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e�saeo-oo�o City of Zephyrhills Permit Application Fax 813-78p-0021
<br /> Bultding Department
<br /> Date Receivad phane�ContacEfor Pernitt#�n
<br /> Owner's Mame L{ /v-�' s� � Owner Phone Number t. �����"" 7��� �
<br /> a � �
<br /> Owner's Address `�� ra~ � � ` � Owner Phone Number
<br /> Fee 8lmple Tltlefiolder Name � � Owner Phone Number '�- �
<br /> Fee Stmple Tltlehold�ar Addresa
<br /> JOB ADDRE'SS � �--. � �� LOT# ���
<br /> SUBDIViS10N �� � PARCEL ID#
<br /> � , (OBTAINED FROM PROpERTY TAX N0710E)
<br /> WORK PROPOSED - NEw CONS7R ADD/A�T � S1GN [� Q DEMQt,ISH
<br /> �:- INSTALI. 8� REPAIR
<br /> PR4PQSEDiUSE Q SFR [� CQMM �,� �OTHER'
<br /> TYPE OF CONSTRUGTION Q BLOCK ` Q FRAME �, STEEC Q
<br /> DESCRIPTIQN OF WORK ' � ��� ��� �� L v ���
<br /> BUILDtt�G SIZE �� � �" SQ FOQTAGE C,-� HEIGHT .��`�
<br /> QBU1�DtNG � � VALUATIOPi:6YF'TOTAL CONSTRUCTiON � �
<br /> QEL�+CiR1CA! �� AMP SEF21110E Q PROGRESS ENERGY Q W:R.E.C.
<br /> QPI.UMBlNG - - . �
<br /> �„.,, �
<br /> QMECHANtCAL $ •�� �L� VALUATI4N OF MECNANIGA�[NSTALLATtON.
<br /> �o, ..� �
<br /> QGAS Q ROOFlNG .Q SRECIAI.TY � OTHER
<br /> FINISHED FLOOR ELEVATIONS ��� FI.00D 20NE AREA QYES NO
<br /> i
<br /> . 8U1l.OER COMPANY~ ` �
<br /> i SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
<br /> � Address = � , Lfcense# �� �
<br /> �
<br /> � ELECTRICFAN= , ::COMPAFtY .� .. , .
<br /> ; SIGNATURE �' REGISTERED Y/ N FEE CURREk' `Y/N
<br /> ; Address ' • . , ' � - License:#:� �
<br /> P�UMBER - CaMPANY _._ � .� _ .
<br /> SIGNATURE" " ' �RE(31STERED,. Y./<.N�. . FEE CURRED . . ' Y/N " .�
<br /> Addreas � License,# � �.
<br /> � f /'' �
<br /> MECHANICAC: ' COMPIWY I fh/S� -C. �V �
<br /> � 51GNATURE t ' � REGIS7ERED , Y/ N � FEE CUFERE� Y/�N'
<br /> Address'` - � , . . - License# ,. . 1��— - �
<br /> t3THEEt � ' - � - `;GOMPANY n .
<br /> SIGNA7UitE ' � � � ' " ' ' ' REGISTERED ' Y/ N... FEE CURREA Y/N. ,
<br /> ,.. . .. . -
<br /> Address ' . . . ' License# �� �� �
<br /> RESlDEN7'IAI:,;• Attac�i{2),:Plo#i:Platis;.{2}sets�.of�Bullding�Plans;{1}sef ciftEiiergy>Fa'rms;}z-O-IN'Feritiit for new ainsttuctton, - '
<br /> •-Mlnimum�tenK(,1.0)�workingydays;a#ter,;subrrilftal date:'Requlred onsite,:�Constriicdan�Plans;Stormwater'Plans w/SIIYFence installed,
<br /> .u.Ju.•Y':.�,�•_, ...!.. .�rt�._^,.nv.. � _
<br /> Sanitary Faclllyes;&:�1,�,dumpste_r,�31te�Work:Pertnit for sutidiVislohs!large.proJech's, . " • , ' -
<br /> GOMMERC#AI. Attach{3)comptefe seE"s"of Bu3lding Plans plas a I.ife Safety Page;{'9}set of Ene'rgy Farms.R-O W Petmit for rtec�i constructton,
<br /> IMinimum ten(10)working days'after submittal dake. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FactliHes&1 dumpstar.Slte Wark Permit for all new:proJects:_All commercia!requlrements.must meet camptlance
<br /> StGN PERMIT Attactt{2}sets of Eiigl%�eered=!?la�is.;-:..; , ; n _ ,
<br /> ' ••"'PROPERTY SURVEY required for aq NEW constructian..
<br /> Directian�: - -, .,,, - .
<br /> � Fill out applicatlon completely.
<br /> Ownsr&Contractor sign back of appiicatton,natarized
<br /> If over 32500,a Notice af Cammencement is r�quired. {AIC upgrades over b750dj
<br /> '" Agent(for the contractor)or'Power of Attotney�(fo�tFie owner)would be someane with notarized letter from owner authorizing same
<br /> OVER THE COUN'iER.PERMi'F'TlNG• -- {Front af-APPIIca�on-Oniyj_. __ . ' t -- - , _ •- • -j �
<br /> Reroofs ifshingles Sewers Service�Upgredes..A/C�: �...F,.ences.(Plof/Sur,vey/Foatage) •; �C;,�':.:;._ .. .
<br /> .__� � _ _ -- !`;e;�;.',.� ��. :�a`. �`� " ;t �' • 'tt ,. �. � _.. �r_1 -,. . .
<br /> Driveways-Nat over Counter if on public roadwayis.:needs:ROW,�: " ,_ z b� - . ���:t - ... � . ' , �- ,
<br /> � ''�`� � , . , �"IG'Y.- ;c!�j •�, .�i:,, . . ,, .�., • �'" ,
<br /> , _ ..,, . . , � -_ ;r.�t, `•`:.. � ' i . ._... . . .. . <. . -
<br /> .....� ,.._:v�.,rr.._ ....w<<.T.. ...�.. .. .
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