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� a�saso-oo2a City of Zephyrhills Permit Application Fax-813-780-Od21
<br /> � �' Building[lepartment
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<br /> Date Received ;,;- � .� . ' ,� . ,,��A � :� _ .
<br /> "Ph'oria Coiitact#or•Permittin
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<br /> Owne�"s Name l�A " �"'1 `� ' � � -�';=�-��- Owner Phone Number c:.al3 ��_ �1�
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<br /> Qwner's Address I S� � .� �* � Owner Phone Number
<br /> Fee Simple Tltleholder�Name. � � Owner Phone�Number � � �
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<br /> Fee Si�ple Titleholder Address ,
<br /> soa�oRess � ' o� � Z-N;3)S 3 3 S y.�. �.o�# �__,�
<br /> SUBDtitl$iON �"`�"'���� 1LJ��� PARCEL IC}# ��
<br /> WOF2#C��PROPOSED ' NEW CONSTR '�AI3I}IALT" � 5���NED FQ PROPER'rr T�7�CEI��M���$�
<br /> jI e INSTALL 8 REPAIR '
<br /> PROPQSED USE Q SER ' "Q � CQMM�' Q UTNER
<br />, TYPE OF CON87RUC7'ION 'Q BLOCK Q " FRAME � S7EEL Q.
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<br /> DESCRIPTiON-OFWORK � 1rn� a �{�1�7n ���`�,Tt.i C. 1 � ' �
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<br /> BUILDING SIZE� �— �, 3Q FOOTAGE��- HEIGHT ��
<br /> ; BUtLDING �_____� VALOATION OF TOTAL CONSTRUCTIC1tV
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<br />' QELECTRICAI. r�r���� AMP SERVICE Q PROGRESS ENERGY �Q W.R.E.C. �
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<br /> �M PLUMBING $��r},'3�
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<br /> !:, MECHANtCAi. $ , VALUATIQN O�MECNANIGA�.INSTA�lATtON � ' �
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<br /> i �I, GAS Q •ROQRtNG .Q SREGIALTY � OTHER �
<br /> FINISHED FLOOR ELEVATIONS �� FLQOD ZONE AREA QYES NO
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<br /> _BtlILDEE2—-- _- -_�,_- -- — - --- -- -------CQ":S�'t�`^'-- -— --.— _. __—_ _---__.�—
<br /> � SIGNAT�RE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#�
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<br /> ELECTRICIAN- i �J r COMPAPtY .
<br /> , SIGNATURE 1�� REGISTERED Y/ N FEE CURRE� �Y/'N
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<br /> Address License#-�_ �
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<br /> PI.UIUIBER ;COMPANY ��. � � C • ,
<br /> 31GNATURE �j ,REGISTERED. , Y/ N FEE URRE�' . Y/•
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<br /> Address �� 3r7' . Cacense# �{���C')'�� l��
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<br /> MECHANtCAL � COMPAN1t -
<br /> SIGNATURE ' ' REGISTERED �.. Y/ N , FEE CURRE� Y/N .
<br /> Adc3ress' � � ` , � �icense#;� � �
<br /> C?TtlER � � � � ' " GOMPANY � �
<br /> i SIGNATI,IRE � - ' � � � � REGIS'TERED Y/ N ��e CuttRE� Y/N . �
<br /> Address - - �c � � . 'L'icense#- ` �
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<br /> RE3lDENTIAL �Attach(2};E!!nt Pians,(2),sets��of:Builiiirig;Plans;(1).set of EnergyFtirms;R-O'-VY Permit f6r new constnictton, "
<br /> 'i . �Minimum ten,(,10),working.day.s•�aRer submi##aI:date:M Reguired'onslte,`Gonstruction Ptans;Stortnwafer Plans w!Siit Fence instailed,
<br /> Sanitary FacillUes:&.'1 dumpster.,-SIte;Vllork�Rermit.for subdivisionsLlarge projects, �' ' - � -
<br /> COMMERC4AL Attach{3}cainplete sets of Building�Plans plus a"i:ffe Safetyr Page;`{i}set bf Energy Focros.R-O-W Perm3t for new cans#tuctian.
<br /> Minimum ten(10}working days after submittai date. Requlred onsite,Conskructfon Pians,Stortnwater Plans w/Silt Fence instailed,
<br /> Sanitary FacUfties&1 dumpster.Site Work Perm(t for all new.proJects:°AI6 commercial requlrements must meet compllance
<br /> SI�N PEC�tMiT Attach(2}sets af Engineered,Plans.. �;; � � �- . - � �
<br /> � "*"PROPfR1Y SURVEY required inr'ati NEW constniction, "
<br /> �lrec#lorts: . .
<br /> Fill qut applicadon campietely.
<br /> Owner 8�Contractor sign back of appl(caUon,nota�ized � ° � `
<br /> tf avar�2500,a Notice of Commencement Fs reguired. (AtC upgrades over�T500} ~�f��`�'"'"�-
<br /> '" Agent(for the contractor)-or Power of Attomey(forthe owne�)would-be"sorrieone with notarized letter from owner authorizing same ,
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<br /> � �YERTHECOUFETER;PERMITTING_,.�.., _{�ront.ofAppiica�an..Oniy}
<br /> 2eroofs ifishingles � Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) I,
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<br /> Driveways-IVot aver Counter af on pubtia roadways:nee(fs ROW"
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