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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-78t1�0021
<br /> Bulid3ng Department _
<br /> Date Received �– _' � / , - -
<br /> . . -� � ! � Phane�Contact far�Permitt[n � –
<br /> Owner's Nama ��D CZ,1��"' �5 �f A' � Owner Phone Numbar
<br /> Owner's Address � Q� C� c �c,�� Owoer Phone Number - � �
<br /> Fee Slmple TItleFiolder Name � � Owner Phone Number �� �
<br /> Fee Slmple�Tftleholder Addresa
<br /> JOB ADDRESS ��� � (��� � ��U LOT# C�
<br /> suaoiv�s�aN � � PARCEL.ID# vj ��� � l.� .l�5 Oc� ,�C��C3
<br /> - , . (OBTAINEO FROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED �_NEW tQNSTR " ADD/A1.T � SIGIV [� [� DEMOLISH
<br /> e. INSTALL 8 REPAIR _ .
<br /> PRUPQSED+USE � Q- SFR � COMM � OTHER ��-i}�tl�i�,� C_ ��''�—r-
<br /> TYPE OF CQNSTRUGTION � Q BLOCK ' Q FRAME � STEEL '[�] [����'���
<br /> DESCRIPTIdN OF WORK " j 1�1� �. ' ���"�� Q., 2;�''4 Q Cyt/� � �j kGi�,(?
<br /> BtlIi.D1NG S�2E ����` SGtFOOTAGE C��� ; HEIGHT ��,`�
<br /> BUi1.DING , •_._v_.
<br /> � ��.�Ua-- VALUATION't7F�TOTAL CONS'i'RIJC'f10N
<br /> �_,.
<br /> QEl.ECi'RICAI �$ " � AMP S�RVIC� Q PROGRESS ENEFiGY [� W.R.E.C.
<br /> �_._._�
<br /> QPLUMBlNG �_ � - _ . ���� �
<br /> QMEGNANtCAI $ � " VALt3ATtON OF MECHAPt1tCAL IidS7A�CATlOi�1 � tu �� �
<br /> � � �� ���
<br /> QGAS � RqQFiNCa Q Si'ECIAI.TY �� OTHER ,/p--�}.����1 r�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE;AREA QYES NO �eS��t'�y�.�p'���
<br /> � t �
<br /> � �
<br /> �u��.o�� f��'� � ��coM�iwv� ��z�- r�#= � ` �`� j.L�-
<br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N
<br /> Address .J r7 C_:..:�'�'�~t C�n.) � -`�`„����. License# l;(�� �`J.5 J'(���
<br /> E�ECTRICIAN; . COMPAldY ' ' - �
<br /> SIGNATURE ' REGISTERED Y/ N FEE'CURRE� ' �`Y/N`
<br /> Acldres� . ,. . �icense•#•,� �
<br /> PLUMBER � C.OMPANY .
<br /> SIGNATURE' ' " �' � � ;REGIS.TERED,. Y_/,.N. _� .;FeE cu�t�n � .' Y/N � '
<br /> Address License.# �� � • ��.
<br /> MECHANICAL � ' ` , C{}MPANY 1 , . -
<br /> SIGNATURE° ' � REGISTERED .,Y,/ N ' FEE7CURREP Y J�N
<br /> Addra��'� , . ' . _ . .... < License# �. ��
<br /> OTNER `` . i , ` ' _;COMPAl�IY -
<br /> StGNATURE • � ' � ' ' 'REGISTERED Y/ N... FEE CURRE� Y/N
<br /> Address ' ` . ,• , ' ' License# � �
<br /> 4.. .. _ .
<br /> RESiD�NTiAI:,'X �-Attacfi"{2},FbfrP,-lans;�(2)sets;oftBullBi�ig�Plans;(1)sefoF=Eriergp�Foiin`s:'R=O=W Peimitfar`newcanstruction,
<br /> ;�, �Min(mum�,ken;,(:1.0),workingidays_aRer;sGbrinlHal`date::R`equlr'ed onslte,:Cbnsfiucdon�Flans;Storrnwater'Plens w/SIIt�Fence lnstalled,
<br /> ' `"`� 8anitary'FadllUes.,&;,1:.dumpste_r,,$Ite Wo�lc;Pemtiffor subiliVislonsAarge.projects,_: .�. = " ` � �
<br /> COMM�RCIA1. Attach{3}�co�plete sets qf Bultdfirig Plaiis�ptiis a'I.ife Safety Page;�(1 j set af Energy Forms.R O-W PermEt for new canstnsction.
<br /> Min(mum.ten(10)woricing days after submittal date. Required onsite,Constructlan Plans,Stortnwater Plans w/Silt Fence installed,
<br /> San(tary FaclUUes&1 dumpster,Site Work Permit for all new:pmJeats..Al!commercta!requlrements.must meet campifa�ce
<br /> S1GTt PERMfT AttacFi{2)sefs-of Eiiglneered�Plaris:, � --�.. .. . � : . ' �
<br /> """PROPERTY SURVEY r uired for,all_NEW_construc8on.. -
<br /> _._� _ ._ -
<br /> Dtrectians: ,-. . . ,
<br /> Ffll out applicatlon completely.
<br /> ��.,\ Owner&Contra�tot slgn back of applica�on,natatized
<br /> ��f over 52500,a Nottce af Commencement ls requlred. (A!C upgrades over S790d) , ,
<br /> �. `'°``'�"' --
<br /> Agent(for the oontracto�)or Power of=Attoriiey:�for;,tF�e�ouimer)�would;be'someone with natarized letter from owner authoeizing same
<br /> DVERTHECtlUNTER.PERMiYfING;- -��.-(Froritof,ApPiication�Only),;n,'�.;~ ; � , � ���
<br /> Reroafs if shingles Sewers ;;Service Upgrades�'WC Y,;y Pences(i'lot/Survey/Footage)
<br /> ,�_ _ :_. ; .^. ,.,..�; �-: � _ � :'..:_`:' . u. � _ . ., ...
<br /> Drivewaya-Nat over Gounter if an publicroadway�s;:needs.ROW��.•==�`--����••
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