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s�sa$o-ooza City of Zephyrhills Permit Application Fa�c-8'l3-780-Od21
<br /> � Building Department
<br /> Date Receivedh %r�" , r(�a . ��• Phone Contact for Permitt[ng (�(�/<"/ � ����
<br /> Owner"s Name ����� �+��r� � � ���� L` Owner Phane Number �� - 36a- 53�
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<br /> Owner's Addr'ss �� 'J� /71 rr l�CI�NQ ��6� Owner Phane Number �
<br /> Fee Simple Tit�eholder Name �_' � Owner Phcne Number � �
<br /> Fee Simple Ti i eholder Address
<br /> JOB ACIDRES� �/ ��S !7�G��LA/�� l'��✓'� LOT# [�GLL_._�i
<br /> suaolvisioN ��1�' ,�t�.� . �1�As� / �a�ce��� 1-�� 3? �'GS i�S --1�
<br /> (OBTAINBD FROM PROPERTY TAX NOTICE)
<br /> WORK PROP�SED e NEW CONSTR 8 ADDIAIT � SIGN Q [� , DEMOUSH
<br /> .� INSTALL REPAIR
<br /> PR4POSED USE Q SFR Q COMM ' �� OTHEt2
<br /> 7YPE OF CO STRUCTION Q BLOCK • [� FRAME � STEEI. Q
<br /> DESCRIPTIO OFWORK ��'�jACE �.�j GfiGG� �E��E L1�ItIa U/�L/�t �d,�ll/A, LJ.� �6'.�1iC� -
<br /> BUIL411NG Sl E C� � SQ FOOTAGE[� HEtGHT C �
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<br /> Q�U, �i�� � I GD„ C p UALUATiON t7F TOTAL CQNSTRUCTIQN
<br /> QEL ICi'RtCA� � � AMP SERVtCE � PROfiRESS ENERGY Q W.R.E.C.
<br /> QP�IMBIt�G $ � ���
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<br /> OME�HANICAL $ VALUATIflN OF MECHA�ttIGRL INSTALlAT{ON �r`t
<br /> QGA� Q =RQQFING Q SPEGIA�'1'Y � OTHER
<br /> FINISHED FLI OR ELEVATIONS r�� FLOOD ZONE AREA [�YES NO
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<br /> SIG ATURE + '�G'i'���" „_,,_� � REGI�S E�D ��jY�N ����E CURRE� Y/N
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<br /> Address �License# �! �
<br /> ELECTRICI COMPANY
<br /> � SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> ' Addres Liesnse# � ¢ � (
<br /> Ptt3M8ER CCiMPANY ' �
<br /> SIGNATURE � REGISTEREp Y�/ N FEE CURRE� ` Y 7 N
<br /> Addres , �-Cicense# �� �
<br /> MECHi4NIC � CONIRANY
<br /> ' SIGNATURE REGISTERED� ' Y/ .N FEE CURRE� -Y/N
<br /> Add�es ' . . � { , License.# �� ^�
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<br /> OTHER� � COME?ANY . �
<br /> SIGNATURE r ��' � REGIS7EREp , Y/ N . ,. FEE CURREM , Y,/N
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<br /> Addres - License# �! �
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<br /> � RES{DENTf �� � Attach.(2}:Piof'Ftans;-(2)=sefsofBuilding=PEans;={1}'set�of'EnergyForms;R-0-W Perrriit,farnew.construction,.
<br /> , �. r =;Minimum,ten.(10).wo�king�days after'submittal'date. Required onsite;Canstriiction Plans,,Stormwater Plans w/Silt Fence installed,
<br /> � � Sanitary;,F.acili,ties;&:;1,dumpste�,.Site�W.or1c.Perrriit'foc sub�divisionsflarge pr'ojects�. - � � ""
<br /> � "'GOMMERCt) Attach�{2)'oorriplete sets of Builtllrig PEans plus a lifeSSaEet}r i'age;{1)set of Energy Forms.R-O-W Perm`st for nevir canstruction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, ,
<br /> Santtary Facilities&1 dumpstes.Site YYork Permit fo�•a!i new projects.Ali commerciai requirements must meet comptiance
<br /> ; SIGN PERMI AttacFi(2)�sets of,Engineeced Plans.
<br /> `"""PROPERTY SURVEY required for.all.NEW construction.
<br /> '-'�Directions: � �_ �-_ ,
<br /> Fill;out�pplication completely.
<br /> � �@3inrii�rer Contractor sign.back af application,natarized
<br /> If over�2500;a Notice of Commencement.is required. (AIC upgrades over$T50Qj
<br /> � " Agent(for th'e'cortt�actor}�or Power of Attome}r(for ttie owner)wauld tie someone with notarized letter from owner authorizing same
<br /> r.-OVER THE �OUNTER PERMI'RING �'„�"(copy,of:contract'reGuired) � -� - � � ` � . '
<br /> '�.Reroofs if shI gles Sewers r ���Seivice"Upgrades�A/C' -Fences(Plot/Survey/Footage) ` -' '�' ' ' � �`���,.' .
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<br /> Drivew�ys-Not over Counter,if on public roadways.,needs,ROW �, " - - ' ", ' , �, , , �
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