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813-T80-002Q Ci#y af Zephyrhills Permit Application Fax-813-780-OQ21
<br /> Bu�ldfng Department
<br /> Date Recetved J :.� —j��= �,{� �j .. Phane�Gontactfar Per�riittln ��� �`�Q� _ � 13`�
<br /> Owner'a Wame 1��� � � ��tr��t�u� '�U.-.`--�� Owner Phone Mumber �� � 7�'�� ���a
<br /> Owner's Address �� ��-�.IY��k_- H�Ll-. �J�"�. . Ownar.phone Number �- �
<br /> Fee Slmple Tltleholdar.Name � � ' � Owner Phone Number � �
<br /> Fee Simple Tltleholdar.Address �
<br /> �oe anoRess •�11 7 �(�1�74 Yl���-�".. }�11�-�- ��... ,.
<br /> LOT# C� ,
<br /> SUBDlViSiON �� � PARCEL Id#
<br /> (qBTA1NED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED •.NEvu CONSTR ADDlAL'f C�` SIGN Q Q pEMOLISN
<br /> INSTALL REPAIR
<br /> FROPOSED:USE Q SFF2 Q COMM '�] OTfiER
<br /> TYPE OF CON$TRUC1'ION Q BLOCK " C7 FRAME [,�. STEEL Q
<br />( DESCRiPT{ON OF WORK .Y?+ f�I��R�- �-V , X- �' � ��-��}-. �"�a.� ��`I��.. --
<br /> SUILDING SIZE �� � �-SC�FOOTAGE���, „HEtGHT'+����
<br /> QBUII.DiNG $ c� - - _ : �
<br /> VALUATiOt�i''"OF�TO'fAL�CO.STRLICI'IOid
<br /> N
<br />' QEIECTR1CAi. ,�$ � � AMP SERVIGE Q PRC?GRESS ENERGY Q W.R.E.C.
<br /> �_
<br /> QPUIMBING $ ' �
<br /> :C�� � ��,� ,
<br /> ' QMECMAfViCAE. $ YALUATtON OF�MECHANiCA{.INSTALlAT10N. �
<br /> � . , .
<br /> [�GAS Q ROOFif�lG ;Q SPEGIHL.TY C� CITHER• � �
<br /> FINISHED FLOOR ELEVATIQNS r�� FLOOD ZQNE AREA [�]YES. ,NO
<br /> L
<br /> BUILDER �t��Z�?.�� -� � OMPAf+IY�` � , .�'��F't�� ����
<br /> � SIGNA7URH � o $TERED Y/ N �FeE cuR�� Y/N
<br /> Address � � Cicense# �� ��
<br /> E�ECTRtC1AFt: : ,:COMPANY �
<br /> I SIGNATURE �' REGISTERED Y/ N FeE cuR�n ' '4 Y/•N` � '
<br /> li Addre� ` _ �� - e � ,. Llcense# �� �
<br /> ' PLUMBER COMRAHY ,
<br /> SIGNATURE' ` ` , ,.REGIS.7ERED . � Y:/.N�; • EEE CURRE� Y�l N. " '
<br /> Address , Ucense# �� . , � �
<br /> MECHANiCAI: � GOMPRNY ` �
<br /> SIGNATURE � REGISTERED „Y./ N ; FEE CURRE� Y./N
<br /> .. ,.,�, .
<br /> .. , , _. � � � � �
<br /> Address='�`, License#
<br /> 03HER - " . = � � `';COMPANY ,
<br /> SiGNATURE , ' � � � ` " REGisT�riE� Y/ N...,. FEE CURtt�n , Y/N
<br /> Address ' � � � � License#'� � �
<br /> RESIDENTIAL' :Attach'{2}rPlo#�.P,laris;{2}sefs;ofBuil`t11ng=Plans;{'1}sefaf:Energy=Foims;F2=0=W Perinitfor new consfcuctlan,. �
<br /> , ;-.;Minimum;ten,(:1,0),worktng,days,_after:subrriltfal`da#e::Requireil onsite,.ConstrticBon=Plans;"Stormwate�'Plans w/SOt"Fence installed,
<br /> "� `Sanitary�Facfl(des:&k1,;,dumpste_r.Site WorkxPertnit#or subdiyisions/large-proJects.. -.-_: � " �
<br /> COMMERC!/U. At#ach{3)�cor`nplete sets cif 8uitdt»g Plai�s plus a l:ife Safiaty Page;('1}set af Energy Fatms:R-0 W Penni#tar new wnstruotton. -
<br /> M1n(mum ten(10)warking days afker submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence fnstalled,
<br /> Sanitary Facllidas&1 dumpster.Site Work Permit tor all new:proJects:.All commerclal requtrements.must mest compliance �
<br /> StGN PERMIT Attacfi�'{2)sets of�Engineer,ed�Plaiis.;: ..�.-�: ` � .
<br /> '•""PROPERTY SURVEY required for all NEW canstrucUon.
<br /> Directlons: . , _
<br /> � F01 out applicatlon completely.
<br /> ' Owner 8 Cantractor stgn back of applicatlon,notarized
<br /> i Ifover S2S00,a NaNce af Commencement is reqaFred. (A/C upgrades aver 5T50d)
<br /> �« . ,.,�,�. ;.,
<br /> Agent(for the contractor)'or'Power of Attomey�(fci�tlie ouvner)would be�someone wlth nata�ized letter fram owner autho�izing same
<br /> ' C1VER THE CQUNTER.PERMiTTING. .�._(Ftont-af�ApPllcatlon Only).. ._ ' - `
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drivewaya-Not over Counter if on pubtic roadways..needs ROW' � �
<br /> I _.
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