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813-�ao-ooxo City af Zephyrhills Permit Application Fax-813-780-0021
<br /> r 4, , � Bufiding Department
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<br /> Date Receiv�¢ � _ - Phone�Cantact far.°Permittin - -
<br /> auvner's Name �� S �iG'° e ��L� Owner Phone Numbsr
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<br /> Owner's Addpess -� � C ���' Owner Phane Number
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<br /> Fee Simple Tltleholder Name �� ��l 3� � Owner Phone Number
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<br /> Fee Simple�leholder Address Y
<br /> JOB AbDRES$ LOT# C� .
<br /> SUBQtViSiOFi �� � PARCEI.iD# /1' "" -C�1���1 �--~1'Tf�r?�-t�U�O
<br /> WOFtK P120Pb�}SED � � � NIEw CaNSTR `� ADDlA�T C�' �'��NED F,�PROPERTYT�ncE)�EMOI.ISH
<br /> � iW
<br /> e, INSTALL REPAIR ^
<br /> PROPQSED�USE Q SFR� Q COMM � OTHER �
<br /> TYPE OF CO�$TRUCTION - Q r BLOCK " Q FRAME �.C� �STEEL Q
<br /> DESCRIPTIQN OF WORK `/' (S� lz`( s • �' �r' �
<br /> BUILD1TtG SIiZE � ' � S4 FOOTAGE�l�. - - .,,HEIGNT �C��--_`-�
<br /> QBU�I.DINC' L � VALUATION>QF TOTAL CONST'RtJCTION -
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<br /> QEI.ECTRICAL • $ � AMP SERVICE Q PRO�aRESS Et�lERGY Q W.R.E.C.
<br /> QPLUMBING $ I • /_
<br /> � - . , �.-�� �X�
<br /> �MECNANtCRL $ � fy� �-Jt? VALURTtON OF:MECHANICAt.[N9'CRLLATtt?N ���
<br /> b t.�� . - .
<br /> QGA�S Q RDOFING Q SPEGIAi.TY � = OTHER -
<br /> FINISHED FLpOOR ELEVATIONS r�� FLOOD ZQNE AREA G]YES NO ' .
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<br /> SUI�DER COIVIPANY' "
<br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N .
<br /> Addres Ctcense# �i �
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<br /> ELECTRICIAN � C'ONlPAAtY � -
<br /> SIGNATURE '� REGISTERED Y/ N FEE'CURREP� Y/N
<br /> Addrag� � � , _ . Licanse# - '
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<br /> PLtJMBER ` CQMBANY � . �. °
<br /> SIGNATURE` ' ' , REGISTERED Y,/-.N �e cuR�� Y/N
<br /> Address , . � , .�icense,# �. , �r I.
<br /> �� _ �----- /�
<br /> MEC1iANtGA1: ' . � . GOMPANY o/;'�"-.,� C.._�ry- � .
<br /> SIGNATURE� t REGIS7ERED Y,/ N . ,' FEE CUFtRE�- Y MN' .
<br /> Add�ess' ' � :_ � ` - - �tcense#�����.�- �
<br /> OTHER ; ` � _ � < �'GOMPANY ' � � � ,
<br /> SIGNATURE � - �� �� ' � - ` REGISTERED � Y/ Nr..-. FfE CURRE� , Y/N
<br /> Addre� .. , ,�� °. . , `, .y � 3 � . Liceitise# � � �
<br /> ' i� ...,�... . .�.. ._� .. . S;,c',: �' f' Y�s' ' ' r-. . .� . .,
<br /> RESIDENiiAt:.:; �Atkairfi'(2),Rlot�Ria"n's;,:(2}sefs=of:Builillisg'Plans,(!}sef of Enaigy=Famts;,R=0-iN'Parinit fot new canshuction, -
<br /> �� ���Minimum�ten(1A);vuo,rking,iiays;after�,"submi(tal�dafe�:R'equired onsife;.Cion`stivallon:Rians,StomiwateF'Pian"s�w%Siit'Fence instailed,
<br /> �M�.�:�._.....;.... .::. ..e..,...�_, , ,
<br /> Sanitary FaciltUes;&;1:tidumpsternSlte�Work.,.P,ermit#or subdivisions/large`proJeots. �- � � '
<br /> COMMERCIAS. At#ach{3}cot'riplete s`sts°'of"Biilidlc�`g"�'laiis pliis a Ltfe'S�fety Page;�{1}set of Enetgy Fotms.R O-W Petmi#for nsW construcUon.
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary Facilitles&1 dumpster.Site Wo�lc Permit for all new.projects:All comme�ctal requlrements.must meek campliance �
<br /> SIGN PERMI'f AttacF�{2}se#s�of'EngliieerediPlaris:, . �rt,-`� ;:..,'-a_`.
<br /> � "`"PROPERTY SURVEY required for,all_NEW canstrucUon._ ,
<br /> Dlrectlons: � ��
<br /> Fill out applicatlon completely.
<br /> Owner&�Contracbor.sign back of appltcatlan,notadzed
<br /> tf aver�04,a NaNce.of CommencemeM Is required. {A1C upgrades aver 57500}
<br /> rr ��.�G:ti�4z':,;!c;.i
<br /> Agent(f�r tlie�contractoc)br Powe"r of Attomey(fi�r tFie oJtimer)would be someone with notarized letter from owner authodzing same
<br /> 4VER TFiE Ct�UNT.ER PERMIT-7fNG � �-� (Frant af Applicatton Oniy}:-.
<br /> Reroofs if shirigles Sewers � Service Upgrades,A/C , Fence's.(PIaUSurvey/Faotage)
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<br /> Drtveways-hlot cver Counter if cn public roadways:.needs ROW. � j
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