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813-780-0020 City of Zephyrhills Permit Application Fex s�sasaoo2�
<br /> BuIlding Qega�tcnent -
<br /> Qate Recetved � -� -- phone-�antact tor�ennttt�n �'�3 � � 1 L/ � _ ,3 0 �
<br /> OLarner's Name � �'f�"��-'��� �L� Owner Phone Number �� r � " �`7 �
<br /> Owne�'s Addrass � •� ��� �+" ��� I��- Owner Phone Number� �� —��
<br /> Fee Simple Titleholder Name ' Owner Phone Number �
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRE3S ��� / � /��fT %(�'� z�' � �: / ./S �� .�-�.��/ LOT# C_��
<br /> SUBDIYISiON � � � ' PARCEL.tD# �` -o�� 'bO,D •� C� Q
<br /> . s (OBTAINED FROIYI PROPER7Y,TAX NOTICE)
<br /> WORK PROPOSED �• NEw CONSTR ADDIAI�T C� SIGN Q �Q DEMOLlSH
<br /> 'e. INSTALL. F REPAIR � �
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<br /> - �FtOPC3SE�7t1S�- :- �----- - :--S�R "__� -- CQNtM ��-�-- OTFIER" : .
<br /> TYPE OF CONSTRUG710N � LOCK '' Q FRAME C� STEEL CJ
<br /> DESCRIPTION OF WORK ~ �/7���tlGS� �f��'S� ��� ��'' ��'���d�� Sl•
<br /> BUILDING SIZE �� �`SQ FOQTAGE���� NEfGHT �� '
<br /> ��»'����'' � ; , ��, �, VALUATION':OF"TO'i'PiL CO(�STRt1GTION *
<br /> EI.ECTRICAt ($ " � �1MP SERVlCE Q 'PROGRESS ENERGY Q W.R.E.C.
<br /> L � �QPLUMBING ' $ � ��� �;�,,t"�/ ,
<br /> �
<br /> QMECHANtCAL' $ " VAII'!ATlON'OF MECHANICAI INSTALLATIt71V ��� `�✓" C�{�-''
<br /> QGAS Q Rt}QFING Q SFECIAI.Tf Q OTHER �' ��
<br /> � �
<br /> FINISHED FLOOR ELEVATIONS FI.00D ZQNE AREA �]YES. NO � ��c�73
<br /> , eu��o�� ���/� coM��r� -��'r��1 x�lv r,�;�sT,QvcTo�v ._,Z� c�2.,S�
<br /> SIGNATURE ��_� REGISTERED Y/ N FEE CURRE� Y/N �
<br /> Address ��1��'fd ff�S"r zc" �f�il,5���,J'S�l Cicense#' ��Cj/�S��b � �
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<br /> lEC'CRiC1At�1: `X.r�-�,��r " �,(J��, 'COMPANY ' ` , �,v
<br /> NATURE �� "" �, " REGISTERED Y/ N FEE CURRE� � Y/N ��
<br /> �
<br /> Addre�s , .. � , ., Llcense,#.�� (
<br /> P�UMBER , � .. � . COMP.AHY � . �
<br /> 31GNATURE ' "` , ,REGISTERED , Y./�.N FEE CURREk ". Y./N.
<br /> Address ` � , � ,.Llcense.# �` .�. � �.
<br /> MECHANICAI: ° - COMPANIf, , _ ,
<br /> SIGNATURE F � � � � '� REGISTERED Y/ N . _ ; FEE CURRE� Y./��N :
<br /> Address` . .. - ', ' ` • � , „ License# ��
<br /> , , , �
<br /> OTHER ` _ - ` � ;GQMPANY �
<br /> SIGNATURE •,- �• �� � � ` ° " ` ` ' 'REGISTERED " Y/ N:G. FEE CURF2E� Y/N.
<br /> Address' _ ` • License# ' �
<br /> ,� � .
<br /> RESlDEN'E�AI:,'r..a Atta�li{2};PtoffP,ians;,(2}sets-af�Bullding�P..lar3s;{1)set oF�iiergysFa`"rm's;R=0-W Perinit for new canstruction,
<br /> �, o�. Minlmum;ten;(�1,0)�workingidays�_after;subinlEtal-dete::Requlred onsite;�C►a�'structlon=Rlans;Stormwater'Plans w%Stlt Fence InstaUed,
<br /> ' "� �� Sanitary FaGlldes;&�1,clumpster��ite Worlc,Pertnit tor.subdiVisions/large.projects,:._ '�-'� • ' ' �
<br /> COMMERCIAL Aftach{3)coin'plete set's''afBultiltiig Pla�is plus a�l.ife�Safefy Page;�{1}set of Energy Forms.R-�-W Fetmlt for new cons#ruc�on.
<br /> Mlnimum ten(10)working days after submlttal date. Requlred onsite,Canstrucdan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliHes&1 dumpster.Site Work Pertr►it for all new,proJecis:All commerGal requlrements.must meat compliance
<br /> StGN PERM�T ,4ttaet�-{2)sets of�E�igliieered�Plans..._�,.-�:°> r ` .
<br /> """PROPERTY SURVEY raquirec!for all NEW.constructlon... _ , •
<br /> Dlreatlan�: < . . '
<br /> Fill out applicadon completely.
<br /> Owner&Contractor sign back of appltcaUan,notarized • �
<br /> If aver S2S00,a Notice of Cammencement is required. {A/C apgrades aver S750Q) '
<br /> ent for the con ':•.�, '
<br /> �,, .I .
<br /> `" Ag ( �� 'tractor)or Povuer of Aktainey'(fo�tlie�bwiner)would be someone with notarized letter from owner authoHzing'same
<br /> DVER 7HE COUNTER PERMiT71NG. _..(Front af ApplicaBon-Only) . - . ._
<br /> Reroofs If shingles Sewers Service Upgradas A/C Fences(Plat/Survey/Footage)
<br /> Driveways-Not over Counter if an pyblic,rosdways::n�eds 120W^ , '"''�"`. , --t „ � " � ��,.�,:,{��,r,' +.1 ;;;ri;�,�.`,a,��,'; ".....,..,..._`. :� - t -
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