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813-yso-ao2o City of Zephyrhills Permit Application Fax-813aao-ooa�
<br /> ' Buitding Qepartment -
<br /> Date Recelved ' Phone-Conkact far Perrnitting j f��3 7� - �'�� �
<br />� Owner's Name ..civtr,t.� � Owner Phane Numb�r ��3-�c��" �.s�'1 t
<br /> Owner's Address `���� �a.�e� �'`^'^� �'�-- Owner Phone Number �' �
<br /> Fee Slmple Titleholder Name � • � Owner Phone Number � �
<br /> Fee Simple Tttieholder Addres�
<br />� JOBAbDRESB � � �J I �� LOT# t�„�
<br />` SUBDIVISION �— � PARCEL ID#
<br /> - (08TdUNED FROM PROPER7Y TAX NOTICE)
<br /> WBRK PROPUSED NEW CONS7R ADD/ALT Q 81GN Q Q DEMOLISH
<br /> , e INSTALL 8 REPAIR'
<br /> PROPt�SED USE Q SFR Q COMM � OTFlER
<br /> 7'YPE OF CONSTRUG710N Q BLOCK R Q FRAME � STEEL Q
<br /> pESCRIPTION OF WORK � /"4
<br /> BUILQING SIZE �— � SQ FOO7AGE I.� � IiEIGHT C��
<br /> QBUiLDING � � VALUATION OF TOTAI.CONSTRUCTION .
<br /> QEIECTRICAL �� AMP SERViCE Q PROGRESS ENERGY Q W.R.E.C.
<br /> o����$��� �----� �t�"�'� � �u o c
<br /> QMECHIWIGR� $ V,4�UATION OF MECHANICAL.lPtSTAL1.AT10N J C{3�}�'Q'�C�
<br /> .; � �s G�S
<br /> [�GAS Q ROOFIRlG ,� SPECIAl.TY � OTFIER
<br /> FINISHED FLOOR ELEVATIONS f r � c90 FLOOD ZONE AREA C]YES NO
<br /> ��, �
<br /> BUILDER COMpANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# r u ��
<br /> Et£CTRICIAN .� COINPANY
<br /> SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address License# �� �
<br /> PLUMBER � COMPAI�tY
<br /> SIGPIATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � �
<br /> MECHANICAC COMPANY
<br /> 51GNATURE REGIS7ERED Y/ N FEE CUFtRE� Y/N
<br /> Address License# C� �
<br /> OTHER J����"� COMP/1t+tY `
<br /> SIGNATURE � REGISTERED Y/ N FEE CURR Y/N
<br /> Address (2- �%`1� �}{ � Licen'se# �C�.-�J`��� ��--��
<br /> RESlDENTIA�. Attach{2}.Plot�P.lans;.(2}setsaf.Bullding'Plans;{1)sef afaEriergy�Fartns;R O-W Pertnit far new canstruot�on,
<br /> Minlmum:ten.(,1.0)�working;days.after.submithal date: Required onsite,Construc�on Plans;Stormwater Plans w/Slit Fence installed,
<br /> Sanitary FacGtUes&�1.,dumpste,r,Site`Wot1c•P.ermit for subdivislons/large projects ' �
<br /> CONIMERCIA4. Attach(3}�compiete setis of Buildirig P1a�s ptus a�ife Safety Page;(1}sat of Energy Forms.R-O-W Fetmit for new c:onstruotion.
<br /> Mlnimum ten(10)working days after submittal date. Required onsite,CanstrucUon Plans,Stormwater Plans w/Silt Fence installed, �
<br /> Sanitary Facilities&1 dumpste�.Site Worfc Permft far alt nei+v pro�ects:Ril c:ammerc9ai requirements must meet compifance
<br /> S1GF!P�RM1T At#acfi`(2)sets of Engineered-Ptans.; � • �. .
<br /> •"•PROPERTY SURVEY reyuired for all NEW canstrucHan.
<br /> Directians: ;�,, r '� � '
<br /> Fill out applicadon completely. ��� � � � �' � ' j
<br /> : ,, . ` . ! , ; , �
<br /> Owner&Contractar slgn bacic of applicatlon,notatized .�.' ' °�� ; t,;. � . t ;; `. � _,t' .
<br /> if over S2S00,a Notice uf Commencement la required: (NC upg�des over$7500) " � ���-� �
<br /> " Agsnt(for'ttie contractor)'or Power of Attomay(for the owt�er}would be someone•-with nokarized letter fram ou+mer authorizing same ��
<br /> DVER THE CQUNTER P.ERMIITING - Pront of A tication„Onl • .,..•, _-�-• •.:--. ^`_,'•"°�;`."`.`'"''t
<br /> t PP Y)-•�:�� .:
<br /> 9 ?•u�•- � p9� � Y 9 ) ;...•.._ ,;�-•�, -.. .�
<br /> Reroofs if shin les Sewers -.Serviae'U`"�rades.A/G � •.�Fence§ Plot/Surve /Fooka e . '� � 'r,
<br /> . � , - ' , .-� '`;t.;. ,::� a,
<br /> Drlveways-Not aver Counter if on putilfa rriadways.:needs ROW ;' . .� "'�,.. '"'• "`+� '
<br /> „t;�� .,� _: :,;., I� `'; �.;. . - . ,� , .. ,
<br /> ' ' --�,.,,, � '�" ' �_.,. , n,..� � —�-'� ., . , ,...x,,., ,._.,.d...._.�.... .. -....,._..,._.._ .
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