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813-780.0020 City af Zephyrhills Permit Application Fax-813asaoaz�
<br /> Bu[iding�epartmant _
<br /> Dats Recelved � - . Phar�e=CaM�o#for°Permttt[a '�
<br /> �
<br /> Qwner's Nart►e W�� . , .' Owner Phane Number �� `� �— �Z 1
<br /> Owner's Address ��� C Owner Phon�Numlaer -� .w� ��
<br /> Fee Simple Tltleholdar Name Owner Phone Number �� ` �
<br /> t , . . �
<br /> Fee Simple Titleholde�r Address • �
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<br /> JOB ApDRE$S �I� I '� � LOT# ,
<br /> sueorvis�oH _ ��1i�� "� .� P�ce�io� ��S� ��—�C� `t,�(�l�d— ���� ��
<br /> , . (OBTAINED FROM.PROPERTY,.TAX NOTICE)
<br /> WORK RROPOSED, �.NEW CONST�t ADD/A�.T �� S1Git1' Q Q DEMOI:ISH
<br /> � •:e,� INSTALL 8' REPAIR � ' -
<br /> PROPOSEQ�tlSE Q SFR- [� COMM C] t}TFEER
<br /> TYPE OF CONSTRUCTION � Q� �' BLOCK `" `Q FRAME [� STEEL 'Q �
<br /> - .
<br /> DESCRIPTiQN OF WORK' �j. C� j {� �/� c�' 0� ��I�'� i
<br /> SUILDING�SlZE' �' '�"��fOLiTAGE `r�-c7Z� HEtGHT � � !
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<br /> BUI�RiNG $ L ,L�I�Q�QQ�. VAIUAi'iON�:t�°F"i'OTAL CO(�STRUGTTON
<br /> QE�ECTRICAi, r$ � , ' �j AMP SERVICE Q �PROGRESS ENERGY Q W.R.E.C.
<br /> �.� .�
<br /> QPLUMBtNfa ' � � '
<br /> Q MECHANtCAL $ Vi4�l1AT10N OF'MEGHANtCAL IPIS7ALCATIUN � J �� ��
<br /> - �_-_ , � � -
<br /> �c,�s Q RC}QF1NG Q SPECIAI.TY [[� OTHER °
<br /> FINISHED FLOOR ELEVATIQNS r�� FLOOD 24NE AREA QYES. NO
<br /> L
<br /> BUI�DER COMPEWY' �' � ��' G.`�
<br /> SIGNATURE � ' REGISTERED Y/ N �EE CUR�n Y/N" .
<br /> Address ��� �(Gr L.►`v � �� - Ltcense# � �
<br /> ELECTRICIAN: >=COMPAt+tY � � �. - ,
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURRE�'' -Y/-N
<br /> ` Add�eas ' - � ._ � . � Licanse#�.�~ . � - �
<br /> � .. . , , , - . : . .
<br /> li PIUMBER � � COMPANY =� � ': :r. `
<br /> SIGNA7URE` � , .. REGIS.TERED.y . Y:/,-N� , ;FEECURRE� Y;�/P�I
<br /> Address - . . . . , ` ,ltcense# �:'� , . �
<br /> ! MSCFiRNICAR: . GOMP1it+tY, .. `- . ,• . .
<br /> SfGNATURE� � "' `" � REGISTERED �' Y:/ N , ? FEECURRE�. Y�/:N -
<br /> Addre��✓ -- , ' . - L � ` � License#.�. ��, �
<br /> OTHEEt` "' ` - � � . � �� � �;GOIIA.P1tNY, , � - � •
<br /> SIGNATURE- '=��` • ��` " '`' -" '"�' ' " � �' `REGISTERED ` Y/ N .� FEE CURRE� � : Y 7 N
<br /> � Addres� .r•' ,t�� _, . . . , : ' Licerise# � 1
<br /> 4 ,�y " x. ��nu��.:�. -. r ,
<br /> RESIt}ENTiAt:;<.,;Attacti"{2},f�lof Platis;,(2)sefs'cf�Bitild�iigF t?laris;'(1}set of<Erierg}i>Forins;�R-O-W Perini#ior nsw construction,
<br /> -� �=Minimumvtenr(�1.0)xworktng;days;after:subiniftal'date::Required onsite,:ConstnicUori�Plans;Stormwater'plans w%Silt Fence installsd,
<br /> .,:��.,�...3,.il . . �
<br /> ' Sanitary FaclllUes�.&;;1#;dumpster�Site�:WorlccPermit#orsubdivislons/Iarge:;p.roJects:�ti... ,,;� . � .- - =
<br /> COMMERCIAR. A#tach(3)�compl8te sefs"af Suitding Plaiis p�us a'Life Safeity_Page;('1}set of Energy Fornrts.R-LI-W Petmlt i+ar new construction. -- � -
<br /> '� Min(mum ten(10)working days after submittal date. Required ons(te,ConsWcdan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Pemrit for all new:proJects..All commerctal requlrements.must meet compliance �
<br /> SIGNPERMIT Attacti"{2)sets"of'Engi�ieer.eil;Plans.; -.Aa: �: .. . . � ' -
<br /> """PROPERTY SURVEY reguired for all NEW.oanstruction.. _ _ -
<br /> 13�rectlans: � . - �� _ , .
<br /> Fill out applicaUan wmpletely.
<br /> Owner&Contractor slgrt back of applicatlon,notaelzed
<br /> tt over�2500,a Notice of Commsncement is required. (A/C upgrades aver 57500} �
<br /> i:��,�;�:;��,�;�
<br /> " Agent(for the'contracto�)or'Poviie�of�Attoiney�(for tiie bwner)would tie someone with notarized letter from owner autho�izing same
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<br /> 4VER'THECOUNTER,RERM!'FTiNG., .,-..(Front�of-Appllca#ion°Onty)_•_ ._ -
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) �
<br /> _ _ _. _. _. .. .. -, .,�", �, . ., ...
<br /> , Drtveweys-Not aver Counter if an pubiic roadways..need"s ROVti�
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