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<br />� •- e�a- so-oo2o City of Zephyrhills Permit Application , FaX-s�3a8o-oozl I
<br /> � Building Department
<br /> Date Receive
<br /> •��0. Phone Contact for Permifting '' - •
<br /> Owner's Nam �� �. ��CL�� Owner Phone Number , ���'�9�- �/�d
<br /> Owner's.lAddr�ss Cv��� T�� - C� � OwnerPhoneNumber
<br /> Fee Simple Ti leholder ldame Owner Phone Number
<br /> Fee Slmple Ti leholder Address
<br /> JOB ADDRES J��/1'l� /�--5 /��'OG�E LOT# �
<br /> susoivisio� � �R fFTG(�p01� C�7�b�r pARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROP�SED > NEW CONSTR- ADD/ALT � SIGN Q � Q DEMOLISH �
<br /> � INSTALL � REPAIR
<br /> PROP.OSED SE. Q SFR Q COMM � OTHER"
<br /> TYPE:OF CO STRUCTION Q BLOCK - Q FRAME , 0 S,TEEL . Q - . - ,
<br /> DESCRIPTIO OF WORK + �4� �I/�,C�4GQJS � I �C'�{ �EDRa3� '� � Kr���E�
<br /> BUILDING`SI E � SQ FOOTAGE� - HEIGHT . _
<br /> QBUI DING $ 9 a,�G�,qo� VALUATION=OF'TOTAL CONSTRUCTION I
<br /> � �J
<br />'�I QELE TRICAL , $ , AMP SERVICE �Q PROGRESS ENERGY Q W.R.E.C: I
<br /> QPLU BING $
<br /> ` , �
<br />� �8�
<br /> QME HANICAL $ VALUATION OF MECHANICAL INSTALLATION �
<br /> . �
<br /> QGA Q ROOFING Q SPECIi4LTY � OTHER
<br />' FINISHED.FL OR ELEVATIONS FLOOD ZONE AREA DYES NO
<br /> BUILDER �f�j�� ����� ,) �COilAPi4NY ��� �GU/��
<br /> SIGNATURE L�l/'`` � � �Q � REGISTERED Y/ N FEE CURREn Y/N .
<br /> Address ' License#`
<br /> ELEC,TRICIAN. COiN PAIdY �
<br /> SIGIVATURE �' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Cicense:#
<br /> ,PLUMBER;; COMPANY�
<br /> SIGNATURE ,- ;REGISTERED� `Y:�/ N _ � 'FEE GURRE� Y/N
<br /> Address - License#� - '
<br /> '_�MECHANICAL COMPAIdY • _
<br /> $IGNATURE` - REGISTERED Y/ N FEE CURRE� Y/N
<br /> � Add�e'ss� � � � - � License#
<br /> ::;�,>� ; . _.. .
<br /> -OTHER<%�•` �_ , . � CO�AflPANY . �
<br /> 'SIGNATURE:7.; �c� - "' �- � REGISTERED Y/.N _ FEE CURRE� Y/N •
<br /> a;c's: . _
<br /> � .. �,_ _ . �� � . ,. ,. - Li e
<br />� �C�(�feSS� , ., _._, . . . CBnS #
<br /> _.: . ' . ,. . !. . . ' . . - '
<br /> - �,-.._ -
<br /> -'.RESIDENTIAL',,: Attacfir.(2:);PIot�Plans;:(2):setsof`Building=Plans;�(1�)_setofEnergy,Forms;`R,O-W PeRriit.for.'new.:construction,
<br /> � ,�,s:;,, :<�. ;Minimum,';;ten;_(;10)wo,rking_;iJays afte�"submittal�date. Required�onsite;�Construction Plans,Stormwater Plans w!'Silt Fence installed,
<br /> - '�..,�..»�.,••.. •,. , Y �. . - ; . ..
<br /> TSanitary;Facilities;&.1;,dumpster;Site:Work Fermit'for_subdivisions/large:projects:;� - "
<br /> - COMMERCIAL. Attach°2�com lete'sefs of Buildin �Plans lus a�Life Safe Pa e; 1 set of Ener Forms.R-O-W Permit for new construction.
<br /> � ) "���P 9 P tY 9 � ) 9Y
<br /> . Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,,
<br /> Sanitary Facilities 8 1 dumpster.Site_Work Permit fo�,all`new projects.All commercial requirements must meet compliance��
<br /> :�'SIGN�PERMIT �AttaoFi(2)sets of;Engineer�d Plans:Z', -, - �
<br /> - '•'"FROPERTY SURVEY required for_aIL.NEW:construction. �
<br /> �=Directions:: _...-... ., , , -- . -
<br /> . . . . ... .
<br /> � �Fillrout ap lication completely. ,'� '
<br /> Oiivner& � ntractor sign back of application,notarized
<br /> If over'$2 00,a•Notice.of Commencement is required. (�41C upgrades over$7500)
<br /> .. ,,,..�r
<br /> Agerlt(for tfie�contractor.)orPower of Attomey(fo�'tFie�ovirner)would be someone with notarized letter from owner authorizi�g same ,.,
<br /> �.:OVER`T'WE:CO_NTERPERMI.TTIPIC�._� �(copy...of-contraet:required) �, ' � � „_ .. -- , � , �
<br /> Reroofs if:shin les Sewers Service.�Upgrades�•A/C`�`�, Fences'�(PIoUSurvey/Footage) � .- :�'�'"`'', , ' . ; '
<br /> Driveway -Not over Counter.�if on pu6lic roadways::needs ROW", � ' , � , �• � _� �
<br /> . ' „ '.t: ., � , . , `. -�` _ , , _ �. .
<br /> +.,Y ,_ . „- . . _-- ..,,, _ � , -...
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