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813-780-002Q City of Zephyrhills Permit Applica#ion Fax-813-780-Qp21
<br /> Building Deparlment
<br /> Date i*lecetved �'` � -. t.� Phone=Contact for^Permittin – '
<br /> � .
<br /> Owner's Mame �� +'�. S 1 ✓!A �nG4.�'C� Owner Phons Nurnber
<br /> Owner's Address S 5 �.1 �J V` J`` Owtter Phone Number � .�
<br /> Fee Simple 7ltleholder Name � �� Owner Phane Number � �
<br /> Fee Simple Tltleholder Address �
<br /> JOB ADDRE8S ��� ` �3 Y� � LOT# ����
<br /> SUBDIVIStON � �` PAitCEt»ID# �f�����u�.�` ��7 �–� � – (�
<br /> (OBTAINED FROM.PROPBRTYTAX NOTICE)
<br /> WORK PR4FQSEQ - NE'W CONSTR ADDlAIT � StGN� �Q Q DEMOLiSH
<br /> � ,e. INSTALL � REPAIR � �
<br /> PROPOSEDaUSE [�• -SFR- � COMM � QTHER . .
<br /> TYPE OF CONSTRUC710N � Q `� BL.00K ' Q FRAME ,[� STEEG C]
<br /> DESCRIPTION OF W4RK ► �b� (_,,- � tt W '� t t� � '�t"2 W"�
<br /> BtliLDING�SlZE ��� �`SQ FOO'tAGE� HEtGHT�
<br /> �BU11..DING $ � rn�� VALtiAT101V`OF1'O'T'Al CONSTFtUCT10N � � -
<br /> ll
<br /> [�Et,EGTRtCAR. $�' '� AMP SERVICE •Q PROGRESS ENERGY Q W.R.E.C.
<br /> ��...�.,
<br /> [�Pl.UMBtNG '$ . _
<br /> �� �
<br /> �[t11ECHANiCAI $ �' � ��y�� VALUA3tOl+i OF MECHAP!lCAL INSTAl.tATItJN
<br /> � „_„_„�
<br /> [�GA.S CJ RQQFING [� SPECfAi.TY_[� OTHER
<br /> FINISHED FLOOR ELEVATIQNS r�� FLOOD ZQNE AREA QYE$ NO
<br /> L
<br /> BElilDER COMPANY
<br /> , SIGN�►TURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> , Address ` L`ici�nse�# � 1
<br /> E�fC'TRiC1At�[; � .'CdMPANY
<br /> SIGNATURE �` REGISTERED Y/ N FEE CURREM' =Y/�N�
<br /> Address , . , . , Y L#cense# � ---�
<br /> I! P�UMBER � i� �CQMPAtaY - : , , , �
<br /> �I SIGNA7URE' REGIS.TERED Y./..N , FEE CURREK Y-/N
<br /> AK�df988 ' � - .LIC8TiS8,� � -. � I
<br /> MECHANICAL •,, '�'� COM.PEWY .: "`11 V l
<br /> SIGNATURE ��i REGISTERED , . Y./ N . ' FEE CURRE� Y�6N
<br /> Address` - . - . + ' Licsnse# � -�
<br /> O?EiER :` - � � ,�;CONIPANY
<br /> SIGNATURE ' � ' " " ' ' � � RE�iSTE�o� Y/ N.. �F�Cu�n Y/N
<br /> Address ` ' ' ' Cicense# �— �
<br /> _ ,� , ,. .,: . ,
<br /> RESEDEN'i�Al:;;. Atkach'{2);PIot=Plati&;.(2}sets:of.iBuil'ding Flans�(1}-sef of-Energy>�onns��R-O=W Perrriit far new construction, ,
<br /> ,��;,,._Mlnimum;tena(<1,0);,working�days after;sub"mlfta�"date.::•Requlr`ed anslte,:Constnictton�Plans;Stormwater Plans w/Silt'Fence installed,
<br /> ' SanitaryFacill8es;&:.1,dumpster�Site;Work;Pertnit,forsubdtVisions/large:proje�,= v.:.�. , ' ' " � '
<br /> COMMERCIAl. Attach{3}obiriptete sets ofi B'aitdiiig`Plans�plus a'l.ife Safe#j+Page;{'1)set af Eriergy Fornts.R G?-W Petmit for new consttucti6n.�
<br /> Minimum ten(10)working days after submittal date. Required onsite,CanstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Faaliitles&1 dumpster.Sita Wark Permit tor all new<proJects.All commerclal requirements.must meet compllance
<br /> SIGN PERMIT Attact�"{2)sefs af Eiigiiieered�Plaiis.;.: ..,:. . ,� .
<br /> •`•"PROPERTY SUR1/EY reyuired.for all,IVEW c�onstrucUon.._
<br /> Dlrecflons: .. . � . ` -
<br /> Ffll out applicatlon completely.
<br /> Qwner&G+antractor sign back of applicadon.notarized
<br /> if over�2500,a N,otice af Commencement ia required. {A/C upgrades ovar ST500}
<br /> � ',;--,:,:;;
<br /> " Agent(far the contractor)or'Povirer ofAttbmey-(for tFie�awner)would beMsomeone with notarized letter from owner authodzing same
<br /> DVER THE COUN7ER.PERMtTT1NG .. ._-...(Frontaf;APAIlc�tlan�Oniy)-��.- -, � ,j,� _ -�.�-_ .,.-{�:�^,,.._;_...._ . �,. .,.
<br /> Reroofs if shingles Sewers ,. >Seniice,Upgrades A/G :� Fences(PlodSurvey/Fontage) _; •,"; ,_ ,. � . ' •� ' " ' _ .,
<br /> Diiveways-Not over Counter tf on public,roadways..'n'eeiis-ROVti'`� �' " ' „ , � � . , y `
<br /> , , , ' 'j .`",�,!� �, ,,. P ., ... ._.. .�-,. �. _.�,<.,_. . ,. - ..,
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