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813-780-0020 City of Zephyrhills Permit Application Fax 613-780-002�
<br /> BuElding Departmen!
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<br /> Date Recetvsd ",-. ' __� _ . Phone-Gantact for Permitfin � �I � ��! � tc� Lt •
<br /> Owner's Nar»e - � t'�. � ...-: � i:{.(2G.Qr/Z, . ' • Owner Phons Ftdnttise..... r�tr �r b
<br /> Owner's Address' ��-S^� CYu�.I -�I U�(. � Owner•Phone Number � �
<br /> Fee Simple Tltleholder Name �� � Owrner Phane Number �� �
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<br /> Fee Simple Tltleholder Addres� `'`
<br /> JOB ADDRE3S .',S� "�' ' `! , I i/�• �-� :�GGc � �G. 3�S�Z . LOT# C_�
<br /> SUBDIVISiON � � PARCEL ID#
<br /> • (OBTAIPIED FROM PROPERTYTAX NOTICH). -
<br /> WORK PROPOSED °� NEW CONSTR ADDJALT � SIGN [�— Q DEMOL:ISii -
<br /> ' e INSTALL � 8. REPAIR "
<br /> PROPOSED U8E Q SFR '� COMM �- OT#iER
<br /> TYPE OF CONSTRUCTION' Q BLOCK "' '[� FRAME [� STEEL Q_
<br /> DESCRIPTION OF WORK ,+ �, U..S �C�Y� • �^ �-.G . .i�✓l v I �(' � �
<br />, BUILDINiG SI2E � � $Q FOCITAGE J�� �. HEIGHT , -.„S�'i-`�" d �� -�1 �
<br /> ��-��D���IA���� C� `�� S a � VAI.UATION'��F T'Ol'AL CQNS'1`Rl'JCTION ���7(�
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<br /> ��EL-ECTRtCA�. $,,�O �� AMP SERVICE ' Q PF20GRESS ENERGY Q W.R.E.C.
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<br /> " ` - M���Si�4£4lGAL $ VAt.UATIOf+t OF NIECHANtCAL INSTALIATIQN � t v��
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<br /> ��5���- Q FtOOflNG. Q SPECIALTY � QTHER ='�`F��l ��
<br /> FINIBHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES: NO �
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<br /> ' �G'ATURE f � ��' (�CCFMPANY �� r/l./��1�--
<br /> ,.�''� � REGISTERED Y FEE CURRE� /N
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<br /> Address S- ��� �� Ucense# � I
<br /> 'r � �`p� �-�./���.�.�..�. � �'a�
<br /> ��FcrRtcia� � ca�r�a�Y
<br /> IGNATURE t REGI3TERED Y/ FEE CURRE� Y/N .
<br /> Address rc.a .c.c�, � , - �ticense# (� f.%S'uS�-'
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<br /> � PLUMBER CQMP,Ai�llf° �
<br /> SIGNATURE RE(31STERED • 'Y/.N FEE CURRE� Y/N
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<br /> Address ;Llcense#
<br /> NIECNANlCAI: COMPAFtY . -
<br /> SI(iNATURE i REOISTERED Y:/ N . - FEE CURRE� Y/.N�
<br /> Address , , ��L . � Ucense# ��--�
<br /> OTHER C0IVIPANY,
<br /> SIGNATURE� � - " REGISTERED Y/ N � °FEE CURRE� ., Y/N .
<br /> Addreas _ . .. °� ' Llcense#'
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<br /> RESIQENTI,AI; --Attach,(2):PlofiPlaits;�(2)sets=of�Butlding.'Plans;(9 j sef of�Energy�Famis;R{}�UV°Pemiit for new,construc.tton,
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<br /> ,,Minimum;ten�(�1�0)iv�torking;day:s�atte�;sutimittail:tlate.�:Rdqul�ed�onsite;•CanstrucHon�Plans;�Stormwater Plans w/Stlt Fence instslled,
<br /> -5anitaryFaciliUes:851;,dumpsterSite�Wo,r,kiPermlt.fqr'subdi"vlslonsAargeprojects�-�.' ��:�A',..' ' =':
<br /> COMMERCIAL Attach(8)'coinplete sefs`iaf Buittfliig Plans plus a Ltfe Safety Page;{t)set o�Energy Farms.R Q-W Permit far new cansfruc�tton.
<br /> .-��""�� MlNmum ten(10)working days after submittal date. Required ansite,ConstruaUon Plans,Storrnwater Plans w/Silt Fence installed,
<br /> anitary Facllitles&f dumpster.SIEe Work Petmit for all'new':projects.All commerclal requlrements must meet compllance
<br /> StGtd.PERMIT A ati{2}"sets af'Engineered'4.P_lans:�;�.,;-�:- -.. ._ -,.: _, ,.
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<br /> " "PROPERTY SURVEY regufred.for;all.NEW constn�ction.,. .
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<br /> Directions: `.., .`` �: - _
<br /> FIII out applicatian completelq. -
<br /> Owaer&Cantractor stgn back of app8catlon,notarized
<br /> If aver.S2500,a Notice of Commencement ts required. (A1C upsrades over S750Qj _ - �
<br /> .. Agent(forth ,,�:;•:-,:<�s$��r:�' . ,__.._ .�. _.�.,- - - ._ . ,
<br /> e cantractor)"or:Powel'�of pttorriey(fur the ownerj would be someone wikh notarixed letter from owner authodzing same
<br /> DVER'THE COUMCER,EERMIlTfHG- -.. .(Pront:af Apptication On{y}- � ' " - ' -
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Foatage)
<br /> Driveways-Not over Caunter if on pubtic roadway"s.:neeiis Rt1W �
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