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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813aeo-oo2� �
<br /> x; ' ;,. Buifding Depactment
<br /> Date Recetve�l � Phone=Canta�ct�far�Pe�m[tti» .
<br /> Owner's Name tlwner Phone Number �� t t `
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<br /> Owner's Addrless � b I �• � l � r Owner Phone Number � � '
<br /> ;i ' � � �
<br /> Fee Simple TIQIeHolder Name � Owner Phone Number
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<br /> Faa 3tmple Titleholder Address ` •
<br /> JOB ADDRES� S r LOT# �___�
<br /> SUBDiViS10N � -� PARCEL iD# ' '
<br /> (OBTAINEQ FROM PItOPERTYTAX NOTIGE)
<br /> WORK PROPOS�D • NEW CONSTR ADDtALT �` S1GN Q � a�nna�rst+
<br /> � �e: INS7ALL � REPAIR �
<br /> PROP05ED.USE Q SFft Q C{3MM Q OTHER
<br /> TYPE OF GONSTRUCTION Q � BLOCK '' `Q FRAME � Q STEEL 'Q _ �
<br /> I� � • . . '
<br /> DESCRIPTION OF WORK �
<br /> BUIIDING�Sl�E"�- � SQ`FOOTAGE�� . ,HEIGHT � � ,
<br /> �
<br /> ,._..�,,,��������. - -v , � !
<br /> QBtlILDEN� S VALUATiO{d''•.OF�TOTAL GOIVS7RIICTICIN -
<br /> �
<br /> QECECTE2iCA� $ " AMP SEFtVIGE Q PROGRESS ENERGY Q W.R.E.C. ,
<br /> QPL�MBING v $ _ '
<br /> �� ��71� �
<br /> QMEGHANlGA� $ ' VAl.OATiON OF�MECHANICAC.I�ISTALtAT10N. �� C`"' �
<br /> QGA� Q ROpFiNG Q SPECIAL'fY Q OTHER
<br /> FINISHED FL�OOR ELEVATIONS �`ff� FLOQp ZONE AREA QYES NO
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<br /> BUtLDER � ____.._._.._ COMPANY
<br /> SIGNATURE �'�"�~ REGISTEREO Y/ N �FEE CUR�� Y/N
<br /> Address� � � , � Ltcense# �� ' �
<br /> �
<br /> EI.EC7'RICIAE! GOMPANY � ' -
<br /> SIGNATURE�� ~ REGISTERED Y/ N FEE CURREK ' 'Y/N
<br /> Addtess ` - Ucense# - *
<br /> Pi.UMBEIt ' _ COMPAPIY .- ' • �
<br /> SI�3NATURE � : FtEG13TERED Y:/.N FEE CURRE�" " Y/N '
<br /> AddtBs� . `
<br /> t:{cense.'� �. ` � �
<br /> MECNANlCAL' ' � COMPANY ' -
<br /> SIGNATURE� " ` � �' REGISTERED Y..,/ N ; FEE CURRE� Y/•N .
<br /> t°* , ,. , . . � � '
<br /> Addres'� �';-' " - ,. License#
<br /> OTHE[t � ' ' - � - � � ;COMPANY � , � .
<br /> SI43N�►TURE ��•� - �� '" '�- �• " ' � � ' �` REGI$TERED� ' Y/ N.. FEE GURFtEh Y/N '
<br /> Adclrasa�, . . , . ' - � � ��icense#�� � �
<br /> 0 �
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<br /> REStQfMTtAL� .:�Attacti.(2}.,P1ot�Plans;;.(2)sefs.of�8uiti!ing�Piaii's;(1)'ss#of=EnecgytForins;��ft=O-W"Pecrriltfctrtewcanstruc#ion,,
<br /> �+ M1Nmum:ten°,(,1.0};working;day��after;submiltai date.:�;R'equired onsite�;Con'stru'ctlon±Plans;Stormwaiter"Plans w/Sllt Fence installed, '
<br /> ���� �Sanitary FaGlitlVes:&1�dumpste,r,,Site�Work;Permitfc,r..subdivislonsAarge.projects_ .4.;..� '
<br /> Ci}MN7ERCi�L Attach(3)�coriipi'ete seCs'of Biiitding P►aiis ptus a�Ufe�Safefy Page;{1}set af Energy Forms.R-0-W Permlt�for new construc#ion.
<br /> Minimum ten(10)working days'after submittal date. Required onslte,Constructlon Plans,Stannwater Plans w/SEIk Fence Installed,
<br /> Sanitary FaciBdes 81 dumpstec S[te Work Permit for all new:proJecfs.;All commerctal requlcements_must meat compllance
<br /> SIGN PERMtT Attacti{2)sets of Erigtiieered;P..lans., ,; -=.,- - �.. .
<br /> � ""PROPER7Y SURVEY reguired_for all NEW construction. ,_ ,� � , - �.'
<br /> Diiectlans: � .. -_ .
<br /> FIII out oppltcaUon completely.
<br /> Owner 1L Contractoc sign back of applicatlon,notarized
<br /> tf over$2500,a Nattce of Cammencement ls requlred. (AtC upgrades ovar#TS00) , .
<br /> '• Agent(for the'conUactor)`or"Power of Attomey�(fo��tFie ovirner)�would�be'someone with notarized letter from awner authodzing same �� � �
<br /> VI � ' ;•,
<br /> OVER'TNE GOUNTER.PEE2Ml771N� -;�{Frontof•A�pllcation-Oaly) � -
<br /> Reroofs if sh�ngles Sewers Service Upgrades A!C Fences(Plot/�aurvey/Footage) ' - _ _ ; - , '
<br /> .,:1„ -._�.. �. i
<br /> dr�vewaya-Not over Countet if on publlc roadways:.r�eeds ROW , i
<br /> i _._.,..._-„•,'., - -y '- ' , : , � , . '. �
<br /> �; , , �, _ , ._ .,, ,_ . . .e .,. - - �
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