...:.......�.,,,..r.,:_..,.„.:uY �__._ =�=J� : , ,.#�:
<br /> DVER THE COUNTER PERMITTfNG-' �`}..(Fronf.of-i4pplica#ion Oniy},;;::, ;,, ,a.. - - ,
<br /> �.� .
<br /> Reroofs if shingles Sewers Ser,vice,•OP9rades A%C.;;� Ftrnces;(P�ot/Survey/Footage) ,. , � ., =�., -,
<br /> . � � .,4, ,, .ti: �r:�., •� ,_ _. � � - .. - •� .,
<br /> Drivsways-Not aver Counter if on putiil'c;roadiivays..needs.RO{N;; � - -�-� ��-• -• �--• Tr ��- �• •
<br /> �, �_. .4 . ..._._. „ a� �w. �. .... ,...n.-,r.�t'
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