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8�saso-oo2a City af Zephyrhills Permit Application Fax-813-780-0021
<br /> Buiiding Department
<br /> qate Recelved --� -�'� p}y��$,�otttact'far Permtttin -
<br /> Owner's Name � � '�1�i'�L (,:."��i1' Owner Phone Number �3" ! ��'+�3� ,� -
<br /> - .
<br /> Owner's Address . � , �L(,. � V OwnerPhane Number � �
<br /> Fee Slmple Tltleholdar Name �� 4N1���L., C��,� � Owner Phone Number � �
<br /> . �
<br /> Fee Simple Titleholder Address �
<br /> JOB AClDRESS W 1� C��� ����2Q�" Z�PI� 1�'�1 1 LOT# C__��
<br /> SUBDIViS10N �� � PARCEL ib# -o� ��� - �i� -a��.�a - i t�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> V4fORIC PRQPOSED 4 NEW CONSTR ADDJALT � 81GN Q [� pEMOLISH -
<br /> e INSTALL 8 REPAIR
<br /> PR4POSEO USE Q SFR Q GQMM � QTHER
<br /> TYPE OF CONSTRUCI'ION Q BL.00K ` Q FRAME � STEEI. Q
<br /> DESCRIPTfON OF WORK � � � •
<br />� BRli1.DING SiZE � � SQ FOOTAGE `�,�1�'J HEIGHT �—_ �
<br /> QBUII.CNNG �� - .._,�. -
<br /> �.,; : ,_
<br /> 111 1 VAtUA710N pOF�TOTAI CONSTRUC710N
<br /> �(�ELEGTRICAI. $ �� AMP SE CE Q PRQGF2ESS ENERGY [� W.R.E.C.
<br /> �UUt l�� .
<br /> QPLUMBlNG $ ��
<br /> [�]MECHANICAL $���.�� '' VALUATtOEV OF MECHANICA�tNSFACLAT101V ' �����
<br /> � � (�
<br /> [�GAS [� ROOFING � SPECIA�.7Y C,� 03HER ���r t
<br /> � Z 3�
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<br /> FINISHED FL40R ELEVATIQNS FLOOD ZQNE AftEA QYES,- _ NO
<br /> BUtLDER Cp(yPqHy
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N .
<br /> Addres� Licerise# � �
<br /> ��ECi'RtC1AN �• �y,� �,� COMPANY ��t t4ct �(¢c �c .�,.��
<br /> SIGNATURE �� REGISTERED Y/ N FEH CUFtRE� Y/N
<br /> Address License# �` �
<br /> PLUMBER �� COMPANY
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �� �
<br /> SIGNA7URE , ��`��— coMPa�„r ���fZ G�N�'7�.tx.. S�Zv��3 ��c+►.
<br /> REGISTERED Y./ N FEE CURRE� Y%N
<br /> Address License# � �
<br /> OTHER COMAANIt . ,
<br /> SIGNATURE ,,_. REGIS7ERED Y/ N ��EE cuttRen , Y%N
<br /> Addreas i , License# � ' �
<br /> RESIQEI�TIAf. Attach{2}Ptot Plans;.(2)set's=of:Building Plans;{i}set af Eiiergy�Forms;R-0=W Periiilt fa,r'new constniction,
<br /> Minlmum ten(10),working"days,after,.submithat date. Required onslte,ConsUuction=Plans;��Stormwater`P1ans w/Silt Fence installed,
<br /> Sanftary FacillUes;&.1:.dumpster Site WoricsRermit for subdivisionsAarge projects' .
<br /> CQMM�RCIAL Attach{3)camplete sets`of 8u11dirig Flans pius a t�fe Safe#y Page;{1}set of Energy Forms.R-{1-W Pemtit far new canstrvction.
<br /> Minimum ten(10)working days'after submlttal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> SaMtary Facilides&1 dumpster.,Site Work Permit for all new proJeats:Ail commercial requlrements must meet campllance
<br /> StGN PERMIT Attactf{2}seGs of Erigineered P_lacis. ' : -
<br /> ""'PROPERIY SURVEY required Forali NEW construction. � •� � � ' � � • � ' �� � "
<br /> Qlrectlons: . . .,, .
<br /> FIII out applicatlori completely.
<br /> ` Owner&Contractor sign back of appl(catio�,nolatized
<br /> � If aver�2500,a Notice of Commencsment ts.�aquired. {NC upgrades aver$T500) . , ,
<br /> , '" Agent(for the contractor)or Power of Attomey(for the owner)wauld be someone with notarized letter from owner authorizing same
<br /> C3VER TNE COUNTER,PERM1'TTING' (Front of Applica#ion Only) - .
<br /> Reroofs if shingles Sewers 3ervice Upgrades A/C Fences(PIaUSurvey/Footage)
<br /> Drlveways-Not over Counter if on pubi[c roadwa naeds:ROW...: _,. ,,,.....,- -._....•- `ti' '-:�' -----__:•_ __ ...•� � ... ..
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