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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � • Bu3Jdirtg DepartmenE
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<br /> Date Received , Phane Contact�.for Fermtttln �,/� _ �f�
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<br /> Owner's Name �� �5 �AN ��'N 4wner Pha»s Numbes ��'����
<br /> Owner's Addr�ss ��{3� �?� �I. Z Q��(�S Owner Phane Number � �
<br /> h� �Fee Slmple 7lkleholder Name � �� Owner Phone Number �
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<br /> Fee Stmple Titleholder Address -
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<br /> JOBADDRESS S��a�� �'�1'1 A� Z � (�N���`� ��� 33�Sya LOT# �_�_�
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<br /> sueo�visiaN� � � PAFtCEL ID# t �'a6-�1-cxsl o-c�e3�-�r Aa� fJ'�c .:o� /e
<br /> �� (OBTAINED FROM PROPER7YTA7CNOTICE)
<br /> WORK PROP�SED NEw CONSTR ADD/AI.T � StGN- Q - Q pEMOI.ISH �
<br /> � INSTAL� 8 REFAIR I
<br /> PROPOSED USE ..Q SFR Q GOMM � {�THEFt
<br /> TYPE OF CON3TRUC710N Q BI.00K ` [,� FRAME �] STEEt, �]
<br /> DESCRIPTIOId OF WORK �T����IC ��/�tccEprp� ��/ ,�,y�'.�-1,�,S
<br /> BUi`LDING St E ����r' � SQ FOOTAGE �� . HEIGH7 j�l�-_� , ,
<br />' �$U��'�l��' � �/p�L,a,�o,`�"' VALUATION CIF TOTAL CONSTRUCTION
<br /> QEl.E�TRiCA� $ AMP SERVICE PROGRES$ENERGY W.R.E.C.
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<br /> QPi.tIMBING $ - �� I� �f `(A,, L�
<br /> � ' ,ati�5 / �� ^J�"t7�.L'1
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<br /> ; QMECHANICAL $ VALUA'i'IQN t}F MECHANiCAt lNSTAL�ATICFitii � •,
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<br /> - 2...��-pl�,
<br /> j QGAS � F20QFING Q SPECIA�'iY � OTHEFi '
<br /> FINISHED FLOOR EI.EVATIONS FLOOD ZONE AREA [�YES NO � �'{������ ����� r �'
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<br /> _ _ �utLDER � � ��- r�COMPAt�tr �ob N��'��v Gc�„�urt'i o�v �.vG.
<br /> SIGNATURE � REGISTERED Y/ FEE C41RRE� Y/N
<br /> Address �ICI�o� C'��� JQj/'E'.N ��, ^��l�+'(,(5 , LiCense# G(�G��%�7oZS � .
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<br /> EI.ECTR1CtAN . . ' °"�'r ������_.—�_�_ COMPA�tY �•''-�.�1 r�� �.
<br /> SIGNATURE � REGI$TERED Y/ N �cutt�ten Y/N ,
<br /> �d�ress �� ��:��� "� ��_� % _ C_'-�:�' ucense# �G/�C�c�/�,�-�?- �
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<br /> PLt!!U'�BEE? COMP/WY -
<br /> SIGNATURE • REGIBTERED Y/ N h'�cuRRen Y/N
<br /> Address . License# �
<br /> t��ct��wic�t. coMpa�nr �AcC� 3� Y�` � "��'
<br /> SIGNATURE REGISTERED Y/ N h'EE cu�n Y/N .
<br /> Address License# � �
<br /> OTHER ' COMPA1�11Y
<br /> SIGNA7URE � REGISTERED Y/ N FEe cuRRen Y/N
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<br /> Address�; ` License# � . (
<br /> REBIDEN"flAt. , Attach{2}Plo#Plans,{2}sets of Bu3CdIng Plans;{1}set af Energy Foris3"s;R-Q W Permit for nsw construation, -
<br /> ' Minimum,ten(10)working days after submittal date. Required onsite,ConsVuctlon Plans,Stomnwater Plans w/Slit Fence tnstalled,
<br /> Santtary Facilides&1.dumpster Site Wark�Pertnit for subdtvisionsAarge projects
<br /> COMMERCIAi. Attach{3}campiete sets of 8ulldtng Pians plus a E.ife Safety Page;{1}set af Enengy Forms.R-O W Ferm's#far new construc�##on.
<br /> �- - - - � Mlnimum ten(10)working days after submittal date. Required onsite,Canstructian Plans,Stormwater Plans w/Silt Fence instaDed; -
<br /> Sanftary Facilttlea&1 dumpster.Site Work Permit for ail new projects.All commercial requlrements must mest comppance `
<br /> SIGN PERMIT Attach{2}sets af Engi�eered Plans. _ -
<br /> """PROPERTY SURVEY requfred for all NEW construction. _
<br /> Dtrectlons: �
<br /> FIII out application completely.
<br /> 4wnec&ContracMr stgn back of applicatlnn,notarized �
<br /> if over�25II00.a Natice of Commencernent is requfred. (AlG upgrades over S750Q)
<br /> " Agent(fa�the cantractor)or Power of Attomey(fitr-the owner).wpuld be someone with notarized letter ftom owner authorizing same
<br /> OVER THE GOUNTER PERMtTRNG (Frant of Application Only)_-° ;
<br /> Reroafs If shingles Sewers Seryice Upgrades.A`/C , Fences(PIoUSurvey/Fbotage)
<br /> Drlveways-i3ot aver Counter if bn public roadways.:needs.ROW::r,; ,,,.
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