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<br /> 813-�$0-0020 City af Zephyrhills Permit Application Fax 813-780-0021 -
<br /> �� Building Department
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<br /> pate Rer,,��v�ad; � °.Rhone-Cant�ct far PerinitEin � � t`f - •6��
<br /> Owner's Name� t '�1 Owner Phone Nunnher ��
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<br /> Owner's Addr I ss � � ` /�--- Owner Phone Number '
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<br /> Fee Simple Tl�leholder Name � � Owner Phone Number � � �
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<br /> Fee 3lmple Ti�eholde�dddres� ` �
<br /> JOB�4DDRES� �o � 2 LOT#
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<br /> SUBDIlIISION , J � �l�(?{�.. �,J,�l ��� RARCEt,tb# ��3`-��-�� ` � '--�J��� �- O
<br /> � , (OBTAINED FROM.PROPERTYTAX NOTICE)
<br /> WORK PROFOSER - ,.NEW CONSTR . ADDlALT � 81GN 'Q � [� DEMOLISH �
<br /> �!I ;e_ INSTAI.L 8 � REPI�IR
<br /> PRQPC}SED��SE Q SFR [� COMM � QTHEi7 �
<br /> TYPE OF CONSTRUC?10N Q ' ' BLOCK "" Q FRAME Q STEEL Q �
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<br /> DESCRIPTIqM OF WORK' � ,�Q--��2_ S �
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<br /> BUILQINi'a SIZE � ' SQ'FOQTAGE ',.,,J S , HEIGNT_'C,�`--__-�
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<br /> UI�.DiNG $ -�^� / VALUATiON'OF T�OTAL'COi�STRUCTION ° �
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<br /> QEL�CTR1GAl $ � ' ' AMP SERVICE Q 'PROGi4E3S ENERGY Q W.Ft.�.C. 3
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<br /> [�Pk�MBlh1G `.$ _ ' ' .
<br /> M I�HA[VlCA� $ ' ' 1tAlUAT10N OF.MECHANICAL{NSl`ARLA3'IC}N y� ��`
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<br /> ��S Q---ROOFt1�G. ,[� SPECtA�TY � o���t� ,
<br /> FINISHED F�OOR ELEVA710NS )Dr 3`/J� FLOOD'�ONE AREA C]YE$. NO
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<br /> BUIL.DER � COMPi4NY' , �
<br /> SIGNATURE, REGISTEREQ Y/ N . Fee Cutt�n ' Y/N
<br /> Address � ' . Cici�nse#'i �
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<br /> E«ct�ci,,� ,. �:coM��r � - � - .
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' 'Y/N� �
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<br /> Adelress / . , License# � p ( �
<br /> PLUMBER ' � . � . COMPAfiiY -. !i = �
<br /> SIGNATURE `" , , , , , REC3ISTEREO Y_/:N. ,FEE CURREN Y�/N.
<br /> Addre�sI , License,# �. � J
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<br /> N9ECHANICAL�` '; . , , . , GG►MPANY
<br /> SIGNAYUREI ' REGISTERED Y,/ N FEE CURREP Y/�N ,
<br /> Address>` r _, � . - ,. . - ` License#��. � .
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<br /> OTHER `, , ,. :"C{aMPAi�tY ��'J
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<br /> SIGN,�TUR�- �• �� �" ` �' ' •" ' �'� REGISTERED ' "Y/ N,. FEE CURRE� Y/N ,
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<br /> Addres� .�- ,�`r� rv� � ;..� - _ "Llceiise#: �C-G�'��'��..
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<br /> REStDENT1l�L;�:� :AtEa'cti'(2)_Plo.tf,P,laiisr(2}se#"s`'of�8uilding�Plans�(.1}seEbE-Energy�Foims;"R=O=W`Perrnit for new consbuc#ion, �
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<br /> I{, :_,,__Minimum;,tenr(1.q);wo.rking;daysbaftef;;submiftal'date.::Required qnsife,:Con'structlon=Plans;�Starmwater°Plans w%Stlt•Fence instailed,
<br /> �, San'ttarjr Facllitles&1Jdumpster;Site Work_P:ermit#cr sutidivlstons/Iarge�proJects. ."' " " ' � �
<br /> CONtIV1ERC�RL Attach(3}�compiete'sets'of�Builiiirig Plans p1u's'a'.Life`Safety Page;{1}set of Energy Farms.R O-W Perm�t far new construcflon. _
<br /> Minimum ten(10)working days'after submittal date. Requlred onsite,ConstruoNon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanikary Facilitles 8 1 dumpster.Stte Work Permtt for a1)new-proJec�..All commercial requl[ements_must meet compliance �
<br /> SIGN PERMlT Attacii{2}'s`efs of Engirieer,ed;Plaris.,,�� ��_: : �: �-,.,, � _
<br /> �, "*'PRQPERTY SURVEY reguir�for„all_NEW.c:nnstruction..� , 1 �
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<br /> Dlreation8:(� �,_:Y, - ' � . _ � `
<br /> Ffll out�,appliraUon completely.
<br /> tOwner&Contractor sign back of applicadon,notarized
<br /> (f over�y2500,,a Notice,of Commencem�et i�cequired. (A/C upgrades over ST500} � �
<br /> " Agent(for the"contraotor)or`Power df Attomey'(for tFi�owner)wiould be someane with nota�ized letter from awner authorizing same � i
<br /> DVER'THE hCOUNTER..PERMiTTiNG -- •(Fronfiof Appiicatian�Onty}- � f '
<br /> Reroafs if shingles Sewers Service Upgrades A/C _ �Fences�(PIoUSurvey/Footage) �
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<br /> Drivewiaya-Not over C:ounter if ompubltc roadwiays''.needs RG1W�',�4µf�J. � ' � `
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