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a�8aao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Buitd'sng Department
<br /> Date Receivsd Phane.Gontact for Pennitt�n � t' �(}a� –�'Ql,�
<br /> Ctwnst's Nams C� ��`� ��`" Owner Phone Number
<br /> Owner's Address (G""/7l ����� � ��b Owner Phone Number � �
<br /> Fee Simple Tltleholder Name �� � Owner Phone Number � �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS J�D�/ L9 !G BO � �' /C/f%G GS �L� ��57 LOT# C��
<br /> SUBDIVISION �' eS '�� G'`��� PARCEL ID# �� � �l �03a t�6�o a7�'�
<br /> (OBTAINEO FROM PROPERTY TAX NQTICE)
<br /> WORK PROPt'3SED � e NEW CONSTR� ADDIALT � StGh! Q Q D�MOLtSH
<br /> INSTALL REPAIR
<br /> PROPOSED�USE Q SFR � COMM � QTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FFtAME �] STEEL Q
<br /> DESCRIPTION OF WORK °i�-�s � e (,,;� C�'~6LL� � �O/ll G'�S 'Y�_. L L�'D77'"7 G/4Ie.
<br /> BU1LdITIG SIZE �� �.SQ FOOTAGE HEIGHT C��
<br /> ���«����' � � VALUA710NjfJF T07'A�CONSTRUCTION
<br /> QEIECTFt1CA� � � � AMP SERVICE Q PRQGRESS ENERGY Q W.R.E.C.
<br /> [�PLUMSIRIG � �
<br /> QMECHANICAL $ ��/,��'�� VAWATION OF MECNANICAI,INSTALUiTIQN
<br /> /
<br /> OGAS Q ftOOFlI�iG Q SPECIAti'tY [� C}THEF2 "
<br /> FINISHED FLOOR EI.EVATI4NS ��� FLOOD ZONE AREA QYES NO
<br /> BUI�DER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
<br /> Address L:Icense# � �
<br /> E�ECTRIClAN COMpANY
<br /> SIGNATURE T' REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address Ucense# �—M —�
<br /> PLUMBER ' COMPAt�tY
<br /> SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Addrass License# + �
<br /> SIG ATURE �i'l7.P „ . �, „ „
<br /> *.. r
<br /> COMPAfi�11Y �}�/Q S G �� ��°
<br /> ,�-� REGIS7ERED Y/ N FEE CURRE� Y/•N
<br /> Address '�L}'�� �11e � Z�'�.� �3� License# �G>�����—�
<br /> OTFIER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CUR�n Y/N
<br /> Address License# � 1
<br /> REStDENi1At'. Attach(2}PI6t Plans,•{2}sets-of=8uilding`Plans;(1}set af Energy�Forms;R-{}-W Permi#for new construction,
<br /> Minimum;ten(�10):working;days aftec_subrnittal date. Requlred onsite,ConsUuction Plans,Stormwater Plans w/8ilt Fence installed,
<br /> Sanitary FacfllUes.&1:dumpster Site Work�Rem►it for subtlivlslonsllarge proJects _ �
<br /> COMMERC1At. Attach{3)�completr�sefs of Bciildiiig`Plans plus a,i.tfe Safety Page;{1)se#of Energy Forms.R-O-W Permit for new•cc�struction.
<br /> - Minimum ten-(10)working,days after submtttaf date:'-Requi�ed onsite,CanstrucUan Plans,Stormwater Plans w/,,ailt Fence installed,
<br /> Sanitary Facill8es&1 dumpster.Site Work Peimit tor all new proJects.All commerciaf requirements must meeYcompliance
<br /> StGN PERMIT Attach"{2)sets ofEnglrieered:P,lans... � � �
<br /> "`"PROPERTY SURVEY required for all NEW constructlon.
<br /> Directlans: � .. ---,
<br /> Ffll out appUcatlon complekely. `'�. , , . '
<br /> Owner 8 Contractor sign back of applEcattor�,notatizei! '�; . k .s' ,
<br /> If over S^�40,a Notice af Commencement is required. caic,u¢s�a�,s over s�soaj .-< - , �,__; .:;.; ;, ,
<br /> " Agent(for the contractoF)or Power of Attomey(for the owner)wauld be"'someone with notarized letter from owner authorizing same
<br /> OVER THE Ct�UNTER P.ERMITEfNG ;:(Front of Appllca�on Oniy),�' ' '� � `�
<br /> Reroofs If shingles Sewer� Service Upgrades,A/C�; ,Fences;(Plot/Survey/Footage) - - - . _ '
<br /> ., ,:;� ..� .. ' �;;y ' �.• , � - - _
<br /> Driveways-Not over Counter if on pubHc roadways..needs,ROVH� � • , � .- ;; - �
<br /> - . -.- , . -, ..�,,, . _,....,. _ , r;, ;4 .. ,,t, . •- ..
<br /> ,. . „ �
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