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813-780-0020 City of Zephyrhills Permit Applicatipn Fax-813-780-0021
<br /> Buiiding Department
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<br /> Qale Recelved � �
<br /> � - � Phone�Ca ct for P rmltEie –
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<br /> Owner's Name t. ` Clwner Phone Number
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<br /> Owner's Address / - � � � Owner Phone Number
<br /> FeQ Slmple Tltleholder:Name � � Qwner Rhone"Numtier '� �
<br /> Fee Simpta Titleholdec Addresa - '
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<br /> JQB ADDRESS � LOT#
<br /> SUBDtViS10N � .- � •- PARCEL Id# ` -
<br /> . �� � , (09'�AINED FROM:PROPERTY:7AX NOTIGE)
<br /> WOE2K PRQPQSED � NEW COt�t57R` , , . . ADQlA1:T �` S1GN- 0 ;Q DEMOI.ISH
<br /> � e.� iINSTALL. � :REPAIR' . `
<br /> PRpPQSED.USE - Q� ' `SFR. Q cb�nM , Q �- -oz�t�� , , .
<br /> TYPE OF GON37RUCTION^,� �,Q �BLOCK' ` [� FRAME �] � 'STEEC '-�] ` . . .
<br /> DESCRIPTION OF WORK 4 ' ' . ` � ` , y
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<br /> BUII.DlNG StZE ,�� , �;$ti FOt}TAGE;�� ..,i�EE1GFiT'.; � -
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<br /> QBUtIQING $ . VAt;UATtON�OF"i`!'3YAL�COh1S'fF2t1C'FIO ;'. , , . .
<br /> QEt,ECTRICAi: � ,�i+r� ACVIP SERYIGE (��. .._ � �P O�RE g�PiERGY � Q W.R:E:C.
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<br /> QpLUNlBIHG .< � ��1f`t���
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<br /> QMECHANlCAL $ � VAl;UATION OF;MECHA[Vl.GAL,INSTAl1.A7'ION.
<br /> QGAS „ �Q ROOFIIyG .Q SPECIA�'FY � ; .OTNER• • -
<br /> FINISHED FLOOR ELEVA710NS r,^-111 � FLOOQ zONE AREA QYES. ,NO
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<br /> BUILDER C#,�MPi4NY": _-', _ _ ' = - . � '. `
<br /> SIGNATURE REGISTERED Y/ N "�'F�E cuwtEn ' � =.Y/N' "
<br /> Address �, � - -, � . , -1:SCense•#=
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<br /> ��ECTRIClAN, / .. 9'COMPANY� ' �1''t;} ' . � U t ,
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<br /> SIGiNATURE � � '' �' R6GISTERED Y N FEE:GURRE�u': ', �'°Y/'N"�:'
<br /> Addtes� : , _ _ , ._. _, , � ' , License;#,<<L_� ti. _ : ,. � .�. �
<br /> PLUMBER ' � � , GQMPANY --..- �.. ' �:, .� ��, , - - :. , ..
<br /> SIGNATURE'`s' r'� � REGIBTERE1a.�y. . ,. :Y:I�N„- :A�r-,.FEE C,UftRE� s: Y•/.N:� :,;;.
<br /> Atidf8is8 . � .. ,_,I:IGBTi$e.,#��,_,;_ _ . <. ,. �
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<br /> MEC[�ANlCAI: ` � , .. . . , :CQMPANX � . , .,...
<br /> StCiNATURE� y,; . , . � > �' • "°-. .
<br /> REGISTERED ,. Y./ N- , ;,,.FEECURRE�; : YI,N' "
<br /> Addrer;ss`:. _ . - " ,. , � _ . - , � ` , _� �� _.License#��( ._. . . � .
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<br /> OTHER � ' - ` � . � . �. � v�0iY1PAHX .
<br /> SIK3NATUR�' -. . - , ` ' , . , - � R�GI§7ER�i`- Y/ N.:.>;' . �E CUR�� Y/N.
<br /> Addces�� �4 ��= . , L:lcense#� �
<br /> 1tESlDEN't'i r <.rA#t$ctt 2 ePt �, ,�,., r ., . 4.,. :,r.,. ._:...�,..� .:..•:,s _ .. , .,. ._ . _ � .
<br /> A�;�- "{. ) ofsPlans;;(2•)sets:o��Bu�lcliiig�Plans::{1�:sefof�Eriergy��o"stris;R-0�{N�Perrriifforitewoonsttuc�on,, �
<br /> :°u=;:Minimum°ten�r1A =workia da aiter;,"submittail"date�'�R" uirei!`onsiEe'�'ConstrucHon�Plans;'•Stormwatei�'Plan's w/Silt`Fence inatalied
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<br /> � 8anita`ry Fadl(tle;s;&e'�;dumps�er;Site�Work:Pennit,for=�subdivlsions/largeaproJeds�:r�:;��,;;. _ ` •� '' - - ' - �
<br /> Ct}MMERCIAL Attac�tt{3)�ooinpleta sets`of Bulliiiiig Plaris P1us a�tfe Safety Page;{1j set o#Energy Farms.�R-Q-W Permit far nev�construc#Son.
<br /> Minimum ten(10)working days'after submittal date. Requlred onsite,Constnuctlon Plans,Stormwater Plans w/Sflt Fence instelled,
<br /> Sanitary Fadlides.&1 dumpster..Site Work Petmlt for aU new�projects::�All commerctal,[equlrements must meet compilance ` •
<br /> SEGN PEltIVi1T Attac�(2}"sets o#�Eiigi�ieer,edYPla�isr.�=>=:�,=j,'. , .. � „ � _ -� , • .
<br /> """PROPER7Y.SURVEY uired for,all•NEW vonsWction. � � -
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<br /> Dtrectlons: � . =- - � , .
<br /> FIII aut applicadon completely.
<br /> Clwner&Contrackoc slgn back af applicaUon,notarized
<br /> tf aver a2500„�.Nottc�,of.Commancemen#ia required. jAtC upgnades aver s�500}
<br /> `.x.v�:wl.t'r�il.^�:'. .
<br /> " Agent(far the'aontractor)or'Povuer of Attomey'(fo�tlie owner)�would be someiane with notarized letker from owner autho�izing same
<br /> DVER�THECOUNTERRERMI�i'�NG: _._.(Fronfof-ApPlicatlbn-i3nlyj.. .- _ ; ' ';:- ;.::' '' �,�...---"""--'"�"�;
<br /> Reroafs if shPngles Sewers Service Upgradas A/C Fences(Plot/Survey/Faotage) - �
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<br /> Driveways-Nok over Cauntar if on public roadways:.needs Rt7V41f '
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