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813-780-002Q City of Zephyrhills Permit Application Fax 813-780-OQ21
<br /> � , Buitding Department
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<br /> Date Eteaelved Phane Contacfifor Permittln ' 7� �� `� _ t ���
<br /> Owner's Name W +�-��/C' ��5���� �`�- �� �Awner Phone Number
<br /> Owner's Address Owner•Phone Number r- �
<br /> Fee Simpte Titleholder Name � � Owner Phone Number � � ,
<br />'� '••_� .�
<br />' Fee 3lmple Titleholder Addres� '"
<br /> JOB ADDRESS �� � ��� �L � f"F���5 FL LOT# C�
<br /> SUBDIVISION � � PARCEL.IR# �
<br /> (OBTAINED'FROM'PROPERTY TAX NOTICE)
<br /> WOR1C PROF'OSED `� NEW CONSTR ADD/At.T � SIGN Q � Q DEMOLtSH -
<br /> INSTAL,L REPAIR
<br />; PR4P05ED USE Q SFR � GOtu1M [� OTHER"
<br /> TYPE OF CONSTRUCI'ION � Q BLOCK " �Q � FRAME � STEEL Q, �
<br /> i' J� t
<br /> DESCR�P110N OF WORK ', i/�M�� l�I G� -
<br /> BUt�DtNGSi2E � � SQ FOOTAGE�� HEIGHT ���
<br /> o����a,N� C . � -� -�_ �,_. . ._ _
<br /> VALUAi'iON OF TOTAL CONSTRCICTION
<br /> QELECTR1GAl. $��. � AMP SERVICE ' Q FROGRESS ENERGY Q W.R.E.C.
<br /> �..�
<br />� �PLC1M8lNG ���
<br /> I
<br /> ( QMECHANiCAI $ V,4LUATION t?F MECMANIGAt,tNSTAl6ATlON
<br /> , ..
<br /> �i OGA3 Q RQQFlNG Q SPECtRi.Tl [�] OTHER
<br /> FINISHED FLOOR ELEVATIONS r`� FLOOD ZONE AREA [�YES: NO
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<br /> �ui���R � � CflMpA�IY �`����L1� ��r'`�t�1�
<br /> SIGNATURE REGISTERED N �e cuttRen N
<br /> Address Cicensa# C��� r7 4-���o� ��
<br /> E�EC't'RICIAN COMPANY '
<br /> SIGNATURE �' REGISTERED Y/ N FEE CUFtRE� Y/N
<br /> Address `Ltcense�#,� �
<br /> PLt1MBER COMP.ANY- , ,
<br /> SIGNATURE REGISTERED � ,Y/.N � •FEE CURRE� Y/N.
<br /> /lddre8S . LiCQ11SA# � �
<br /> i MECHAi�ilCitl: , .COMPAFtY
<br /> ,, SIGNATURE ,Re�is7�o _Y.;/ N ,Fee cuw�en Y/�N' .
<br /> ; Addre�s` , t : , ° . _ � _� Llcense# � I
<br /> ��� O'iHER , COMPANY �� � - . - -
<br /> SIGN�TURE ' rtEG�STE�o Y/ N>.. ; �EEcurt�� . ; Y%N� .
<br /> � Addr�ss . . _.. `;- . .. ._ , _ . .. � . . _ '-Li�cense# �� �
<br /> RESID�NTIAL� -Attai�.2 P!o#`;P.,lan's�.:� SA�S-Of k� { _ , „ '- • ' , j 4. `Y:�, : ��-:. ��<.,.'.� ,
<br /> { )` ,.( }. 8ultding'Plaris;(4}sef of=Energy;Foilns;12-0=W�Perinit:for.iieini,,c9nstruc#ton,.,�
<br /> . . . 9 . " _ .- , - ... . . �. ..,:. ,: _,
<br /> Minimum,.ten;(10.)�workin �;days�afte'r„'su6mittal"date.�Requlred onstte,•Constitiction�Plans;�Stortnwate�'Plans w/Sllt Fence tnstalled,
<br /> �� �Sanitary�FaciltUesr&a1{dumpste_r,�-SIte:WorlcAPerrnft,forsutidivislons/lerge`proJects�'',`=��';;',� °,_ ':s� " �`
<br /> COMMERCIAL Attach{3}'coinplete`.s`e#s tif Btillding�Pians plus a'l:lfe Safety Page;(1}set of Energy Forms.R-{?W Petmtt for new canstructton.
<br /> h7�nirr�um ten(10)worktng days after submittal date. Requlred onsite,GanstrucNan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanlfary Fadlitles&1 dumpster.Site Work Permtt_for�It n+auv`proJects.All commercial requirements must.mest camp4fance
<br /> S16N PERMIT Attacli{2)"sets ot"Engineer.ed;,Plans;,.;,,,.�, • . - . . .
<br /> ' """PROPERTY SUR1lEY regulretl for;all NEl(V construction..
<br /> Dlreatlans: ;, .`::.. _
<br /> �� FIII out epplicaUon completely.
<br /> Owner 8 Contracto�sign back-of appllcallon,notatized
<br /> j if over 52500,a Natice afCommencement is requlred. (�4/C upgmdes over f7500)
<br /> � �„ t`�.,is t��:rr.,,
<br /> li Agent(for th�e contracfor)or:Pbwe`r of Attorriey-(fo�#ti'e�owner)would be�someone with notarized letter from owner autho�izing same
<br /> ' "C)VER THE CQUidTER..P.EitMl'fTiNG -- (Front-of�ApPlica�orrOniy)
<br /> � Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> i Drivswaya-Not over Counter N on pubiic roadways.needs ROW
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