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<br /> 813-780-0020 City af Zephyrhills Permit Application,,.:,.�.. ..�.. �- � FeX e�s-7eaoo2�
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<br /> ` Bu1�a�ng Depart'rrient"�"` - ;
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<br /> Qate tieceiv d �7 / ' ' � -
<br /> � ''�G-�L � Phane-Contact'for Pernittt[n' ' . . . �
<br /> � L a- 2t�R� �-ft� �. ,; 8����9�=� t� i
<br /> Owner's Nar»e � Owner Phone tdumb r . �
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<br /> Owner's Adciress �.��7�-' ��� ���� 'Ow�er Phone Number�- �
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<br /> Fee Slmple Tltleholder Name � � Owner Phane Number �� � �
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<br /> Fee SImpV��tlehold�r Addresa � • " ;
<br /> JOB ADDRESS ' LOT# ���
<br />' SUBDIViStO I�����G��C�,�� PARCEL ID# ' i
<br /> I � (OBTAINED FR4M PROPERTY TAX NOTICE)
<br /> WORIt PRO�OSED , �NEW CONSTR ADD/A�T � SIGM1i [� Q DEMOI.ISH
<br /> INSTALI. REPAIR
<br /> PROP05ED USE SFR [� COMM ['� aTHER
<br /> TYPE OF CO�WSTRUCTION � Q 6LOCK " [� FRAME [� STEEL Q �
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<br /> DESCRIPTIdAI OF WORK ��J��/�LGf/IIG � Gf�/Nj}�IGf�JS "'� � ,QQO/Q.. �
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<br /> Stlt1.QIFIG'S�ZE �� �` S4 FOD'TAGE C�, .. HEiGHT�.��� �
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<br /> 8��11.D1iVG � ,,,, ,,,�,,,, , ,
<br /> � �,�G�� � VALUATION OF TOTAL CONSTRUCTION ' �
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<br /> QE� CTRIGAL $ " AMP SERVICE Q PR{O�RESS ENEFiGY Q W.R.E.C. �
<br /> QPL�MBIN{3 � � -_
<br /> [�MECHANICAL $ VALUATION UF'MEChfANICAI.tNS'TAL6ATION
<br /> Q „ � Q FtOOFfNG Q SPECIAI.TY � OTHER
<br /> FINISHED F �OR ELEVATI4NS r�� FI.00D ZONE AREA QYES NO (
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<br /> ��a�����a ����<u'• G-l/��,'�.,�C� � � c���a�nr' ,��- ;
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<br /> SIGNATURE �� REGISTERED Y/ N FEE CURREP ' Y"/N !
<br /> Addres L`Icense•#'� �
<br /> ELEC7RlCIAN .'C�MPA41X
<br /> SIGNATURE I � REGIS7ERED Y/ N FEE CORRE�` 'Y/N
<br /> At1dT8s8 " LiCQ11Se# � � � �
<br /> ��i�MBER COMPANY
<br /> SIGNATURE' REGI3TERED Y./,-N� FEE CURRE� ' Y/N.
<br /> Address .License# �� � - i �
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<br /> �VIECH,AAIICAt.' ` v CQMP_ANY ,
<br /> SIGNATURE� " ` � QEG�ISTERED YJ N . _ FEE CURREA= Y/�N �'
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<br /> � Address - - � ' + � :' , < � ' . ' License# �. .� - � �
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<br /> a�t��rt ,� , � � .. - : t'coM�i�r � - .
<br /> SIGNATURE. '-- = '�' - ' " ' REGI$TERED Y/ N;.-. � =FEE CURRE�` Y/N
<br /> Addre�s- ' � '. ` - Cicense# 1 � t
<br /> RESIDENTIA�t' > �Aitacfi'{2},Ptot�Plan&;.;(2)sets•-cf=B'ulliling�Pians;•(.1}seEofEnercjyFoiins;�R-0=VfFPermitfarnewcons#�uatEan, ' � �
<br /> Miniroumeten~(:1:0)yworking*days after„subiiilttal'`d'ate.'Requl�ed onsite;ConstrucUon:Plans;Stormwate�'Plans w/Sllt'Fence installed, i
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<br /> � �� Sanitary FacdllU.e.s;&,1,dumpsterkSite_Wa�ic_��Permit fo[:su6divisionsQarge p„roJegts.,_, °:.. ,,. ; � `
<br /> COMMERCIAL Attach{3}°complete sets of'Bulldfng Plans plas a I.tfe SaFety Page;{1�s�t of Ectergy Fcrms.R-O-W Pei�iit for new canstruct�on. �
<br /> Minimum ten(10)woricing days after submittal date. Required onsite,Constructlan Plana,Stormwater Plans w!Silt Fence installed, ,
<br /> � Sanitary Facilities&,1 dumpster.Site Work Pertnit for all new proJects:.All commerctal ret�utrements.must meet complianca " ' '
<br /> SIGN PERN4f� Attacfi(2)se�sb`�`Englneer.ed=Plajns.,4.. F;�^=�.- ., �.. ,. _
<br /> •"•"PROPERTY SURVEY required,afor ap,iVEW construction.
<br /> Dlresttans: . ,
<br /> � FIIFout applicadon completely. �
<br /> '� Owner&�Contraator stgn back of applicatton,notarized �
<br /> if ov�r 52a00,a Nottce e►f Car►�mencament is cequired. {NG upgrade�aver ST500j �
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<br /> Agent(fa�the�contractor)ar PoVuer of Atkomey(fa�tFie owner)would be someane with ncatarized letter from owner authorizing same
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<br /> DVER THE CQUN'fER PE�MI'fTiNG.-. .._..tFront of Applic�tion flnly}_,.
<br /> Reroofs if shinigles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) � ,
<br /> Drivswaya-Not avgr COunter tf on public�aadways..needs ROW �
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