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<br /> 8�a'�780-0020 City of Zephyrhills Permit Application Fax 813-780-Q021
<br /> � v • Butiding Depactment
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<br /> Date Recelve}d � = Phone�Contact for Femtlttin ` —
<br /> Owner's Na N e .� � >� �� " �.�.�`5� ���^ Ownsr Phoae Hum6er � �� ��� � � �� '
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<br /> Owner's Ad�lrass � � & .a�.���'`• S ° �'��'�������^� Owner Phone Number
<br /> Fee Simple'fltleHolder Name t — � � Owner Phone Number �— �
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<br /> Fee Stmple�itlehold�ar Address - °
<br /> JOB ADDRE$S_-/".- i � `'� � .�F1 � � �i�� �,�c ��`� � �1�G.�j .�,��L'S LOT# ��
<br /> SUBDIViS10� �— � PARCEI.ID# -
<br /> I) , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PRO�OSED =NEw CONSTR ADDlACT' -� 31GN� Q Q DEMOI.ISH
<br /> � e. INSTALL 8 REPAIR �
<br /> PROPOSED��tlSE Q SFR � COMM � �OTHER -
<br /> TYPE OF CQ�NSTRUC770N Q� BI,OCK " [� FRAME C� STEEC Q
<br /> DESGRIPT�dN OF WORK � �4 r � �` t � E�Ei c cv �1 r� l� '� ' 4C C�i �! ;
<br /> BtiiLDlAtG SFZE ���� � � SQ fOQTAGE�� . ,HEIGHT ��
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<br /> 0��������' �� VALt3AT18N�OF'i'OTAL CONSTRt1C1'ION
<br /> � �3� ��a
<br /> QEt.�Gi'RICA� $ ' AMP SERVICE Q PRt�GRESS ENERGY Q W.R.E.G.
<br /> QPL�MStNK`a $ 1 '
<br /> �M�CHAt�lICAL $ '' VALUATlON OF=MECHANiCAI INSTAIIATIt�N j� /
<br /> �s . �Y l ��� �
<br /> [�GA Q ROOFING Q SPECIR�TX-�� OTHER�
<br /> FIfViSHED F�QOR ELEVATIONS p�00D ZONE AREA QYES NO
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<br /> eu��.�E� COMPANY� �����
<br /> SIGNATURE � REGI$TERED Y N FEE cuartEn Y/N
<br /> Address Ltcense# �� ��
<br /> �J .,
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<br /> ElECTRIC.; . � COMPANY '
<br /> SIGNATURE � REGIS7ERED Y/ N FEE'CURRE� ° 'Y/N
<br /> Atldress , . , ' . . . License# � ' �
<br /> PLUMBER ' COMP.ANY ,
<br /> SIGNA'fURE ` " , ,.REGISTERED YJ-N . ,-:F.EB CURRE�` Y/N �
<br /> Address License.# � �.
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<br /> MEClfAN1CAL` GOMPANI( .
<br /> SiGNATURE�' � � � � ` � � REG.ISTERED Y,/ N ; FEE CURRE� Y/�N •
<br /> •�"�.. _ .. ' . .. r .. k � • " v
<br /> Address` -� License#
<br /> OTHER ''�� - - � ,CONlPANY
<br /> SIGNATUREi� '�;: =- ' • •• � `REGISTEFtED � Y/ N;., Fee euRtten• Y/N
<br /> Addres� ' � � x,° T "+� u �r License# �_ �
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<br /> RESlR6N'T1A�::� ;1�ttach`{2�,P-_fofiP,lans;.(2�`sefs��af:8ullding�Plans;•(1)`setafEnergy,Foiigs;,R-O=W'Peri»Itfarnewconstruct�on, -
<br /> ;:;;�.;;:�Minimum;ten(:1.0),woricing;days:�afler:;subriniEtal dafe.�::Requlred onsite,•:ConstrucNon'Fians;�Stormwate�Plans w/Stlt Fence installed,
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<br /> �'�� `�Santtary Facilltles.&;„1;dumpste_r,TSite°Wor1c.P:,ermit for subdivislonsAarge'proJects� ,�� ��-= � � "
<br /> COMMERCiI�t. Attach{3)�oomptete sefs''of Bultdiiig`Plan's plus a l.tfe'Safe#y Page;{i)set of Energy Foims.E2-O W Petmtt#ac nev+t canstructtoo:
<br /> Minlmum ten(10)worlcing days after submtttal date. Requfred onsite,Construction Plans,Stormwater P1ans w/Silt Fence installed,
<br /> I� Sanitary Facilitles&1 dumpster.Site Work Permlt for all new:projects.All commerclal requlrements.must meet compliance �" �
<br /> . SiGN PERMI� At#acti"{2)sets ofEngineered:Plans., �_,.°.. ` .. � �
<br /> ••«"PROPERTY SURVEY re,quired for all WEW constructlon.
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<br /> Dlrectla�s: II . °�.,�", - '
<br /> Fill out a�pplfcaUon completely.
<br /> Owner&Gantractor slgn back of appl(catlon,notarized
<br /> If over�2500�a Notice of Comm�ncem�nt Is required. {A/C upgrades over 57500}
<br /> '" Agent(for the conbraotor)`qr PouVe�of"Attomey(for tlie o�rner)would be someone with natarized letter irom owner authorizing same
<br /> t1YER TNE COtINTER,P..ERM1T[ING._..__._{�ront of Application On{y) � " _ , ,
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fe�ces(PIoUSurvey/Footage) -. ., ' , , �•,. f
<br /> Drlvewaya-htat over Counter if on pubifc roadways..needs F�tlW t ' ' , -
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