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<br /> s� '�eo-oo�o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> _ . Buiiding Qepartment
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<br /> Date Recelv'd t ' .. :.Phone=�ontact far:�Permltt�n f . 2 _ O. -
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<br /> Owne�'s Na 'i e •� .���G Owner Phane Number
<br /> Owner's Add as� d � �:!. ���• ' Owner Phone Number�
<br /> Fee Simple TltleFiolder-Name � � ' � Ownar Phone Number '�� - ' �
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<br /> Fee Slmple tleholder Addresa �
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<br /> JOB ADORESIS . LOT#
<br /> SUBDIVlSION � FARCEL IQ# "
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<br /> WORiC�ROPt?SBD NEW CONSTR ADDlA�T �� SiGN' '[� - Q DEMOLlSH
<br /> ji � .e,. "�INSTALL �� r. REPAIR -
<br /> PROPOSED;IYS� _ Q : SfiR, [� GOMM� _. Q �CITNER ` .
<br /> TYPE OF CO STRUCTION"�� Q� 1'BLOCK " [�' FRAAAE � 'STEEL' `Q
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<br />�i DESCRIPIIO OF WqRK,' � ��' � � C�.C�I ��'t �9 "�
<br />� �UI�DiNG=SIZE � • - �'SQ�FOOTAGE,���: , .HEI,GH�"���;
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<br />� QBUI I�DING � . VALUA'�IOIV�.OF"i'OTI4L COhISFRFICI'IaN - � � '
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<br /> i QELEJ�TR1CAi: $ AMP SERttICE. . ✓� Q � "PROGRESS ENERGY Q W:R,E.C. �
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<br /> QMEC� i0.NICAL ,�' �p VA�UATlOIV C?F;tuIECFli41UiCAl:tNSTALLATi<?N.
<br /> �]GA3� , � , ROOFJNG� ,CI ,- SPECtAL1Y�:.._C'_;],�� t?TFiER=; ,,� . .
<br /> FINISHED FLO�I R ELEVATIQNS ��� FLOOD�ONE AREA . L,QY�5. ,NO �
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<br /> MECNANIICAl:` � ,� .; . - ; . � . ` �COMPANY � - _ � , � .� �j fI '
<br /> SIGNATURE� " � �� •�- `"' '" i��i"s7E�o Y%,N ~L r�e Curx�En,:. Y. . .
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<br /> � SIGNATURE�. J.,, '"� ,` . .'� �' ��. .' �REG157E'ti�o�' Y/'N;..:- ;FEE"CURRE�'' Y/N
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<br /> ��EtESiDENT1AC."� ..Attaoh:2�;P�ot�Plaris:;2 sefs�ro�`Bu�tdfn";�?lans;'(�)set'of;En'ergy,For�ns;�F2=t}=W�PemiiCfariieyv�c�nstsi�ctlon,
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<br /> �• tVlinimumkten,°{1,0)�,wa�ingyde�ys;afte.r�"sabri�ffta7�"defe::<Required oinslfe;:ConstrucUon'Pians;Stortriwater Plan`s w7�Silt Fence ins�lled,
<br /> "���"^�Santfary�Fedlitles,&n1.�dury,�.pster-°81te�Worlc;Pertnit�qr.su4divislons/lergetprojects°?;w�;;-,:��y ' - �-..;�}- ' �. , �, ' �'-�: ' � ., .
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<br /> GOMNAERCIAi. � Attach{3)�asinpi''sCe'sets'of`Bu1Rdi»g'Plan's ptus a L{fe Satetiy Rage;(�)se!of Enetgy Forms.R-C1 W Petmtt fcr naW�canstruGtton. "� `
<br /> Minimum ten(10)working deys af#er submlttai date. Requlred onsite,Gonstruc�tian Plans,Stortnwater Pians w/Silt Fence instalied,
<br /> Sanitary Factlitles&1 dumpster.81te Work Permit for ell new:proJects.-All commerotal requlrements_must meet c�mpliance ��' �
<br /> � StGN AERMIT Attacti(2)"sefs af'Eng',�e`ei�dyP.lajns:�;.K=;;,.<..�a�, .y-,:� =.:_,;,. : � ._ -.. ° - � _ _
<br /> � ••"PROPERTY SURVEY requlred for all NEW construcUan._._. �
<br /> Directlan�• " .-.��;.,�:;�,:�;� ;. _ . `
<br /> Ftll out appp �tloa compl�kely. �
<br /> Owner�Con ctor sign back of appltcatlon,notarized
<br /> If aver�50Q a_Notice of;Commencement 1s cequirsd. {AlC upgrades�ve�'�T540) , .
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<br /> "' Agent(far the�c�ntractq�)o�Power of Attom`ey(fo�the ownerj��n'rould be�someone�with notarized letter from owner authorizing same
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<br /> 01%ER TFiE.CQUF#�, E2�PEE2MITTiNGr...-�-._{Front<of AppllcatiomOn{y} --- _ �` {
<br /> Reroofs if shingles� Sewers Service Upgrades A/C Fences(Plat/Survey/Footage)
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