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� 813-I�0-002o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> I Building depaKrnent
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<br />'� Date Recelved �Fhone-Contact'for;PermitEln -
<br /> Owner's Nam�l G(�GV �� Owner Phone i+tumber
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<br /> Owner's Addr ss -I v�i. (l� Owaer Phane Number. �� �
<br /> Fee Simple TI�eholder Plame � Owner Phone Number
<br /> Fee Slmple TI leholder Addrasa I
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<br /> JOB ADDRES� V !l� LOT# C__� I
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<br /> SUBbIVISiON� � � PARCEL tD#
<br /> (OBTAINED F.ROM PROPERTYTAX PIOTICE) I
<br /> WORK PROP�SED >•� NEw�CONSTR ADDlA1:T �] S1GN' 'Q Q pEMO�iSH
<br /> ��, INSTALI. �� REPAIR �
<br /> PROPOSED•: SE Q� SFi2 Q 'COMM [� Oi`FtEi2 �
<br /> TYPE OF CO+STRUCTION Q �BLOCK '' � FRAME � � STEEL Q
<br /> DESCRtPT10 OF WORK' C�t.,..� � , , � G{,J. fl,G� , �
<br /> BUiLDENG�SI�E� �� �'SQ'F80TAGE , , HEIGHT�.���
<br /> �8�� ����'' � VALUATION°OF 7'�TRL COWSTRUCTION �
<br /> QE CTRIGAC � '�$ � = ' r� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
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<br /> QPL MBING ` �
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<br /> [�ME�HAiV3CA� $ q��� �Aj�j. VAl:UATIOI+i OF MECHAi+lICAI tNSl'AlIATlON. J� jU �
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<br /> �GA [�J EtOOFlNG .Q SPEClALTY [� OTHER
<br /> FINISHED FLOOR ELEVATIQNS FLOOD ZONE AREA QYES ,NO
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<br /> BUILOER COIVIPANY� •
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� ,Y/N
<br /> Addrsss , � Llcense�# � , , �
<br /> E�EGTRECI. -�COMPANY' , _
<br /> SIGNATURE `� REGISTERED Y/ N FEE CURREK=' Y/N
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<br /> dre�� . . - , License# � , f
<br /> � PI.UMBER � CONIRAS+tY ' ,
<br /> SIGNAYURE' REGISTERED Y/:N• � �FEE CURREP ' Y/N. �
<br /> Aatdre I ,Ucense,# .
<br /> MECF#AAtFCA1.` � � CflMP�WY ' t t�
<br /> SIGNATURE• � 4 � REGISTERED N FEE CU (" YI N
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<br /> � Addres� `; � ; �� � �, /�� License#� � �.. t
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<br /> OTHER >' � . _ +;COMPAHY -
<br /> I SIGNATURE �� • � '� � � ' REGISTERED Y/ N.. � FEE CURREh Y/N
<br /> ' Addre' �- . . __ . � , � ,. . - - ', License# � �
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<br /> REStRENTi �;"�e ;Attacti'(2}rP-.lct�.P.;ians;:,{2}sets�.of;Buitil3ng=Flaris;(1}se#of�Energy�Foims;�R-0=W`Pemilt for new canstruction, ,µ ,
<br /> -� � � Minimum�.len�(•1,0),working;days�aiter.submlEtal date.'vRequlred onslte;:G'o`nstiiictlon'Plans;Stormwater Plans w/SIIt Fence installed,
<br /> - �"��� Sanitary Facilldes.&:15;dumpster-Slte_Worlc;Permit,for su6divlsions/Iarge.proJects
<br /> COMMERCI Attach{3)eamplete'sets of'Bultding Ptans plus aUfe SafetyPage;(1}set of Energy Focros.R-t3 W Perznit far new cans#ruction.
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Canstructlon Plans,Stormwater Plans w/Silt Fence inskalled,
<br /> Sanitary FaciUdes&1 dumpster.Site Work Permit for all new projects:All commercial requlrements must mest complieace
<br /> SlGN PERMt, Attadli{2}'se#s ofEngiiieered,Plaris: �,�,��- L .�;
<br /> I •"`"PROPERTY SURVEY reGuired for all NEW canstructlan.
<br /> Directlons. �� • . -
<br /> Fill out opplicadon completely.
<br /> Qwner l�Coniractor slgn back of appllcatlon,natarized
<br /> if over�2500.a Notice cf Commencement 1�required. (AtC upgrades over iT500)
<br /> " Agent(for the contractor)or Power of Attomey�(far�tFie owner)would be�someone with notarized letter from owner authorizing same
<br /> OVER�THE�OUi+FFER:PERMITTft+IC3- •--�; {Front of Apptication-Oniy}-
<br /> Reroafs if shi�gles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage) _
<br /> Drivew�ys-Not over Caunter if an pubtic roadways..needs ROW
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