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<br /> 1 813aso-ooao City of Zephyrhills Permit Application Fax 813-780-0021
<br /> / Bu[Iding Department
<br /> � Dafe Received ° Phone�Cantact for�Permittin '
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<br /> --�Owner's Name •L Owrner Phone Number <�"'�d�f"���
<br /> —�Owner's Address � � (� V � Owner Phone Number �� �
<br /> Fee Simple 71Neholder Name � ' � Owner Phane Number �— �
<br /> Fee Slmple Titleholder Address
<br /> �08 ADDRESS � LOT# C_��
<br /> SUBpIVIS10N �— � PARCEL Id#
<br /> (OBTAINED FR4M PROPERTK TAX NOTICE)
<br /> WOEtK PROPOSEO • NEW CClNSTR ADDlA�T Q S{GN Q Q DEMCt1.ISH
<br /> �,,e: INSTAI.L 8` REPAIR '
<br /> PltOPO3ED�USE [� SFR Q CQMM � OTNER
<br /> TYPE OF CQNSTRUC'�ION [� BLOCK ` [� FRAME [_] 'STEEG [� �
<br /> DESCRIP710N OF WAR� �J L�. S 'i�✓
<br /> BUtLDtNG StZE I�X�'1��' �� SQ Fp4TAGE /?-ta _ .- HEIGHT t�__�,!�
<br /> ����i����'' � ��� � .�'i"} VA�UATION"tOF Tt)TAL CO�JSTRGCTION �
<br /> •fJ �[
<br /> QEl.ECTRiCAL $ AMP SERVICE Q PFtOGRESS E[titERGY [� W.R.E.C,
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<br /> OPLUMBING � � , � („�y�L�
<br /> � v
<br /> C]MECHANICAL ($! � VALUATlON OF MECHANICA�INSTALL,4Ti0i+!
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<br /> [�GAS Q ROOFIAlG .Q SPECIALT' � - . QTHER
<br /> FINISHED FLOOR ELEVATIONS �� F1.00D�ONE AREA QYES ,NO
<br /> � Y• • - " . '�` . � •�t' !t�� -_t �� t-���....� . � - _ _...___ __`
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<br /> --��,���R____ �"Ia �{ � -� � �r-��� �����-��T _. - -����. . '
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y-/N
<br /> Address - � , • Ctcense# � �
<br /> ELECTEtIC1AN. � 'COMPAP!!Y' " ' �
<br /> SiGNATURE � REGISTERED Y/ N F�CUwtE��^ �Y/N '
<br /> Addre�s , LEcense#:� �
<br /> PLUMBER ' .GOMP,ANY . ,. .
<br /> SiGNATURE'' ' �REGISTERED Y/..N•. � ',;FEE�CURREA �; Y�/N.'
<br /> Address . _-�icense# � , • , �
<br /> MECMANlCAl: � ` '�pj{�pp�,�y �
<br /> SIGPIATURE' REGIS7ERED ,Y.,/ N � FEE CURRE� Y/rN -
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<br /> Addre�s� - � _ ' , . � Cicanse# � �
<br /> OTliEEt - � , � , ','COMPA�tYi :' u '
<br /> StGF1ATlIRE " � ` •' ' ' � REGISTERED� Y/ N.,.. FEE CUFiRE� Y/N
<br /> Asidrass - � _ . �Ecense# 1 ` � �
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<br /> RESIDENTIAL � ;Attach�(2),.i?ta6Rlans;-.(2)sets.of'Buftiling`t?l�iis;(1)'sef of;Eaergy�Fa"tins;R=Q=W:Pertnit for new canstruction,
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<br /> ,� Minimum:ten,(:10);rn+orking;days:after,:submlftal-date.�:R'equired onsite,�ConstiucNon�Ptans;�Stortnwater Plans w/Siit Fence installsd,
<br /> "��j Sanftary Facil(ties;&;�1�,dumpste_r,�Slte WorlcxPermit for subdivislons/large.pro)ects . ; ,:'- ' � �' .
<br /> COMMERCIAf. Attach(Sycoiiipiete�sets'of Suitdirig Plans ptus a��(fe Safety�Page;{1}set of Energy Famts.R O-W Petml##or new construc�an. -
<br /> Minimum ten(10)working days after submtttal date. Required onsite,Canstructian Plan�,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Fadlitles&1 dumqster.Site Work Pertnit for all new�proJects:.All commerctal requlrements.must meet aompllanca
<br /> SlfN PERNfiT Attact�'{2}sets of Eiigineer,ed:,Plaris.. -. � - .
<br /> """PROPERTY SURVEY requlred„for ail NEW consWcUon. .
<br /> Dlreet3ons: , . .
<br /> Ftti out applicatlon compietely.
<br /> Owner 8 Contractor sign badc of applicatlon,notadzed
<br /> Ef over 52�00,�Notice a#Cammencement[s required. {AlC upgrades over 57500}
<br /> `" Agent(for the contractor)'or`Power of Attomey'(frar ttie owner)would be someone with na'tarized letter from owner autho�izing same-� ° ��• �� °-h
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<br /> �YER THE CCttil+fTER PEF2M}'i'TiAlG- --{Frortt of AppllcatiamOnly) - - . , �. _ _�'_ � . .,_- `
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<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) ; �� � - ,, -, -. �`°�'_ � -��
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<br /> Drlvewaya-NoE over Counter�€on public roadways..needs ROW .... .� _. ,Q_�q,_.,�..� . ..3.A.,..... ._
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