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�- 813lrso-oo2o City of Zephyrhills Permit App(icatian Fax-813-780-0021
<br /> • Building Department
<br /> Date Receive�d .r _ •�
<br /> ��"'C�0 Phane Cantact far Permitting ' �
<br /> Owrner's!da e 1 J Owner Phooe Plumber , -°� �
<br /> Owner's�Add ess _ Ouvner Phone PJumber �/��'"' __�,��
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<br /> Fee Simpte T'tteholder Name 9 •- „��;�/1 � Owner Phane Number
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<br /> Fee Simpte T"t�eholder Address �
<br /> JOB A6�DRE�S �r-%�� /'CY� LOT# �
<br /> StlBDIV1S10 I � � PtdRCE�lD#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WOFtK PRO OSED _ NEW CONSTR ADD/ALT C� SIGN [� Q DEMOLISH
<br /> e INSTALL. � REPAIR
<br /> PROPOSE� SE � SFR Q COMM [� QTHER �
<br /> � TYPE`4F CO STRUCTION BLOCK - [� FRAME � STEEI. Q
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<br /> nesc���T�otv-oF woRx -
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<br /> 8Ut1:DIPIG'SiIZE-�������„s,��,��.SG!FOOTAGE F9E[GHT ��
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<br /> ���i�'D��� � �(,,,� � VAl.t1RTION'OF TOTAL CONSTRUCTtON
<br /> L_.�L(� °
<br /> �EL GTRlCAL � $ p ��' � AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.G.
<br /> QPL MBING �� /� ]� f�
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<br /> 0!V! CHANIGAL $ VALUATtON OF MECHANICAL INSTAIlA7tON � �j -'' �
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<br /> C]G S Q ROOFlNG Q SPEGlAL.TY 0 QTHER �/�? t i �
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<br /> FINISHED FLOOR EI.EVATIONS FLOOD ZONE AREA L]YES NO ��
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<br /> BUILDEf2 _ '�)�O�tIPANY � . ��j� �� �
<br /> SIGPLATUR� (__ V, ��� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres License# �� �
<br /> ELECTRICI tst CONlPAtdY �'ft� �C.�.,�vl f `
<br /> S1GPlATURE � �' REGISTERED Y/ N FEE CURREP Y/N �
<br /> Addres Cieense# �— �g �
<br /> �CUR��ER.,. GOMPA4tY
<br /> SIGN/�1TURE REGISTERED- Y•/ N FEE CURRE� Y I N
<br /> . Addres License# � �
<br /> MECNANtCAl. COMPANY
<br /> SIGPIATURE� ' REGISTERED Y/ N FEE CURRE� Y/N
<br /> � �;ddres � License# �� �
<br /> ii� , .
<br /> OTHER.� `.'.' COMPANY
<br /> 'SIGNATURE , "� ' REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Addres � = - License# � �
<br /> �`RESlDEPlT1,4!_ : Attacli,{2}�Ptot P.lans;(2}se#s of�Builcliiig�Plans;{1�)set of°Energy Forms;R,O-W P.ermit.far new.consfruction,
<br /> _ . • ,.,,;�,,; ;iVlinimum.;ten.(.10)working�days after.submittal-date. Required`onsite;Con'stniction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanita.ry Facilities.&1,.dumpster Sife.:Wotk Permit foa.subdivlsionsllarge.projebts
<br /> COM3U1�RC1 Attach�{2}comple#e sets of`Building Ptans�plus a L3fe Safety Page;(1}sef of Energy Fotms.R-O-W Permit far new canstnsction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt.Fence installed,
<br /> - Sanitary Faeilittes 8�1 dumpster.Site Work Perrrtit foi•all new proJects.A!I commercia!requirements must meet compiiance
<br /> -;SiGN PERMII AttacFt{2}"sets of;Eng�neerQc!Plans:'.� . ` .
<br /> '•"`PROPERTY SURVEY required for_aII,NEVV cpnstructian.
<br /> ;•Direcficns:. _ ,- . - , . , , . � '
<br /> � Filhouta�pplication completely.
<br /> Owner 8{Contractor sign back af applicatian,notarized `
<br /> �, if aver'$2500,a NaEice of Commencemen4 is requirgd. (kJC apgrades over$7500) ;
<br /> I ** Agent(for'the cont�actor)�or Power of Attomey(for tlie owner)would be someone with nokarized letter from owmer authorizing same
<br /> t3VER.'fHE C�OUNTER.P�Rt�tl'fTiNG. (copy.af contraet-required)
<br /> Reroofs if shingles Sewers 8ervice Upgrades A/C Fences(Plot/Survey/Footage)
<br /> . - =- ___.. _. , --`-. _..... _ ,. Z . , . . ,. , -. .. ,
<br /> Dr(vewra s-Not over Counter if on public roaii`ways.:needs;ROW , � - - .
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