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� 813-�so-oozo City of Zephyrhills Permit Application ��-���-7$°-°a2�
<br /> ( { µ Building Department .
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<br /> Date Re,ceiver�� , � _ �-� � '
<br /> • Phone Contact far Permitting �
<br /> , Owner's Flame �' 4 Owner Phane Number , �
<br /> �Owner'�:Address � � ' Owner Phane Number
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<br /> Fee Simple Titleholder fdame Owrner Phane NumbeP
<br /> Fee Sim le Titleholder Addtess
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<br /> OB ACIDRES�B lA G U . LaT� ��
<br /> SUBDCNiSlO�� �� � PI�RCE�ID# � �
<br /> (OBTAINED FRC1M PROPERTY TAX NOTIC6)
<br /> WORIC Pi20Pt)SED � IVEW CONS'�R t3DDlALT [� StGIU Q [� DEM0�18H
<br /> � e INSTALL 8 REPAIR
<br /> PROP.OSED USE i Q SFR Q COMM C� QTHEF2'
<br /> �, TYPE'OF CONSTRIiCTION Q BLOCK ~ [� FRAME C� S,TEEL . Q
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<br /> DESCRIPTIOpd`OF WORF(
<br /> �Ult-DING`SI�E � �_ SQ FOOTAGE�,�,� HEIGNT �^�
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<br /> 08UI�DtNG , � � VALUATION�OF�TOTAL-CONS'i°RUCTtON
<br /> QEL�C.T,RICA� ,$ A�t1P SERVICE �� PRC?GRESB ENEF2GY Q W.32.E.G.
<br /> OPI.�MBtNt3 $ ' �
<br /> � � � � ,�A� �����
<br /> OMECHANICAL $ ' VALUATION OF MECHANlCA�INSTALLATtQN L�""
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<br /> ._ G�S Q Ft04F11�G Q SPEGIfi�TY 0 OTHEFt
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<br /> FINISHED.FL�QOR ELEVATIQNS FLOOD ZONE AREA YES NO A�
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<br /> � �� /� CQIVIPANY �VcL� � ��C�r�1c� �AA��i �«7rt tT�t?
<br /> ATURE � REGISTERED Y/'N FEE CIJRRE� Y/N
<br /> Address UC U�� � t.{) �►GJ 7�`' ��x�`��License# '� � ��� �.����
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<br /> ELECTRIGIAN CQfl6PANY �
<br /> � SIGNI4,TURE � REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Aiddress Cicense.# �!
<br /> PLUNIBER..,. COMRANY% �
<br /> SIGNiATURE ' � REGISTERED• Y•/ N- FEE GURREn Y/N
<br /> . i4ddress, Liaense#"�� � ' �
<br /> ;; :MECMAIdIG I • COMPANY
<br /> : SIGWATURE ' � REGIS7ERED Y/,N FEE CURRE� Y/N
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<br /> �iild'ress�� License# �
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<br /> OTHER�`��:-,' . ' � CC►NIPANY
<br /> �`SIGWI.ATURE::> � - � • ' REGISTERED Y/.N FEE CURRE� Y,.I N
<br /> ��ddres�:_. �, � ��:- .- - - . . " , License#
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<br /> ���RESI�DE1VTi, :_ Attacii.(2);Plot'Plans;(2)="sets of Building-`Plans;�,{1)set'of°EnePgy,Forms;'R-O-W Pemitt.foc new`cansfructian,
<br /> � �..;�-t�Minimumw{ten;_(:1'Q,)workingedays afte��"sutamittal.date. Required'onsite;Constnlction Plan"s,�Stormwater Plans w/Silt Fence installed,
<br /> Sainta.ry..Faatities:&ti,1:dumpsterSite;:Work�Rermit'far_subdivisi'ons/large�prbjecfs,f� " �
<br /> .. 4.,�y...,s_:.*.,....:'..-rt.,_�i� :..r v.
<br /> 4 GOMMERCIAL Attach°(2)'complete`sefs'ofBu9tding Pians ptus a�Life Safery Page;(4}set af Energy Fanns.R-O-W Permit fiar new consfrucfion.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence:installed,;
<br /> Satti#ary FaciEities&1 dumpster,Site Work Perrriit fot all new projects.All commercia)requirements must meet carr�pllance
<br /> ���SIGN PERM�T 'Attacfi(2)sets of�Engineer�d Ptans:�-.° ,� � � � •
<br /> ; •"""PROPERTY'SURVEY,required for_aII.,NEW canstruction.
<br /> ':Dire'c,4ions:_, ,�:�,>',: t � .
<br /> '.Fill�out application completely.
<br /> Oinrner&Gontractor sign back of applicatian,no#arized
<br /> If over$2500,�Notic�of Commencament is required. (A!C upgracles.over$75Q0)
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<br /> Agent(�o'r''ttie�contractor)orPower.of Attomey{far ttie`ovirnec)would be sameone with notarized letter from awner authorizing same
<br /> �',OVERtF1E•COUNTERPERMITTIRIC,_ .(copy-of-conVaet•.required) `� �
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<br /> Reroofs if sh�ngles { Sewers Servfae Upgrades A/C Fences(F?IoUSurvey/Footage)
<br /> Driveways-Not over Counter if on pu6lic road`ways.:needs ROW
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