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s�s-yso-oozo City af Zephyrhills Permit Application FeX-a��aaaoa2�
<br />` Bufiding Qepattment
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<br /> DateReceived Phone�Contactfar�Perntittin t^�1� �� � —�����
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<br />, Owner's Name Ownar Phane Hunnber
<br /> Owner's Address ° Owner Phane Number � '.j�
<br /> Fee Simple Tltleholder Name � � Owner Phone Number �' �
<br /> Fee Simple TIllehold�r Address
<br /> JOB ADDRESS 02� (�`'!�i"Ll /UI LOT# ��
<br /> SUBDIViSiON �� � PARCEL ID# / l� ��—' �� " b�1� �'�����"""G0�-�
<br /> (OBTAINED F.ROM PROPERTYTAX NOTICE)
<br /> WORK PROPClSED � NEiN CONSTR ADDJALT �� S1GN � Q pEMOLISH
<br /> INSTALL REPAIR
<br />� PROPOSED:USE Q SFR. Q GOMM [� OTHHR
<br /> TYPE OF CONSTRUCI'IOW �� Q BLOCK " Q FRAME �� STEEL Q �
<br /> pESCRIPTION OF WORK �S�G( �"� IC� -
<br /> BUILDITtG StZE �� �`SQ FOOtAGE�__�, HEIGHT�.. S�t _�
<br /> �$U«;��' $��o(`).ts 11 I ' VALUATION"{SF�TOtAI CONSTRt1G1'ION � ` '
<br /> .�
<br /> QEI.EGTR1GAl. � � AMP SERViGE Q PRt3GRESS ERIERGY Q W.R.E,C.
<br /> QPI:UMBING �p�� .
<br /> QMECHANICAL $ VA�IJATiON OF MECliANICAt.INSTALIAT!{aN.
<br /> ��� ' � A' .
<br /> I QGAS Q ROOFtNG .Q SPEGIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS ��� FI.00D ZQNE AREA QYES ,NO
<br /> au��Q��z /� .�s/ /� i� � �con��;a��r � Sj��s' £ ����;C.1'
<br /> SIGNATURE `�/ ���'�'C �'"'�'� '�-- �� REGISTERED Y/ N �eE cuaREn .Y/N
<br /> Address ��f �N� fi%�G i�+ ��� r"Y �G" •" L"(cense# � �
<br /> ECECTRlCIAN: . GOMPANY � ` - -
<br /> SIGNATURE !' REGISTERED Y/ N FEE CURRE�'� ' �Y 6 N'
<br /> Address ' ' Ucense#.��, �
<br /> i , .. -- . ,
<br /> I PIUMBER - COMPANY , --
<br /> � SIGNATURE , ;REGI5.TERED , Y./•N•, � FEE�CURFtE��� Y/N.
<br /> � Address � License#�� . N - . ���
<br /> MECHANIGAL` . . GOMP�WIC
<br /> i , - � . �..L,:_.. �
<br /> � SIGNATURE� REGISTERED .Y/ N FEE CURRE� Y/N'
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<br /> , Address.` , - � ` ' ' � License# � I
<br /> 071iER ° ,':GOM�PANY �
<br /> SIGNATURE - � � � ` �ReGiS7Er�� Y/ N..> " �e CUR�n Y/N
<br /> Addre�s , . . * license# � :�
<br /> .. .,..: ._,.. . ; j,y., ., . . . .,: •
<br /> . . ,�,._ �.. n. . _
<br /> REStDENf1At:` -Attacti`{2�,,P..Iot=P,laos,..t2)sets�af�Buililing�Plans�{'!}sefaf'Energy�Fo�s;.R=O=W:Perinit far new cons#ructFon,
<br /> . , Minimum�ten�(•1,0)?workingydays`a(ter,:subinitfal'date.=.R'equlred onsite;�ConstiucNon�Flans;Stortnwater'Plans w/SIIt Fence installed,
<br /> � �~� Sanitary Facllldes:&�1,dumpste_r,�Site•Work:.P,,ermitfersubd(visionsllarge�proJecfs, . � � �
<br /> _ CdMMERCiAt. Attach�3)compie�'se#`s"of Bu1l�irig Pians pius a�E.t€e�8afefy Page;{4}set af Energy Faims.R-Q W Permit for neW const+ruction.
<br /> Minimum ten(10)warking days�after submlttal date. Requlred onsite,Canstructlan Plans,Stortnwater Plans w/Silt Fence instsilled,
<br /> Sanitary Facilitles&1 dumpster._Site Work Pem►!t fer all new:projects:.Alt commercial requirements.must meet compflance
<br /> SIGiV PERMIT AttacFi(2}"sets of�Eiiglneared=P_lans.:-:-.; - . "
<br /> "`"PROPERTY SURVEY reyuireci for all„NEW cansfnictlan.
<br /> Dlreattans: � .- -- -. _
<br /> � FIII out applicatlon completely.
<br /> �� Owner&Cantractor stgn back of appi[catton,notatized
<br /> If over�500,a Nottce af Commenceme�t 3s requirsd. {A!C upgrades over 57500)
<br /> .. �_ .. � ,...,,:,. {-_.,.,�.�,...<.;.....r.,.:.Y�:.�-�.
<br /> Agent(for the contractor)'or>Power of Attomey;(far t�e�owner)'would,be'someone wlth notarized letter from owner autharizing same
<br /> k •;... ;. : .,.; � . .�,,. 4 , , �
<br /> OVER THE COUNTER-PERMi'i'fifNG��``.��:"��jFror�t�ofiAppitce8an Only).�;;, •
<br /> Reroofs if shingles Sewers� � 'Se'rvice Upgradi�s��NC � ,�Fences(PIoUSurvey/Footage)
<br /> _ _ � �-.._..., : .._. E:. _ , . � : ....r
<br /> Drlvewaya-Not over Counter if on pubNcroadways:.needs`ROW�`•�-" `
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