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<br />' e��-yeo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � Buiiding Department
<br /> Date Recelved , : Phons=Contact for�Rermtttin —
<br /> Owner's Na I e Owner Phane Number d��� 7�7�' '��^�� I
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<br /> Owner's Ad�ress �� � Owner Phone Number �
<br /> Fee Slmple ,�Itleholder Nlame � Z O� Owrner Phane Number � � �
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<br /> Fee Simple�itleholdet Addresa � d ^ E '' L �'� �3 �
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<br /> JOB ADDREiSS L07#
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<br /> SUBDIViS10� � � PARCEL ID# �
<br /> ! (OBTAINED FROM PROPERTY.TA%NOTICE)
<br /> WORK PROPt}SED t--. - NEW CONSTR ADD/A�T [� SiGiV' Q [,� DEMOI.ISH
<br /> ��e_ INSTAI,:L � REPAIR
<br /> PROPOSED�t3$E Q SFR: Q CQMM � •OTF{ER '
<br /> TYPE OF CONSTRUCTION Q ��BLOCK '" Q FRf1ME � � STEEL [�] ;
<br /> DESCRIt�TiQN OF WORK' y �'� � �' '��'�'c
<br /> BUILDlNG SFZE � �-I� � SQ FOC3TAGE��� ,• ,.HEiGiiT f�` ��
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<br /> �� f��"d�N� �� �� VALUATtO'N?'OF'fOTALCONSTRUCTiON I
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<br /> [�ELECTF21CAl �� AMP SERVIGE �Q FROGRE5S ENEi2GY Q W:Ft.E.C. �
<br /> QPLUMBlfVG �� � 1
<br /> �MECHANIGAL $ VAIUA"FIQEI OF�MECHANICAL tNSTALCATtt?(V � �V�/ � i/r
<br /> � � ��-�l`�` ;
<br /> [�cAs CJ Raa�iN� .[� sPEc�a�.rr � o�H�R � ,
<br /> FINISHED F�OOR ELEVATIONS FI.00D ZONE AREA QYES NO �
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<br /> $ui�a�� � c� coMp�r� 1����N ���� �f� ;
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<br /> SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N �
<br /> � Addre�$ - � - L(cense# �� � ,
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<br /> � E�EC'YRICF. • . - ` .�GOMPANY Y - - ,
<br /> I SIGNA,TUREi `�'4 REGISTERED Y/ N FEE CURREF Y/N �
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<br /> i Address " . -� license�# � � � I �
<br /> PLUMBfR � � � , I
<br /> , _ -� C.OMPANY �
<br /> , SIGNATURE� � " � � RECi1STERED Y/ N. FEE CURRE� " Y-/N �
<br /> Addresa � Ucense.# ( � � � � .�
<br /> MECHANIG I" � � CCIMPANY.
<br /> SIGNATURE� � � " ' REGISTERED .Y/ N . ; ; FEECURREA Y,/~N . I
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<br /> Addr�a.� License# i
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<br /> 03HEFi '; � , � � � ';GOMP�1t�lY; ,
<br /> SIGNATURE+ " � ' � " ' REGISTERED ' Y/ N�. FEE CURRE� � Y/N �
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<br /> Address � - . .Ucense# '
<br /> I !'-� ' Y' .. . �. . ._ �,. � . n,.� � < : . .
<br /> i RESIQEN'TfAi:� - •AttacFi`{2}.ptotEP,latis;�,(2}set"s`°ofjBuEldingFi?lai�s;(1}set of`Ener%�y=�oiins,.R=0-W Peririit for new�nsttuotion,
<br /> - Mlnimum:ten:_(;10);y+rorking;days;afteesubrinitfat date:>:R'equlred bnslte;;Constructlon�Plans;Stormwater'Plans w/Sllt Fence lnstalled,
<br /> Sanitary Fa,cillfles.&T�1.;dumpste_r,,_Slt�.Woric:Permit for su6diVlstons/Iarge�roJects. � ' '
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<br /> GO�IflMERCI!&!. Attach(3)�complete'sets�of Ballilfiig'Plans plus a�.ife Safety Page;(1)set of Eaergy FaRns.R-t�-W Petmtt for new canstruction.
<br /> Minlmum ken(10)working days after submlttal date, Required anslte,Constructlon Plans,Stormwater Plans w/Sllt Fence Installed,
<br /> Sanitary FacIIIHes 8�1 dumpster.Slte Wark Per+mlt for alf new:proJects..All commerclal requlrements must meet compllanca
<br /> SFGN PERMIT Attadi(2)`set"s afEngli��er.ed',Plaiis..... ;;:; •, - ;; ,- � - . . ,
<br /> I ""`PROPERTY SURVEY,reguired,,for.aU NEVV_constructlon. '- . , • , •- � ' � . � � ��
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<br /> Dlcection�: � __ .__.__-- .. _ - . - • _ . _ � - .. ' � ' �
<br /> FIII out applicadon campletely.
<br /> 4wner&�GontracMr slgn back of applicatlon,notarized , ',
<br /> If aver�2500,a NoNce.of Commencemen#is required. {ac u�$raass oYar srsaaj � , . � _ '
<br /> " Agent(fo�r the`contracto`r)or Power of Attomey`(for tFie owner)�would'be someone'with notarized letter from owner authorizing same.
<br /> DVER THE.CC3UH'i'ER PERMI'ETIi�tG,-�. _;.{FronE of-APpt(catiomOnly} _. � , ,
<br /> Reroofs If shingles Sewers Seryice Upgrades A/C Fences(PIot/Survey/Footage) .,. ^ . �
<br /> Drlvewagra-Not over Caunter if an pub�ia roaduvays.,ne�s ROW�.�.e ~, � � � .'` - - r'.�t-' , ^.J a
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