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813I��ao-oazo City of Zephyrhills Permit Application Fax 813-780-002�
<br /> �� 8uliding Department
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<br /> Date Recetv�d ��. 7, t . Phon�<Contact far�Permlttin "
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<br /> Owner's Nartie �� � ' � "rVf t� DY S Owner Phone Narnbe� — G� � � /Cl
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<br /> Owner's Ad�ess � �����. �� , �+ �� �U' Owner Phane Flumber
<br /> Fee 5lmple 7ltleholder Name � Owner Phone Number
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<br /> Fee Simple q tleholder Address Y
<br /> JOBADDRE�SS � �✓� 4 �� �'t� LOT# �,�
<br /> SUBDIVISiO� � � PARCEI.ID#
<br /> � - , , � , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> --� WORK PRO�OSED --- NEw CANSTR . _'_,._.AD4IALT.- � SiGN - [�- �[�- DEiUlOL18H -.
<br /> I J� I INSTAI,L 8 . REPAIR �
<br /> PR4PQ3ED�USE [,� SFR Q GOMM � OTHER
<br /> TYPE OF CO�NSTRUCTION Q " BLOCK '' Q FRAME [,� STEEL �] t
<br /> DESCRiPT10N OF WORK ' - � � (' ' f� f'' v�':
<br /> BUII.pING S�Zf- � �'SQ FOCITAGE��: , HEIGHT .0,,,, �
<br /> tl�
<br /> ��������`' � �"` 7 �� VALUATION'�t3F'1'C►TAL CONST'RUCTION � "
<br /> QEL.ECTRICAL $ - ' AMP SEf2V10E. PROGRESS ERtERG'l W.R.E.C.
<br /> � 0 �
<br /> �PLUMB[NC3 $ .
<br /> �� �� ��'��" .
<br /> Q �CktA{V1CAl $ VAl:UATtON QF'MECHAI+lICAI INSTA�CATIQN
<br /> QGAS Q ROOFING .Q SPECiALTY [� OTFtER
<br /> FINISHED FLOOR ELEVA710NS �� FLOOD 20NE AREA QYES NO
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<br /> BU1I.DER � � C{�MPAt�iY� V C�,�"�`LP-�
<br /> SIGNATURE REGISTERED Y/ N �FeE cuRrtEn ,Y/N
<br /> Addre�� ' , ,. ' .Ltcense# l._ �
<br /> ELEC7lttCl�!!V . ,:COFRPANY�
<br /> SIGNpTURE ''' REGISTERED Y/ N FEE CURRE� �Y/•N
<br /> Addre�� � , , `
<br /> � License#
<br /> PLUMBER CQMRANY �
<br /> SIGNATURE � � , REGfSTEREQ Y L N Fee cURtte� Y/N -
<br /> Address , � , �License.# ��- � �
<br /> MECHAAtFGA�L „ ` ' -" � ' C{1MPANY
<br /> SiGNATURE l� � � � REGISTERED Y.,/ N ; FEE CURREn Y/=N
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<br /> Addre�s � " • � � �� ' � License# � �
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<br /> OTNER Ii. � _ � . . , - -
<br /> +:COMPANY
<br /> SIGNATURE� ' - � '" � " ' ' 'REGISTERED~ Y/ N:.. FEE CURREh Y/N ,
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<br /> Address ':; � - . • - .. Uceiise#�� � �
<br /> RESIDENTIAl:;� •Attacli{2},Rldt�Plans;:�.(2}"sets:of:8u1lding�Plar�s;{1}set`of'Energy>Forrns;�R-0-W Peririi#tor new t�nshuation,
<br /> - , Minimum.teny(1.0);y+%rking;days_after,submittal�date:-Requlred onsite;eConstiucdan�Rlans`,•�Stormwater'Plans w/Stlt Fence installed,
<br /> I;���� �Sanitary Facill8as:&;1z�,dumpsterrSite-Work.Permit[ar subdiVisionsJlarge:projects - ` � '
<br /> _- _COhtMERClFlL Attach{3)complete sets ot Bultilirig Ptans pla`s a'I.Ife Safety Page;{'I}se#af E[iergy Forms.R-Q-W Permtt Eo�new constructicn.
<br /> Minfmum ten(10j wo�lcing days after submittal date. Required onsite,CanstrucHon Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary Facilitles&1 dumpster.Sfte Work Permlt for all new�projecfs..All commerciaf reqWrements_must meet compifance
<br /> SIGN PERMI'F Attacli{2)sets of Engliieer,ed�Plans:.,-'-.� - ,. � . �
<br /> ; .«.«PROPERTY SURVEY r „uired for all NEW cansWc.tlan.
<br /> li _..__..�.... .__.__.._.._.��.._�...,. .,... _ _ . _
<br /> Dlrectlons; � . .,;_,.;} ,. . , ,
<br /> FIII out appNcaUon completely.
<br /> Owner B��Contractor.sign back of applicaUort,notarized
<br /> � !f over��2500,a Natice of Cammencement is required. (AIC upgrade�over 57500)
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<br /> " Agent(for the contractor)'or Power of Attomey�(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> OVER'TWEGOUFtTERP.ERMiTTlNG.. :::.�..(FrontofiAPPIlcaNari-Only}� ' , • _I__�. , . , - , _- . .. . .
<br /> Reroois If shingles Sewers $ervlce Upgrades:A/C ' �,Ren�es(PIoNSurvey/Footage) ,� � �., , � �,
<br /> � - --__. ,, v � ,. , - . �
<br /> Drtvewaya-Not over Counter if on pubiEc rosdways..need's ROVV� i , � � � � � �
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