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<br /> 813-7eo-oo2o City of Zephyrhills Permit Application Fax 813-7so-0021
<br /> ' Buliding Depattment
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<br /> Date Recahred _ �_f� .. . Phone�CantaatforzPerinittin �Z � — t�
<br /> Owner's Nam� ���" �1 Owner Phane Number - c� � �7�7�`tc��
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<br /> Owne�'s Addr ss /q i/1/� C!� L. Owner Phone Number
<br /> Fee Slmple TI IeHolder Name Owner Phone Numb�r �— �
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<br /> Fee 3imple TI�leholder Addre�s b
<br /> JOB AbDRE$S � c:�"J=� B T LOT# ��,T�
<br /> SUBpIVIS10 � � PARCEI.ID# �
<br /> . , (OBTAINED FROM PROPER7YTAX NOTICE)
<br /> WORK PROP SER �„NEW CONS7R ADD/ALT C� StGN "Q = [� DEMC?�ISH
<br /> I �,�_ INSTAL.L �- REPAIR �
<br /> PROPOSED;�$�. � :Q• SFR- Q GOMM [� -OTHER
<br /> TYPE OF CQ�I3TRUCTION [�` '' BLOCK '' .[� FFtAME [_] STEEL [�
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<br /> DESGitIPTION OF WORiC, . ' /G� !D/(�C9 � . Z•l'�f�'.�tC'- i.S b �T. /Z�!�
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<br /> BUILqING StZE'`� � �`S4�F007`�I,GE��, , NEI�HT r.� �f�./t1�
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<br /> 0 � ��� VALUATIONfOF�TOTAL CONSTRUCTION � � '
<br /> BU IQING $
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<br /> QEL CTRiGAI $ AMP SEltVICE Q �FRt}GFtESS EN�RGY Q W.R.E.C.
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<br /> QPG MBING ,� � - ,
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<br /> QM CHANIG� $ ` tilALUATtON OF-MECtiANtCAI IPISTALlAT10�1. I `'�������G{��
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<br /> 0 ; s 0 . �eoa��N� ;p spEciA�.�nr [� OTHER• �
<br /> FINISHED�OOR ELEVATIQNS FLOOD ZONE AREA QYES ;NO ������
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<br /> BUII.DER ���� ��C� t CCtMPANY� -' Yt�:J�l.'l�� C�� �1��R.�CrC) C.o
<br /> 31GN�►TURE �����,�' REGISTERED Y/ N FEE CURRE� Y'/N
<br /> Addres � Cicsnse# � � �
<br /> ELECTRICt.,� . <�GOMPANY� ' .
<br /> SIGNATURE `� REGISTERED Y/ N FEE CtJRREK`� �Y/N
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<br /> Aafdre' ` � „ � License#�( �. . �
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<br /> PLUMBER C.OMP..ANY r . `
<br /> SIGNAYUR� � '`' � REGI$TEREp Y./•N- .FEE CURRE� Y•/N '
<br /> Addre ' LL License,# �— � .
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<br /> MECHANIC ': - ' COM,P.ANX �. ,
<br /> SIGNATUR { � '' � REGISTEREp Y.I N j FEE CURREP Y I^N
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<br /> Address''. ' ' � . ~i', � � License#
<br /> OTN�R - - - ° �- ' . � `;C0�11PANY ' . . ,
<br /> SIGN,ATUR � - - ~ ' � � � ' " ' � � REGISTERED� ' ' ' �Y/ N...- FEE GURREh Y/N
<br /> Addres `� .'y � _ ° ` , , _ �" � Liaen'se#`� "� , -
<br /> RESIDENTIAL;�,_ :A�tacti�(2},PIot:Plaiis,,(�}sefs':.of=8utl�Ing�Plans;{9}sef of-Energy�Foiins;�Ft-0-W Perinit for new canstnictiori, �� -
<br /> ��.;Mlntmum.tep;r(�10);working;days'after;submiftal'date:?�Requlred ansiie;iGiinstrticdon'Plans',�Stormwaite�'Plans w/Sllt Fenbe inst�lled,
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<br /> '=- �r 8aiiltary Factl[ties;&:::1y dumpster�Slte rWo,rk;Permit;for subdiVlslons/large proJects_ y::�,j: • , `� '' .
<br /> COM{MERClAL Attach{3}'ebmplete sets o#Suililiog Flans ptus a.life Satety Page;{1}set o#Energy Forms.R-O W Permit for new ca»struc�an.
<br /> � Minlmum ten(10)working days'after submlttal date. Requlred onsite,Constructlon Plans,Stormwater Plans w/Silt Fence lnstalled,
<br /> Sanitary FaclEities 81 dumpster.Site Work Permlt for all new�projects...All commerctal requtrements.must meet compltance
<br /> SIGNPERMIT At#acfi'(2}setsof�Engineer,ed;Plaiis.: :: ;:�--�= : :. .. .. , �
<br /> """'PROPERTY SURVEY regui,r�d for all NEW consWotlbn. - ,
<br /> Directlons: ,..,,,,,�,,-..._r. , _ . . r � '
<br /> FIII out�pplica�lon completely.
<br /> Owner, Contcactar stgn back of�ppltcaSan,notarized
<br /> If over�500,a Noti�of Commencement t�required. (AlC upgrades over�7900)
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<br /> '" Agent(for ttie contractor)o�Pbwe�'of Altomey`{tor ttie owner)would be�someune with notarized letter from owner authorizing same
<br /> :::.fT.:-...._.s.o.s.:✓._t:_S'_.a......,�........
<br /> �VER'THE�OUNTER PERM17'i1NG-•:•��}:(Front�ofi4ppllcatlon;:Qnly).- � -
<br /> Reroofs If shingles Sewers :�_;Service.Upgrades1 A/C .,^" Eences(PIoUSurvey/Faotage) _
<br /> I+ " :_.�,. -- :.._ :� _.. ... ,. ' .
<br /> Drlveaiaya-Not over Gaunter ifJon pubflc roadw�ays;:need"s RQW, '
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