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r e�3�eaoo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �ullding Departrnent
<br /> Date Recelved " : ; : Phone=Contact for�Permlttin - , � ,
<br /> Owner's Name ���s •�i y�� � Owner Phone Numb�r 2`)G� -oZ33-'ro�3y I
<br /> Owner's Addreas 3 r % � OwnerPhone.Number.�
<br /> Fee Simple Titl�6olderName � - Owner Phone Numbe� � '
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<br /> Fee Simple Titl�holder Address � ,
<br /> JOB ADDItESS� c7 U�2 i Z �� . 5 - LOT# �(�
<br /> SUBDIVISIOPI {���G �l/� - f+ARCEL ID# " � �
<br /> . , (OBTAINED FROM.PROPERTY,TAX NOTICE)
<br /> WORK PROPO,SED *-NEW CONSTR ADD/AI:T [�� S�GN' 'Q � ' Q �:DEMOLISH
<br /> 1 , , e, �INSTALL �, `..�•REPAIR
<br /> PROPOSED.U$� . , Q SFR• �. � COMM . '� OTHER ' �
<br /> TYPE OF CON3TRUCTION`� 'Q" a'�BLOCK " Q FRAME � STEEL' 'Q `
<br /> - ,, ��-. �. :
<br /> DESCRIPTION OF WORK" � •�2O1�� ` ��S � a �G't' '
<br /> BUILDING�SIZ I' • � � '`SQ'FOOTAGE���, , ,.HEIGHT�.��.�
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<br /> QBUILDING $ .. . ... �'� . . .. _ -- - .: -
<br /> . , ��,.�1� . 1/ALUATIONi0�:1'OTAL-COPJSYRUCTION - .'
<br /> QELE,CTRICAL. $ 1 - AMP SERVICE. ' '`PROGR'
<br /> � �C] ESS ENERGY [� W.R.E:C.
<br /> QPLUMBING � $ ,. - -- ' ` "�� (,�
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<br /> QflfiECHANICAL . $ � � -- VALUATION OFiMECHANI,CAL-INSTACLATION:
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<br /> [��S Q ROOFING ..Q, ,, SPECIAL7Y�-�] .;,:OTHER•; . -
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZOiUE AREA QYES. ,NO �
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<br /> BUILDER '/ --COMPANY'' �. - .,: :: `�r ° .,-= '
<br /> I SIGNAYURE • / REGISTERED Y/�N .�'4,>��F E CURRE��"� `.Y - •
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<br /> Address ,�>_ .��; -, - - .. •4:� ;Ltc;ense�#"' ,sd
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<br /> ELECTRICI�N. � , s , . � _ t-$COMPANY'yF „c ;�.',�.;.;;t�,.::i:.: _ - __ . .. - :, " _
<br /> SIGNATURE� • � �' ��GIs7�tteo Y/ N FEE?CURRE��Y • ;��Y N ' -
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<br /> Addre}ss ' . , . ., - .., � '. • -_ . - ,.___ ; , ... .. "�i:�_'�=, s:. �. :,_. . . , ,. � .. .
<br /> „ ;:,> : ..;� License,#� �-
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<br /> PLUM�ER�' n' , . • . - ' � ,C.OMPAtdY . ' ,'' .;<, Y .;� _ ` 1_ ' . , _ ,
<br /> SIGNATURE� a�. �,� . . , .-.e t rY..: s:::;.-�:..:� .::,;� w. :,, �:_... ..
<br /> . - >. �_REGIS.TEREp :Y./p.N.::� �-;�F�;Cuwzen;.: Y-/.N,:.�.
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<br /> AAECHAI�IIC�41:` C.OMPANY _ •s�
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<br /> SIGNATURE� • • �� � � � � REG�STERED Y/..N ,`$_FEE:CURI3E�.. 'YLtN'..r .
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<br /> Addreas� �License#
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<br /> "REGISTERED"`� Y/'N,..,�,. 'FEE CURREA" Y"/N .
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<br /> Addre� � - ..r:• �:�°N=�'��:�. _ _ ,.;s: �-a'� - . . License#�� Y .
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<br /> RESIDEPITIAl:,�h�a:<Atta "2 P1ot�Plah`s 2. sT f ��Plan 5 � i, `��. , '-� � •
<br /> �1:.( );� ;.-( ) et`s:of:Bu(Idingi s;=(<�)set'ofEnergqrFo"rm"s;�R-O=WaPermif#6�new=con`struction,T
<br /> '� Minlmum,.tena(;1,0)�wori�ing�de�jis�afterasub�iilftal;d"afe`:`�;R;equliied onslfe;Constnicdon.Plans;�Storinwater=Plans w%Sllt'Fence�tnstalled,
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<br /> �`�San(taryFad�ltl,esti&;1:�dWmpster;Slte�Work;Pertnit;focsutiiifvi5lons/la e� roectsz�s::-=z`ri:�A',"_ �.a'»� , ., . ' _ ,-
<br /> COWIMEItCIAL+ Attach(3)`oomplete"sets'of'Bullding PIanS'plus a�Llfe Safety Page;(1�et�of'Energy Forms.R-O-VU�Permit far new oonstructlon. ' . .
<br /> Mlnlmum ten(10)working days after submlttal data. Required onslte,Construcdan Plans,Stortnwater Plans w/Sflt Fence Installed,
<br /> Sanitary Facllitles 81 dumpster.Site Work Permlt for all new;projects::AlFcommercta.Lrepulrements_must meet compllance '"� � � " � '
<br /> �SIGN PERMiT AttacFi"(2)§efs of Engl'neer.edsPlaAs:i;�:��°A��'� ,. .. .;;a�.> . _ . _ ... - . � � . -
<br /> '•••PROPERTY SURVEY require�l for ell NEW oonstrucdon., __._ . _. _. " -
<br /> Dlrectlons: 1 ..�:,s�,;;�{. .,;=y .. . .- , . _ -
<br /> FIII out appllcadon oompletely.
<br /> Ownar 8 Co�tractor slgn.back of applfcatton,notarized
<br /> If over 5,2500,a Notice:of Commencement Is required. (AlC up�r�des over 57500) . �
<br /> " ent for the�contrdcto��'dr'PoViier of Attortie for the owner would tie�someone with notarized letter from owner authorizln same
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<br /> �VER•THE:COUNTER:PERMI'RING-��-��Y�(Front'of-i4ppltcation�Only)"�=;:;;;;°°" �� " �� "��
<br /> Reroofs lf shingle's Sewers Sarvice,Uparades"A/C �'��Fences•(Plot%Survey/Footage) .,. - -.- -.>•.-�_...,. ..^'-._. .,.. - ,;
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<br /> Drlveways-IVot over Counter if on;publlc roadways::iieeds'ROW� - � � � �' �' ' `'
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