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aas-zao-oo�o l�'2d� ((�� City of Zephyrhills F�ermit Application Fax-813-780-0021
<br /> � �=.�,�� 8utld�ng Department
<br /> Date Recstved . Phane�Contact far�Pernntttin
<br /> Owner's Namo � ''��� 1� � Owner Phoae Hnmber �L���`�`
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<br /> Owner's Addr�ss � � �`'�I� Owner Phone Number '�.: 1�(,�L���
<br /> Fee Simple TI4lefiolder Name r�4t„^I'�-�. � � Owner Phane Number � �
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<br /> Fee Simple Tltleholder Address "
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<br /> JOBADDRESS � V�� Z.J�-� �l. � � L07# / � "�"�
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<br /> SUBDIVISION� �„�,,, ����,PARCELID# I.JZ�"' -'Z�"� �� � ""' ��
<br /> , , , (OBT/IINED FROM PROPERTKTAX NOTICE)
<br /> WORK PROPOSED - : NEw:CpNsnr ADD/A�T � SIGN Q [� DEMCtLiSH �
<br /> � e. INSTALL 8� x.REPAIR �° .�
<br /> PROPOSED�USE Q SFl2 C] `GOMM • 'C�� OTHER
<br /> TYPE OF CdNSTRUCTION Q ` ��BLOCK ' Q FI2AME ,J STEEC Q
<br /> DESGRIPTIO�OF WORK. Y v* C��..�L.' , -
<br /> 8t71LDING'SI ZE� �- ' � SQ FOOTAGE�__� � ,_HEIGHT'��
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<br /> 0��»'d��'�' � , VALUATION�OF'TOTAL CQNSTRUC'TION.
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<br /> QEI.ECiR1CA� $ , " AMP SERVICE Q PRt}GRESS ENERGY Q W.R.E.C.
<br /> OPL�MBING , $ `
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<br /> QMECHRN{GAL $ '� VAl.t3ATiON QF MECHANiCA�lNS'fA��RTIG1Id.
<br /> QGAS [� ROQFING Q SPECEA�TY.�� � QTHER '
<br /> FINISHED FLOOR ELEVATIONS r�� FLOOD ZONE AREA QYES ,NO �
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<br /> sv».o�� � co�n�i�nt� . . .
<br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N .
<br /> Address � License# � ��
<br /> E�EC7RlCIAN:� � ` �COMPAFtY .
<br /> SIGNATURE I � REGISTEREp Y/ N FEE CURRE�^` ' Y/N
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<br /> Actdre$s " . j ,. License•#.� ` �
<br /> PLUMB�R ,� C,ONIPANY ' .
<br /> SIGNATURE a '' , „REGISTERED Y./..N F.EE CURREA � " Y./N. �
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<br /> Addrass; . . Licen3e,# �.`- �
<br /> MECHRPtFCAl: . • � � - ,. Ct?MRANY. - ,
<br /> SI(3NATURE• � � � ' '� REGISTERED , Y./ N . ' FEECURRE� Y/�N
<br /> Addrsss - � ' , . � ' T ' ` ' License# � �
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<br /> OTNER .'� - = . , . . _ ' � ;GOM,PANY ,.
<br /> SIGNA7URE ti :_ "~ �°' � � °' ^ - ' ' ' � '' � REGISTEREp � Y/ N..._ FEE CURRE� Y/N
<br /> Addre�as ' . . . _ ;Y i Uceiise# j � �
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<br /> RESlDENTIAd:;� �A#tacf�(2j�F?1tst�Plan"s;�(2}sets.of�Biiltd3iig�Plans;(0}'sef of=`E�iert�y�Fo�s;,R-O-W Peiniitfar'new canstructton,
<br /> , ,, . .:,Mintmum:ten�_(;1,0)wori4tng�days�after'subriiiftal date.'•R'equlred onsite,yConstr'ucUon�Plans;=Stormwater Plans w%Silt Fence installed,
<br /> �--`--Saiili.ary.F�cllltl��.&::1�durr►pster,tSite�,Wor1c,,P.,ertnit#or stibdfylstons!large;projects,. . ;.N; .__ ' �
<br /> COMMERCI�t,. Attach{3)ooinplete sets of 8ulttling'Flaiis plus arlife S�afety Page;(1}set of Energy Farms.R O-W Permit for new canstsuc�tian. � �
<br /> � Minimum ten(10)worktng days'after submittal date. Required anslte,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary Facilitles 8 7 dumpster.Slte Work Perrrrlt for al!naw�proJects:All commerclal requlrer»ents_must rtieet compilance
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<br /> SfGN AERMl� Attacti{2)'s`ets ofEisgineered:Plans:: - -5� � � '
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<br /> ""'PROPERTY SURVEY repuired for all_NEW constructian.,
<br /> Dlreations: ; : �� � • '
<br /> Fill out applicatlon completely.
<br /> Owner&y Contractar sign back of appi[catian,natarized -
<br /> tf over�2504,a Notica of Commsncement is required. (AtC upgrades over�9500)
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<br /> " Agent(fpr the contraotor)'or Powe�of Attamey"(far ttie owner)would be someone wikh notarized letter fnam owner authodzing same
<br /> DVERTHE�QUHTER.PERMI=TfNG� ....-.�(Fron#of,ApplicationOniy)- • ° � . �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Foatage) `
<br /> Drtvswaya-Not aver Counter if on public roaduvays..needs ROW
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