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<br /> s� -7so=oazo City of Zephyrhills Permit Application Fax-813-'780-0021
<br /> Sui{ding DPparfinent
<br /> Date Receiv��d �����"�� Pho�ne C¢�nfact for Permitting (J�� t���` -- `����
<br /> � / I . .
<br /> �wa�er's.Mai e l/1 �k�}S OvunerPhonef�amber �(� "��'� -t�
<br /> Owner's�A�dress�:, t��� 1 V�cJT(�"� � ��} �1t� S F� 3�S`I Owner Phone(durhber� . �
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<br /> F�e 5imple 7itleholder Mame Owner Phone Mumber� � �
<br /> Fee 5imple Titleholder Address •
<br /> .�oa.,��or��s��. l.t�o�I�� I G�h�~�rP� � h � h�l l S �l �3 SN a �Q�# ��
<br /> susnivisi...t� ., �1. r�z-�- � �P�r�ac��:t�� Ua�l�-al -�I�l b '6t�ttiC� �Uy c�L�
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<br /> �{08TAINED FRQM PROPE62TY TNX NOTICE)
<br /> WOF;iK;P.,ROPOS�D' NEW CONSTR ADD/AL,T �� SIGN [� MOVE Q DEMOLISH
<br /> 8 � INSTALI. � REPAiR J
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<br /> PRC►POSEE3 USE SFR � COMM Q OTHER —r U '
<br /> 7VPE OF CIONSTRUCTION BLOCK � � FRAME C] STEEL Q OTHER
<br /> DIE�CRlP.,7'�oN;_o�s.wo�a�c, � �Q�4� (e�foo� �err�o���. � �i�l reS '�11Sf�1 0�� G, .�(�' �,�j j1'��tz,t�� (��Y3�
<br /> BUII.bING�IZE`, •� , � :;SQ,,�OOTAGE�D�(��� HEIGHT ���,
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<br /> UILDING $ •r:,�' '."
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<br /> f� �'�.;,� `(,�. � �" �� ;:VAL.97ATION':OF'TOTAL.,CONSTFi,UCTIQM
<br /> �!..;�' i���� ; ..0 � . , � • - .
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<br /> 0 LECTRICAL � � AMP SERVICE � PROGRESS ENERGY � W.R.E.G,
<br /> � L.UMBiNG /
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<br /> , Q ECNANICAL $ VA�UATION OF MECHRNiCAL INSTAI.lJ1TEt�R2 �,�`' ��
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<br /> I Q AS Q ROQFENG � SPECIALTY Q OTHER � �j ,-��V
<br /> FINISHED L.00R ELEVATIONS FLOOD ZONE AREA QYES [�NO �,���
<br /> 8UI9,DEi� ' C�MPAtdY . .
<br /> SIGNATU E REGISTEREp Y/ N , FEE CURRENT Y/fV
<br /> Addr ss ' Ucense# � �
<br /> EL�CTRIC AN COMPAMY - .
<br /> SICIdATU E REGISTEREp Y/ N �FEE CURRENT �Y/N
<br /> , , . . � �
<br /> Addr�ss ' License#
<br /> PLUM�ER �43`yypq�qy
<br /> SIGPdA'�7J E ' REGISTERED Y I N FEE CURRENI' Y/N
<br /> Addr Iss
<br /> Liaense# �— __ �
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<br /> AA�CIfANt�AL �OiNiPAi�Y
<br /> SIGP�ATU�� REGISTEREp Y/ PV FEE CURRENT Y/N
<br /> Address License#
<br /> �TFi�Ft;,t,_ /�; � j � � ' '
<br /> ss�i�a�eu��.� l.J"��,c.,.�CL. C�C�t� c,c.�� � ���`J� :;R om�R�p. Y a� bU�E URR�I�� Y N •
<br /> ;�►aa��ss �tGa �,� ��J�� � �i f�li��S � ,��J��` `•`License# ���-f�Z:�����
<br /> t�ESIpEiVTP�,L � Aftach,{2)Pto#Plans;(2}sets of�uilding Plans;(1)sef af Energy Forms;F2-O-V1!Permit far new construcfion,
<br /> �I , .�Minimurrm ten(10)working days after submittal date. Required ons3te,Construcfion Plans,Stormwater Plans.vid 5ilt Fence installed;
<br /> . 5anitary Facill#fes&'1 dumpster;Site Vlfork Permit for subdivisionsliarge proJecks
<br /> COMMER�tAL Aftaoh(3}sets ofBuildirig Plans;(1)sef of Eriefgy Forms.F2-tJ-W.Permit for new consfruction: �
<br /> � Minimum ten(10)warking days after submi#al date. Required onsite,Construdtion Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dnmpster.Site Work Perrnit for atl new projects.Ai!commercial�requirements mus#me'st compt�ance � �
<br /> S1�N1 PER 17 Aftach(2)sets of Engineered Ptans. , �
<br /> *""'PRQPERTY SURVEY'required for all NEW cos�struction. . , � �
<br /> Directions. ' ' -
<br /> Fill o�aPplication completely. '
<br /> f3wns &Gonfractor sign back of applicafon,nafarized
<br /> tf oveI �258a,a Notice of Carnmencement.is req�aired. (A/�upgrades aver$5000)
<br /> *" Agent�(for fhe cantractar)or,Pawer of Attomey(for the owner)would be someone wi#h notarized!ek#er from owner authorizing same
<br /> 'dVER THE COUN7'ER PERMIT`i'iP9G (Front of Appltcation Only)
<br /> Reroofs Sewers ,,�Service.Upgrades � A/C Fences(Plot/Survey/Footage) �
<br /> �lrive�ays-Nat over Counter if on�public roadways..needs ROW
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