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8��-�saoozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department
<br /> x: ��� ! � --t ^�
<br /> Date Receiv�d .{ Phone Contact far Permiftin -�� — 1 � t -
<br /> Owner's Name . .� . � y � Owner Phaee Namber
<br /> Ownar's Address - OwnerPhone Number �— �
<br /> Fee Simple Tltlehalder Name � `� Owner Phone Number �� �
<br /> . �—
<br /> Fee Slmple 1'itleholder Addr�as °°
<br /> JOB ADDRESS � ��� � I�l LOT# ��
<br /> SUBDiVISION � � PARCEL ID# � �
<br /> (�BTAINED FROM PROPERTY TAX NOTICE).
<br /> WORK PRQPOSED '� NEW CONSTR ADD/AI:T C� SIGPi Q Q DEMQt,ISH -
<br /> INS]'AI:L REPAIR •
<br /> PROPOSED tlSE Q S�R [� COMM , � OTHEFt , � . .
<br /> TYPE OF CONSTRUCTION" [� � BLOCK "' Q FRAME � STEEL _Q, �
<br /> DESCRIPTION OF WORK � Y I C�--� �.'f Y� '(,, '
<br /> BUILqING SIZE � � SQ FOQTAGE� HEIGHT �,�, �
<br /> QBUlCDING �--� ti..s_-z_ .�;.. .....,.
<br /> .VALUATION�F TOTAL CONSfiRUCTION
<br /> QEt,ECTRICAL r> � AMP SERVICE ; Q PRt3GRESS ENEF2GY Q W.R.E.C.
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<br /> �Pl.UN1B�NG �{'� 6�1��_ J - „ . �/ ��
<br /> �,� ���I V � /
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<br /> QMECFfAtVtCAI $ VALiJATIOI+t OF MECHANtCA�ENS'fAL�ATIO(V �
<br /> QGAS Q ROOFlNG Q SPEC1AI:l'Y•�� OTHER ! { �
<br /> FINISHED FL.00R EI.EVA710NS FLOOD ZONE AREA ' �YES. NO
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<br /> ' BUt1.DER CQMPAFiY '
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y./N.
<br /> Addres� � License# I �
<br /> ECECTRlCIAN , C��IPIINY � .
<br /> SIGNATURE �"% REGISTEREp Y/ N FEE GURRE� Y/N
<br /> Address - � -.License# I , �
<br /> PLUMBER � - COMP.ANY� • -
<br /> SIGNATURE .. Rec31S7eREo . Y/ N FEE CURREA Y/N
<br /> Address � License# � �
<br /> MECHAI+tICAI. � CC?MPANY ..
<br /> SIGNATURE ' ' ReGisTEri�o Y:/ N Fee curt�n Y/.N,
<br /> Addrsss� ' t „ , �
<br /> ' _ Lfcense# � I
<br /> o��� �-� - � �o�P� �'1 �-F-� 1 lr.r1� � �,� .
<br /> SIGNATURE � REGISTERED Y/ N , � FEE C REA , Y/� . .
<br /> Addreas ���t�; .V.ti,1�.' j0.2�- � � • � License#�'�������
<br /> a- � - ,�... . ._„ . „.. ,,�s` ',�:,� •�_.... �:Hf.; .
<br /> _ . ,, ..,.�.,._ ......-
<br /> RESIDENTIAL-; �-Ait'acti(2)�Plc#�Pla�s;:{2}sefs=of:8uilding�'Plans;(1)se#of�Energy�Foiins;F R-O=W;Permif for new;construction,
<br /> . Minimum�ten:(E1,0);wrorking;days;after„sutiinitfal:tlate:�:Required onsfte;-Canstrticd'an=Plans;StormwaferPlans w/Silt Fence installed,
<br /> ( , .. 5ariltary FeciUties,;&�1;dumpster,-Sits*Work:=P:_ermltfor.'stitiilivi5to'nsllarge:proJeCts`::�"�•<;`'.,., ,=� �
<br /> COMMERCIAL Attach{3)complete sets of'Bullding P1ans�ptus a Ctfe Safetyr Fage;{1}set of Energy Forms.R O-W Permit For new wnstruc�tton.
<br /> Mi�imum ten(10)working days afker submittal date. Required onsite,ConsUucUon Plans,Stormwater Plans w/Slit Fence Installed,
<br /> Sanitary Fadlitles&1 dumpsier.Site Work Perm.lt for ai!new:proJects�Ai!cammercial requlrements must meet compltance
<br /> SIGN PERMlT Attacli{2)"sets cf�Eitg�nee.�ed=.F_.lans;�,;:;t�-a'.`% ,.. . }�.�.r , .. ' �
<br /> "'"PROPERTY SURVEY:requirecl for aIN NEW conshuctlan., _
<br /> Dlreatlons: �.,...; . . _ �
<br /> �FIII out applicadon completely.
<br /> Owner&C,ontraGtor stgn back of appiicat[on,notatized
<br /> if over�2500,a Notice,of CommencemeM Is required. (AIC upgrades over 57500) . ,
<br /> , ;..�s,f�,;;�,;,��,
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<br /> " Agent(for the coatractor)or,Pbwer of Atft�riiey(fii�tFie ciwner)would be someone with natadzed letter ftom ov�mer authorizing same
<br /> DYER'fHE COUNTER�PERMITTiNG, ,....{Front.of Application Only} -. . • 1 • �
<br /> Reroafs If shingles Sewers Service Upgrades A/G Fences(Plot/Survey/Foatage)
<br /> Drivewaya-Not aver Counter if on pubtia roadways..neecls�ROW � ��'� �
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