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813-780-0020 City of Zephyrhills Perrnit Application Fax-813•780-0021
<br /> � • 9ulldiag Department
<br /> Date Reaelvad . , , . � -Phone-Coetact�for`Permltt(ri ;`� . v� �j' O� – �l`�� .
<br /> Owner's Naene r !� � Owner.Phone Number � .
<br /> Owner's Adelress ��'�� e�� '�'. ,_,� t1,�.,{ �$ .. Owrier-Phane=Number � � �
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<br /> Fee 5lmple T!kleholder Name �� � Owner.Phane.Numbei ;�. :
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<br /> Fee Stmple Tttleholiler�Address _ '"° '
<br /> JOB ADdRESS ��Jr�J S�� �%�/GZ.S /��. �3•� �' L.OT# ���
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<br /> suBo�v�s�oN . � .. !�� �n�cEt��in# ��l �lv,� -�!� �1��'� t��'G`�
<br /> �.�{OBTAINED FttGM PROPERTYTAX'N8'ttC�. ��
<br /> WORK PE2�POSED ; '" • NEW CONS7R � �'� ADDJAl:T� � � StGN =[� :. Q�" DEMOLISH ,
<br /> � _ .. � .e . INSTAI:L :�• =RERAIR � - _ .
<br /> PROP03ED:USE. Q ' SFR [] COMM`' C,_,—] OTHER:. '" ' .
<br /> TYPE OF CONSTRUG710N�; ''Q `BLOGK�' ; (��,.. F,RAME ,� STEEL ..Q �
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<br /> DESCRIP'i1�N dF WORK j� �� �/� � ' �j"���Al}.G'�I�' �'/C ^C�3y7'I �.u' "�" ^�' � �
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<br /> BUlLDiNt'sS1ZE',�� ��SQ.FOOTAGE�� .��� � ;�HEiGHT'�.. : � `c� � �:/
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<br /> QBUILDING $ ����w.�—�, 'VALUATION 0�01'AI:'CONSI'Rt7CYlON � �`^rt' �" �' �;`j'i`'�$itrti, jQr,��L
<br /> � E�ECTRICAL $ = AfitlP SERVICE ` Q PROGitE3SS ENEt2GY [�. � W.R.E.C. .
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<br /> QPLUM8ING $ ` , , ,. � �/: ��
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<br /> [�MECHANICAL - $ � 'VALUAI'ICIN�OF...MECHANICAL.lNSTAl.LATION "
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<br /> QGAS Q ,ROOFING�,;��] SP.ECIALTY�-[�' OTHER. ' ' �
<br /> FINISHED ILOOR EI.EVATIONS FLOQD ZONE AREA �YES. „ NO ,
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<br /> BUlLpER � . ' ' COMPANlf' , .
<br /> SIGNATURE REGISTERED . Y! N FEH GURREt+'..,F �.Y l.N�:.. , . ., .
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<br /> Address � , � l'lcens�# ;
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<br /> EI.ECTRIClAN�.�-.<�� y COMPANY ., `�'�S£ "�-. �L��.tc�.`t, ,.
<br /> SIGNI�TUitE ��"' REGI3TERED Y 1 N �cu�n Y!N
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<br /> Addreas C,� 2 �"'— t, G-�3'��3 � � I . .:ltceiise#:';��`-.et3c�o r353 � �
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<br /> PLUMBE1t , x . r COMPANif^ : " --•'• "
<br /> SIGNATURE - . } :REGISTERED� ���. -Y/.-<N:. . ._r.�.cuR�+ '.. Y/N:
<br /> Address .. ,-.: .• / ..Ucense#: , .
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<br /> �SIC3N�TURE ' " ��"""��""� �-Q/Yt� �,�✓ , REGISTERED: , -.Yr/�N , ='�FeE CURREt� � 'Y:kfll.;;,_ • .
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<br /> SIONATURE :' � ,;�`, . .� , . �'REGISTEFtED . Y L Pl:.� .fEE GURRE� ,:j:-Y-/�.Nn
<br /> licldee�.,,. ..ta;,,;;:,�;.�.,� . . : '.�}, . _.�,'..:_ � _ - � " ' rLlcense# _ : , „ �
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<br /> S bENTlAL:-: `°=Attaoti�`2'Plot=Flans�.2�.sets'=of'BWtdl`n j'Rtans�-�1.��y ot'=Erie� �Foriirs``R-U=W�P t: �z�` :`,,`ri,. .
<br /> '� � .,._.�`- .., ...{_?..,, .:.. . . ,,'t,,}.: '...,� .g , ��;);seti;:;,:,.,.. ,�!.�.. ,�.•,.,w���.:-, ->erinf for;new,`kco.:�.treic�on,:
<br /> � �'s,liAlnlmum+;,ten,(�10)tworking;dajis,afte'r',;sutir,'nittail�d"ate:�'Requlredonslte;�Constnicdon�plans,.Stormwatei°Plana�w%:StltFenqeinstelled, __
<br /> .'� ,Sanitary Fec�tiUesh&s+1,,c�unsnps,'�r,Site�jlVork�Per.m�t.(or:sutid�vi'slori&liatge,pro)ects �:;;§�,�f���.,�;`.;~,� . °. �- �.''= `� , -. ' � - .
<br /> GOMNlERCaAL Attach(3�''comptete setsrgf"Biiltditig f'laris pltis a'l:Ife.Safety!'sge;('1}set of Ehergy FOrms.R-C?W Permtt fo[naw oanstructton.
<br /> Minimum ten(10)working days after submittal date. Requtred onsite,�Canstructian Plaste,Stormwater Plans w/Sllt Fence installed, ;
<br /> Santtary FadiiNes.&ludumpstec..Site Work-Pe[mit fo�r all,�new�proJec#s:";All`commerclai.requirements�mu�st meet compilance ,_ -
<br /> SlGN PERMlT Attacti(2j=set"s ofEn'°g]�eeii;ed:F'f'a =�:��:r:=:. ..,. .. . � � � , , . -
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<br /> , •""PROP�R7Y_:SURY'EY:required for,all•NEW ponstructloc�:: � -, - .
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<br /> Flll out applicaflon complekely.
<br /> Owner 8 Conlractor sign back�of appltcadon,notarized
<br /> If over�52600,a•Natice of.,Gommencemesrt ia requiresi. �(/UC upgredes pveP STSdOj _ •.. • -
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<br /> Agent(#or t#se contractor•}or:Power of Attoiii'syi(farttie bwner}wauld be someone;wi.th no#arized letter from awner authori ng same
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<br /> OVER'TFiE C{3Ut�1�:�Et:P�ttM1TTINt#::. _:-'{Front;of=FtPPllcatiori Oniy) -
<br /> Reroofs if shingles Sewers 3ervice Upgrades AlC,_x:..,Esnces-(PIaUSunreylFaotage) -. _ . � ,� , ; v ...
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<br /> dNveways-Nat over Counter if on.pub(ic roadways.:iieeds ROW � �
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