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813-780-aozo City of Zephyrhills Permit Application _ Fex-e�aa$aoo2�
<br /> , Buiiding Deparkment .
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<br /> Dat�Racstyed Rhone=Cantact for�Perm[tfin
<br /> Owrner's Name � � Owner Phons Number
<br /> Owner's Address ! � � Qwner Phone'Number • � �
<br /> Fee Simple Titlehalder Name � • � Owne�Phona Number ��' ' �
<br /> Fee Slmpla Tltleholder Address _ -
<br /> J08 ADDRESS "Y r}' E'� � �!f" r� LOT# C�
<br /> SUBDiVIS10N �� ] PARCEL td# — � � "'(�} �
<br /> (OBTAINED F,ROM.PRdPERTY TAX NOTICE)
<br /> WORK PROPOSED. �,HEw C4N5TR ADQ/A�T � S1GN` Q Q DEMOI.ISH
<br /> -e, INSTAI:L 8 REPAIR
<br /> PRC?POSEQ•=USE Q SFR Q 'GQMM C� OTh{ER ' �
<br /> TYPIE OF CONSTRUCTION • Q ' BLOCK Q FRAME � STEEL Q
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<br />, DESCRiPTIQN OF WORK ¢ ' �'✓
<br /> BRl1GDING SlZE �� �` 34 FOt3TAGE ' , HEIGNT .���
<br /> QBUI�DING $ } .-� --..- . .
<br /> , �^a�r �., VAI.UATtON``OF�'Ol'ALCC3NS'f`Rt:lGIION
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<br /> QEI..ECTRICAI $ - AMP SERVICE Q PROGRESS ENERGY Q W.E2.E.C.
<br /> QPi:t1MBiNG ��— _. G0�'���
<br /> � a
<br /> [�MECHANiCAL $ ' VAl.UATION OF'MECFiANlCAI iNSTALIATIQN
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<br /> QGAS ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES NO '
<br /> BUtl.DER COMPIWY�
<br /> SIGNATURE REGISTERED Y/ N �e CurtttEn � Y Y N
<br /> Address Ltcense# � �
<br /> ECEC1'l7tC1AN,, ° C'tJMPANY ' ' - .
<br /> SIGNATUR� '� �GIs7eRED Y/ N FEE'CURRE� '� "Y/N
<br /> Addr8s8 . . , _ � , L.Iq@ASe# �° ,�
<br /> PCtIMBEt2 ' . COMPANY ' ., �
<br /> SIGNATURE' ' _ :REGIs7eRED Y�/..N ,-FEE�CURREN . ' Y/N
<br /> Addre�s ` , k + l.Icanse# I,... - . . �
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<br /> MECF!!4NlCAL" � ' � ` � CC?MPANX : `� �; _ ;
<br /> SIGNATURE� � ` � ` REGI§TERED .� � Y_/ N . ., ; FEE�cuw�n Y/�N
<br /> I Addres�s'1 . . . '- . ` Licens.e# ( �{�,( `.
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<br /> i07#iER : � � ;Ct?lI�PAN'Y C� r/'tA
<br /> SIGNATURE - �` REGISTERED ' / �•FEE CURRE� � . Y/N
<br /> � ,,,��- � . �
<br /> � AddrBss ..C� ,� — , . F:itferise# ������ �� j�
<br /> .,T .� .. �: i"�Y: . .. �`. . , .• '
<br /> RE8IDENT4ALt'°: Attacti;(2).;PtofPlans;�(2}set`s.ofBu[I�ing'Ptans;{1}sefof-Energy�Fonns;'R-O=W-Peimitfar�awconsttuc#tan,
<br /> � -, Minimum;rten�(�10):working;days;aftei_"submlttal`date::.R`equtretl onsite,.�nstiuoHon'Rlans;Stormwater Plans w/Stlt�Fence Installed,
<br /> ' ��y 5anttaryFaci�litie5s;&,1:dumpsterSite;Work,,Permit#crsubdivlsfon§/large:projects_,._ ,:. � ` -
<br /> COMMERG114� Attach{3)�cbin}itste sets'tif'Bultiliiig Pla�is plus a tlfe Safety`F'age;(1}set of Energy Forms.R-O-W Petmit#ur ne+ni constructton.
<br /> Minimum ten(1Q)working days after submittal date. Required onsite,ConstrucUon Plans,Starmwater Plans w/Silt Fence instelled,
<br /> San(tary Facilides&1 dumpster.Site Work Permit for all newprojects::All commerciel requlrements.must meet compliance`
<br /> ( SIGN PERMIT Attacti(2)`sets cif'Eisgiiieered�Piaiis.: .r.�:��-- _ �� -
<br /> I "•"PROpERTY SURVE'1f requlred for all_NEW,constnuction.
<br /> Dlre¢tlons: � r � • - ' ',
<br /> Ffll out applicatlon completely. �:.T,' ' � ` r 1 �,
<br /> Ownar&Contcaotor slgn back of applfcaflon,nolarized ( '•1�• '� � �1 ' `, { ,
<br /> i !f ovar a2500,a Notics of Commeacement!a reqglred. '{A(¢up�radeg!+over 57500} . -...--�j'{-� w ?,�"' _
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<br /> " Agenk(for tfie contractor)or Power'of:Attomey(fo�tlie qwner)would;�ie;5om+e�one with notarized letter from owne�aGthorizin"g"�same"�'.�: " "� " ",�', �
<br /> �, �:-;:,.> � _a�.� , '- ; � � � �; ��,.�� . .� „ , t ..,
<br /> DVER THE COUNIER.PERM17'C1NG---.,._�(Fron#af�APRlIca#3on.t3rrly)=;�''��:. ';�..� , � x' , i .-s;t<< . , � ,
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<br /> Reroofsifshingles Sewers ServiceUpgredes j4%C�r ,.,'Fences�fPioU�urvey/Foatage) i; �. . .t:� �:�: � ���'_. :: ��. ' ..
<br /> .-- :='i; �` �t ,_.� .,�,�.�:.,: . „ .., ,._ +`' ;;a; .;�
<br /> .. _, ._.. ': ._ . '..� '�ir..-zi:: .�,a:^:�r�l. - � , _. . _. � .. ._ ...
<br /> Drlvewaya-Not over Caunfer if on publlc roadways:.iieed"s��RG1W LL�� `. """". � ;r .-.�_ . __ _= ��. �- r •- . � •
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