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s�s-�so-ooaa City of Zephyrhills Permit Application Fax 813-�eo-0021
<br /> Bullding Degartment
<br /> da#e Re�e�vec� ` .., .�.� , - < Rhone-Cantact for'Permittln - - ��� :�J tt/� _ Q� � � -
<br /> • - a -
<br /> Ownar's Name � n� _� - .. ���o L-1 '�'����Q� . . ' Owner Phone Namber
<br /> �nrner`s Addrass, OwaerPhone Number � �
<br /> Fee 3lmple Tltleholdar Name � � � Owner Phane Number � �
<br /> . �---
<br /> Fee 3imple Titleholder Address- ''`
<br /> JOB AbDRESS ���✓ � ' �""�� � �' LOT# �
<br /> SUBDIVISIQN -� � PARCEL ID# •
<br /> - . (OBTAINED FROM PROPERT.YTAX NOTICE):
<br /> WORK PROPOSED NEW CON5TR ' ADD/ALT � SIGN � Q � DEMOt,1SH -
<br /> e }� INSTALL 8 REPAIR
<br /> PROPOSED:,USf Q' SFR '[� COMM � t?THEiZ _
<br /> TYPE OF CONSTRUCTION'. Q BLOCK"' Q �FRAME ` ' � STEEL [].
<br /> ,.� �/. , .
<br /> DESCRIPTION OF WORK .t' � i 1 Q.�) 1 C�� �-KJ Y�1; U�.C✓"�
<br /> BUILDING SIZE �r � S6!FOOI'AGE�,.r_� HEIGHT��� .
<br /> =�r<��,:�.�, �:,�-•� .._ .
<br /> � �8�������" . � � VALUATION�F]'O7AL CONSTRUCTION
<br /> L...�..
<br /> [�EE.�CTRICAL �SS� AMP SERVICE •' Q PRCIGRESS ENEFtGY D W.R.E.C.
<br /> L
<br /> �F�UMBING $/y3 j�� t�U�� ` ,
<br /> �- w��� , � ,�f 2-�
<br /> QMECHANICAC $ VALUATtON t3F MECHANICAL IIVSTAL6ATIOiV s�'T
<br /> , '
<br /> Oc�s Q. �tao�tN� p s�EciA�.�r Q oTr��r�
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE Ai2EA QYES: NO
<br /> BU0.�ER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FeE Gu�n ,YJN ,
<br /> Address License# � �
<br /> ELECTRICIAN � GOMPANY '
<br /> SIGNATURE �"' REGISTERED Y/ N FEE GURRE� Y/N
<br /> Addres$ Llcense#;� . �
<br /> PLUMBER . . COMPANYr =- �
<br /> SIGNATURE � REQISTEREp : Y l-N - FEE CURRED Y/N�. .
<br /> Addres� , License# � �
<br /> MECHANICAt ' CCIMPANY
<br /> SIGNATURE � ' ' ' REGISTERED Y./-N Y FEE CURRE� Y/:N;.-,
<br /> � , . �" _ �
<br /> Address��� ' ' ' " License# 1.. • -
<br /> ? , _ , z �-� ��1 �r��` :��r'I��'1
<br /> OTHER , • � ' ' , COMPANY '
<br /> S1�3NATURE.~ REGISTERED Y/ N--> .� ,FEE CU . � `: Y .- „
<br /> Addra�s -.�� U ``V�;'�'����� ' - �, License# ( �
<br /> , � ,:.x�... •`-4-.,. •'�;:�:-=. �.'E'�'.�" '
<br /> ' �,.. ._.tt.,...:.,_ i �- -.�< > , ., ..
<br /> RESiDEN1'IAL.-_�:~AtNacti(2}�Plat�Ftans;.�:(2}`seis=offBuilding�"Plans;-(1 j"set of.3Energy��oi�m`s';R=.O�W�Permit fornew,'consbuction,
<br /> �:�.:
<br /> � ,; .Mfnimums.ten�(�1;0);worlcing,days�,after�;su�:mittal tlate:�:Required onsite;;Constnictlon=Plans;-�Stormwater'Plans w/Silt Fence insCaited,
<br /> ... '`Sanitary�EacVtiti�s;;&�1,,dumpst�r�Slte�.Wo�tckPermltfQr sutidiylslo�is!large'proJecGs``:"��a�r:�'R;:-.,��, ' , -
<br /> COMMERCIAL Attach(3)'comptete set`s bf Baflding Plans pius a Life Safefy Page;'(1j set of Energy Forms.R-O W Permit far nsw construction.
<br /> Niinimum ten(10)working days aftar submittal date. Required'qnsite,Constnuctlon Plans,Strartnwater Plans w/Silt Fence instadled,
<br /> SanlNary Fac�liUes&1 dumpster.Stte Work Permit far aU;newiprojecCs.Al!wmmercfal.requlfements must meet compllance
<br /> SIGN PERMiT Attactt(2)`set's af`Englnesr,ed:.P,ians;z-.�,.-- . , w-• - * � °
<br /> , "••PROPERTY SURVEY reguired forall NEW,.constr.uation.,.. . _ �
<br /> � Dlreattons: : :�.,,. ,::,..,,s. , _ - `
<br /> Flll.outapplicatlon completely. -
<br /> Owner.&Confractor.sign back of applicaUon,notarized .
<br /> If over E250Q,,a Notiae of.Cammencement is required. (A/C upgrades over 37500) , ,.
<br /> e� F.,:w?.l,`,S:!r1:?;Y�=:
<br /> Rgent(far the'cantracto�)ar;Poiwel''of Atfgiiiey+(fo�Uie owner)would be snrrieane wi#h notarized lettar from awner authorizing same
<br /> OVER THE.COUNSER',PERMITTING��--•:�-{Front;of-Appifcation Only) � � � t`" ' �
<br /> Reraofs if shingles Sewers Service Upgrades A!C Fences(PIoUSurvey/Footage)
<br /> `.Y'.,1+.. } r , � a . ,
<br /> 'Drivawrays-Not over Caunter if on public roadways:'needs RQW
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