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<br /> easaeo-ooxo - - City of Zephyrhills Permit Application Fax 813-780-Q021
<br /> Buitding Qepattment _
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<br /> Date Recetved � --. � - - '~lphane�Caiitact for.Perrn�ttln -�
<br /> O�rner's Name � � �7 wn+ar Phone Nurr�ber
<br /> ��'Owner"s Address � ' Owner Phone'Number'-� �
<br /> Fee 5fmple Titleholder Name � � Owner Phone Number � �
<br /> Fee Slmple Titleholder Addreas •
<br /> JOB ADDRESS ! % � �� � LOT# ��_�
<br /> SUBDIVIStOPt �� � P.ARCEL ID# ',�. `�-"�`A�-� t..C,� � '
<br /> , (OBTAINED FROM PROPERTf.TAX NOTICE)
<br /> WORK PRaPf}SED �..NEW CONSTR ADDlAI� [� �81GN" �- � [� DEMO�tSH
<br /> , 'e. INSTALL -8 : REPAIR � C �
<br /> PROPOSED°USE _� Q SF12= � 'GOMM � OTHER .
<br /> TYPE OF CON$TRUC710N � Q� BLOCK * 0' FRAME �] STEEL [�
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<br /> DE�CiZIPTION OF WQRK ..e {-�j"t `P V� M'�T��''� 1 ��S Z S��
<br /> Bt71LDING SlZE � � � SQ FOOTAGE� . HEIGHT���
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<br /> Q�uica��� � .:r,. , �,..�� ..�. �.-- .' , . .
<br /> , f.. �, VALUATtON=O�TOTAL COt�S'FRCiGT10N
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<br /> LECTRtCAL. $ AMP S�k�VtGE l�� Q PRG)GRESS EIUERGY Q 1N.R.E.C.
<br /> �G> ����-,�
<br /> QPLUMBING , $ ` �
<br /> OMECHANICA� � $ ` . VAI:tJATtQN OF;MECFiANICAL ENSTALLP�TIC1i�F �. 1��`
<br /> QCAS Q ROOFtNG Q SPECIAI.TY �,� OTNER
<br /> FINISHED FI.QOR ELEVATIQNS (��� FLOOD ZONE AREA QYE$ .NO
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<br /> BUILDER CQMPANY' ,
<br /> SIGNATURE REGISTERED Y/ PV FEE CURRE� ' Y/N
<br /> Address � L'tcense#� .
<br /> ELECTRiC1AN: 'C014APANY" �
<br /> SIGNATURE � REGI$TERED Y/ N FEE CURRE�`' � Y/-N�
<br /> Addres� , . _ License#, � f���„l��,�
<br /> PLUM�ER .. : CQMPAAIY ,. � . � � ,
<br /> $IGNATURE � � REOI�TERED .. ; Y/.�N.: .• :FEE-0URREK. T-� '° Y/N.-
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<br /> Address ` , �icense,# ��.� �
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<br /> MECHAPi1CA1: ' , . � _ Gt}MPAN1! � - . t
<br /> SIGNATURE� ' � " � "" � REGISTERED Y_/ N FEE CURRE� Y/rN' �
<br /> Addres's �^ - � ` . . . � t" ticenSe# ��. �
<br /> OTHER ,: _ c, - - � . , :GOMPAM! ' .
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<br /> SIGNN►TURE ''�' � - "^ '� - ' � ' `REGIS7ERED ' ' ` Y/ N�,: -FeE curtitEn ' , Y 7 N.
<br /> Addre�s; , , � „ I - - � ' . .' L"ECense# { �
<br /> RESIDENTIAL,:_ Attacti'{2).;Ptot Flarisr�(2)sets�of<B`uililing�Plans;'(.1}`sefaf`Energy>�ciins;,`R=Q�W'Permit for new canstruotion, � .
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<br /> ;_.Minimumwten�(:10)iworkin,g�days;atter'�submlNal'date.�:�R`equlietl onsite;.Constrticd'a`n`Plans;Stotmwater Plans w/SiitFence instailed, '
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<br /> ' SaNta'ry Facllides,&,lq�,dumpster�Site:Worlc�Permit for�subdiyision's/lerge'�projeci'sw:, .;;.,;, � • ` �
<br /> COMlU{E12CiA1. Attach{3}campiets`sets af-Suit�ing Ptans ptus�Clfe`Saf�tty Page,{1)set of Energy Forms.E2-O-W Petmit#c�r neuv canstruc�on.�
<br /> Minimum ten(10)worfci�g days afker submittal date. Required pnsite,Canstrucdon Plans,Stormwater Plans w/Silt Fence installed,
<br /> __ Sanitary Faci{iiles&1 dumpsterµSite W,orK Permit for all new;proJec�:All commarcial requirements.must meet compllence
<br /> St�N PERM11' Attac�{2)sefs"�ofEngiiieered.Plans.:`:.>;-�; _. : ..� _-a-__--- -.=- -- .-,�•-----::.� � _�,__�,_____
<br /> ""«•PROPERTY SURVEY reguira�cl for_ail IVEW canstruction.. •
<br /> Qlrections: , , .. . - . , , , .
<br /> Ffll out applicaUan completely. r `�;, 11 1/v�` w
<br /> Uwner 8 Contractar sign back af appticatlon,notarizzeti �'; � �; ' ;�,�t
<br /> If over a2500,a Notice of Commencement ia required.��4►G�upgrades�bver 3Z500) :
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<br /> '" Agent(for the ctintractor)or Power of:Attomey`"(for tfie°owrter)would be'-someone with notarized letter from owner authorizing same
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<br /> DVER THE COUNTER,P...ERMiTTiNG---•,- ��(Frontaf-Application 0niy}-�s:�',,,'�;., r"" "�
<br /> Reroofs if shingles Sewers Se'rvtce Upgrades A/C Fences(I?IoUSqrvey/Footage)
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<br /> Drivewaya-NotoverCaunter-tfomputilic�roa�ways::�ieed`s-ROW�`�••-_�":.�-�_. _� "
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<br /> rav. .. ..: ,.�E 4� . �;u'�..w � ��,
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