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813-78Q-0020 City of Zephyrhills Permit Application Fax-813aeaoo2�
<br /> � Buitding Qepartment
<br />� Date Received � �� � ° Phane�Cantact for�Percriittin �� – ��`-' !
<br /> Owner's Name f Q 't �-� Owner Phons Number
<br /> �—�.
<br /> Owner's Address Owner Phone Number� -
<br /> Fee Simple Tltleholder Name � � ' Owner Phone Number �— �
<br />� Fee 3lmple Titleholder Addresa
<br />� JOB AbDRESS C�1`1� � LOT# ��
<br /> SUBDiViSiON P.ARCEL ID# �`
<br /> (pBTAINED F.ROM PROPERTIGTAX NOTICE)
<br />, WORK PROPQ$ED- Y NEW CONSTR . ADptAIT � SIGiV` Q `[� pEMC?LISN
<br /> ' INSTALL -REPi41R
<br /> PROPOSED:USE Q"� SFR• Q �CC1MM Q C?THER '
<br /> 1YPE QF CONSTRUC110N Q 'BLOCK `" Q FRAME � �] 87EEC Q
<br /> DESCRIpTION OF WORK - �Y� �
<br />� Bt711D1A1G S[ZE � - � � SQ FOOTA4iE MEIGHT ����
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<br /> QBUII.DING $ '`''� .�.... .�,_.. ...,v., ._..� _
<br /> �11 I VALUATiON:OF 30TA1.'CONSTRUCTION
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<br /> QELECTRIGAI. �$ ' � AMP SEF2VICE Q FROGRESS ENERGY Q W.R.E.C.
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<br />� �UMBlNG $(?F1� �(�}� "
<br /> "�CJ
<br /> ') QMECNANICAE, �� VALOATlON OF MECHANICAI.IN3TAI.LATION �
<br /> QGAS Q ROOFI{�tG :Q SPECIALSY; Q C?TFiER
<br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA [�YES NO
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<br /> ` BUF�DER COMP74t�IY� - , .
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � License#'r'� �
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<br /> ElEC7RiC1AN: =COMPANY - .
<br /> SIGNATURE �' REGIS7ERED Y/ N FEE CURRE��' '��Y/N'
<br /> i Addresa , , � . License# ' : / . � t �
<br /> � P�UMBER ' COMP.:ANY . , ,
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<br /> ', SIGNATURE' " ' ; REGIS.7ERED Y./,.N�, _hEE cuRRE��� , Y•/N.
<br /> � , _ , � � . � .
<br /> IAddress ` . License# �- ^t� .
<br /> � MEGHANICAL` � COMPANY � . ,
<br /> I SIGNATURE� ` '" � REcis7�Reo � Y/N �E Cu�n Y�/:N �
<br /> i Address`: _ �� . , _ _ . « _. � � L`icense#�� � -
<br /> �` t�'fHER , ;GaMPANY � �� � �_ �.� O
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<br /> . :z. . � �,
<br /> • -. .. �; �.
<br /> � 81GNATURE "'Y'- . '( ` "REGISTEREn Y/ N;. � FEE CU , � Y N ,
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<br /> AdBress ;.� ��r��,•{� -�C�-�� - , � - . Licenae#' C� � � ��.3���
<br /> RESIDENTIAi:�t.. �Attac#i`(2j,;P..lo#�Rlans;:(2}se#s:of:Bullding�Plans;(1}ssfof�Energy�Fain►s;'R�W Peirnl#fot new canstruc�on,
<br /> ;�:Minimum:ten,(10),working;days;after„subml.ttal'dat"e.� Requlred onslte,�ConstnicUon�Flans;Stormwater'Pians w/SIIt Fence installeii,
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<br /> Y �Sanitary Facillyes;&a-1,dumpster°Site Work;Permit#ar subdtvislonsllarge pr6jects .:_ � _ __
<br /> COMMERCIA[. Attach{3}compfete sets�of Saltiltrig!'lans'plus a�!lferSafaty Page;(1}set of Energy Forms.R-O-W Permit for new canstructton.
<br /> Mintmum ten(10)working days after submittal date. Required onsike,ConsUucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Santtary FactliUes&1 dumpster.Slte Work PermiR for all ttew.:proJects:All commerGal requlrements.must meet compliance
<br /> 51GN PERMIT Attacti{2j sets ofEngineeted=.Pians..,:-,-�T: . . _- . - - , . �
<br /> ' ""PROPERTY SURVEY required for ail,NEW constructlbn.
<br /> � Dtrectlon�: . ..�_ , -
<br /> Fill out applicatlon compietely.
<br /> Owner 8 Contractor stgn back of appllca@an,notadzed
<br /> if over�2800,a Ftotics af Commencement is requlred. {A►C upgrades over ST500) _
<br /> ,,.t.;,, -,�..�;.,;'.,_ . .._ , - .
<br /> Mk Agent(for tlie contractor)"or Powe�of Attorimey(fo�the owner)would be�someone wlth notarized letter from oymer�autho�izing�same�•�= ��•,: ..•
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<br /> CIVERTHECDUNTER.FERMITi1NG-• - �(Frontof�Applicatlon-Onlyj-- " � �, • -, „ �
<br /> Reroofs If shingles Sewers Service Upgrades A!C Fences(PIoUSurvey/Footage) , � ��,�; . . . ; , „
<br /> _ _ ._. - -+ , .
<br /> Drivewaya-Not over Counter if on publia roadwa}+�..�eeds ROW ° �-- _��•� � - -� � -- ' :••�I
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