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s�aaso-ooz�o City af Zephyrhills Permit Application Fax-813-780-0021
<br /> `', ' . Bunaing Deparanent �
<br /> Date Recefved . PhonaxGontaafifor�Pert�t�ittfln �
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<br /> Qwner's Name � Owner Phone Number
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<br /> Owner's Add iess �G� �+�� ��/� � �Owner Phone Number �
<br /> Fee 3lmple Titleholder Name l — - � � Owner Phane Number " �
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<br /> Fee Stmple TMtleholder Address °
<br /> JOB ADDRESS LL.. LOT# ��
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<br /> SUBDIVtSlO , � � PARCEI.iD# '
<br /> - , , (OBTAINED FRpM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED .a NEW CONSTR ADD/ALT � S1G{V' Q [� DEMOI.ISH
<br /> � ��. WSTALI» �� � REPAIR �� '
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<br /> PROPQSEDFt/SE � SFR Q COMM �[� OTHER
<br /> TYPE OF CO�STRUCTION - Q�� � BLOCK " �] FRAME �.[ '� STEEL �[� ,
<br /> DESCRIPTION OF WORK L !9 F/' �' OZ7'
<br /> Bt!llD1NG`SIZE �� � �`SQ FOOTAGE.��. . ,,HEIGHT � �
<br /> ���E��N�'" � �" VALUATIONµtOF 1'OTAL-CONSTRUC'GION I
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<br /> QEL�CTRiCAI $ AMP SERVICE Q PFiOGRESS Et�ERGY � W.R.E.C.
<br /> QPLUMBING $ '
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<br /> QMECHANlCAL $ VAIUATiQN OF MECNANIC/1l tNSTAL6A'FION '"� �
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<br /> QGA�� [� ROOF!!VG CJ 3PEC1A�Tl. � � OTHER< �
<br /> FINISHED FL,OOR EI.EVATIONS � FLOOD 20NE AREA QYES NO
<br /> $
<br /> BUtt»DER �C CONIPAt+IY �. '�.�--
<br /> SIGNATURE r' REGISTERED Y/ N FeE CUFtREn Y/N
<br /> A�ddress � License# � � '
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<br /> �lECTRICIAN; , .�COMPMiY � � .
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURRE�° 'Y/N
<br /> Aiddr�ss ' . . License# �• • � �
<br /> PLtlMBER �' � , � COMP,.ANY • � � - i
<br /> SIGNAfiURE ��" , REGIST.ERED X/ N,. ,Fee eurttten- ' Y•/N. �
<br /> Address ` � L1c�nse,# � � _ <, ': j
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<br /> MECH�NICAE:' ' CCIMPANY, � , j
<br /> SIGNATURE " � REGIS7ERED Y./ N . ,, FEE CURRE� Y/�N . i
<br /> Addre�s` � . � � `� . � . , - ' Ucense# �— .—.'._.�
<br /> OTHEtt "�' ' .� - - r " �;COMPAHY _ .
<br /> SIGNATURE; '.� - - ' � �� ' ' REGISTERED Y/ N... FEE CURRE�• Y/N
<br /> Addr�ss� � . .. � _ . ` � ,T � l'icense# � � �
<br /> � � �. . ,_.:, , .. ._ s,w...;,-,. _
<br /> EtESlDENTlA!»,�>, �:Attacti`{2);Ftot�.P.,lalis;.,(2)sets�.ofBull�ing��Rtans;('!}set of=Eriergy;Fortns;�R-0-VY�Perinit for new consttuction, .� „
<br /> - y,�;:�Mlntmum�;ten�;(�1.0),�„wo,rkfn'g�atiays;,,aftersubmtEfal�ilate:::Requlr''etlanslfe;:CansfnicBori�Flans;�Stormwate�'Plans�wlSilYFenceinstalled, �
<br /> Sanifary FaGlltles.&;.1;dumpste.r,nSite�WorkrPertnit for subdivi5ions/large proJects;_ ..`,.�= _. ;
<br /> GO�iMERCFAi. Attach{3)coiiiptete sefs of Biilldtng'Pians�plus a'1.ife�Safety Page;(1}set of Energy Fortns.R-C11IV Permtt for nevwt canstru'cUon.
<br /> i Minimum ten(10)working days after submittal date. Required onsite,ConstrucNon Plans,Stormwater Plans w/Silt Fence installed, I
<br /> Sanitary FaGlitlas&1 dumpster.Site Wark Pertnit for all naw.proJects:All commercial requiremenGs_must meet compllance �
<br /> SIGN PERMFF Attact�"{2)"sets"of Engineer,ed��f?lans:, �-_�-.:- •:. .a.. '
<br /> � ""'PROPERTY SURVEY required,for all NEW canstrucUon.
<br /> Dleectlans. ; -- - -.- .
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<br /> Ftll out applicatlan wmpletely.
<br /> Qwner&�Contraotor sign back of app!(catlon,natadzed
<br /> If over��500,a Natice af Commence,t�nent ia rsquired. {AtC upgra�des over 57500)
<br /> -��.:a;�:_ .;.
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<br /> Agent(for the contraotor)`or'Powe�of Attariiey-(fa�tFie,awrier)�would�besomeone with notarized letter from�owner"autiio�iiing;sarrie" '� ,�� ;
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<br /> 01fER THE Ct}1�NTER;PERMtTTiNt3 ;;� -{Frant of�Appllc�tion Only}:=-.=-�;�. ' _' , , �, � . "
<br /> Reropis If shingles Sewers � Service.Up'grades R/C �.Fences(Plot/Survey/Foatage) , � ` ., . - •• �• _
<br /> Dr{vewajra-Nat over Caunter tf on public roaduvays..neel"s ROW���::... � .. �. . . �. .. .,". : . ,,.� '� �.. � .
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