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<br /> e���aaoo2o City of Zephyrhills Permit Application Fax-813aeaooz�
<br /> Bullding Department
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<br />� D�te Reeeived ' � , �
<br /> ii r , �.Phone�Contact:for:Permlttin -' , _
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<br /> Owner's Nam� l� �[ � � Zp �P C ` Owner Phone Number �� �.��- � (�
<br /> owner•s�dd��a 22 02 �� ��T� ��v� �� � - Ow�er Phone:Number�
<br /> Fee Simple T tlefiolder.Name � � - � ' Owner Phone Nufnber � � '
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<br /> Fee Simple T tleholder Addreaa _ �
<br /> JOBADDItE S � G(� ��& � S( � /� � �� �� 3JS�2 � LOT# �
<br /> SUBDIVISIO � PARCEL-.ID# /l.� 2• �D: �BI=�� �f
<br /> , , (OBTAINEDF.ROM..PROPERTY.TAX'NOTICE)
<br /> WORK PROP SED +tNEW CONSTR' ADD/ALT [�� SIGN' 'Q � ' Q �DEMOLISH
<br /> �,,. B INSTALL � ..:..REPAIR -
<br /> PROPOSEDa�$E - :Q � SFR. �] •COMM . Q OTHER'
<br /> TYPE OF CO I STRUCTION'-� Q�'- r��BLOCK "" Q FRA�AE Q STEEL 'Q �
<br /> . 'i- . ,e �C � f�2S,�
<br /> DESCRIP710 OF WORK I' - K�-Q.CL�O $ ��./�. � •� � t Q.4lJ�A-�"G��..p�'r v� v✓e�ty r-�2, ,S� � �
<br /> �UILDING�SIZE`` � � � ' � '�Q'�FO'OTAGE;�. , ,.HEIGHT�
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<br /> QBUILDING $ yALUATION'OF'TOTAL COPJS7RUCTION � ' � "'
<br /> _ .�� ..ZZ$. �J - .
<br /> QEL CTRICAL $ " AMP SERVICE. = �Q � '"PROGRESS EfVERGY- Q W:R.E.C.
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<br /> OPL MBING � :$ ,,. .. � � _. �/��
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<br /> OME HANICAL' . $ '` � 'VACOi4T`ION OF;MECHANICAL INSTALLA710N: � �
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<br /> [�GA „ � ROOF,ING , . � SPECIAL,l'�Y�.Q;f,.;,OTHER; , _ -
<br /> FINISHED FL OR ELEVATIOfVS FLOOD ZONE AREA „QY�S. ,NO
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<br /> BUILDER COINPANY'` �t � .`', ` •� , "
<br /> SIGNATURE REGISTERED Y/ N . ��`'-�'%'F.EE CURRE��-` °°Y�/`N` " � `
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<br /> Address -. ri: . ,,�c ,.; : .,[tCense:#�` '�'r `,r � ` .
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<br /> ELECTRIC��� - ,�_ . , , r�COMPANY`'; _ ix;-,��„�,,:;�.:, :�K " : � � , '
<br /> SIGNATURE ' � �REGISTERED y } Y/ N F.EE;CURFtE�f`< "'�`:'P Y/•:N.. �: .
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<br /> Addre$s ' . .. ; .... . , . . � . , , . � , -,u.,l.igense{#��. ,`
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<br /> PLUMBER3� � ..C.OMPANY ...r,:>._.:_ ,'r � s�:..,. -. ,.� r,. .
<br /> SIGNATURE:� �'. _ ., _ .�. � �:� • �, � _ - - .,. .
<br /> , - `REGIS.T.ERED :r. _Y/.N:.� ��FEE:CU,�3�n�� �x:.`Y/.N,:..� _,
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<br /> Addre�s ,. , , , ,k.._. -�,License,# ' -_ ` _ � - �
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<br /> •MECH�NIIC . , . . _ .., ". . �.., . COMPANY �='� _� _ >. t ;�•:;,�.._„ •�� ' , , �.,. _� -
<br /> SIGNA7UFtE; �r: Rr.r, �,,. , .. , , . ,r, ,_ .z�;.... . . ._ ,. , ,
<br /> �' REGISTERED _ Y/,N :t,FEE�CURRE�.. Y./�:N.��
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<br /> Addr� '-- v. , , ,: � � �License#� ' .
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<br /> OTHER , � '"�' L"� ;�. . ��.U'o�� �+ ,,., � ..� , �., G `
<br /> '''' .CO,IlNPI4PIYq� � ��- ;/1� 778�1 � _ ,T�y('' ,
<br /> 51GNATURE _. ,�+ _ _, ., , � „ _ .:�, , ,9..: , ,
<br /> REGISTERED`' Y/"N..,. ;FEE CURRE�'�� Y`/N
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<br /> �►ddre� , -�'`i3�°� .:1� �.�--���t.33.6';a - .'- ' �Liceii`se#�� ���`�!" (3 �j D �j'` � ° .,
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<br /> "RESIDENTIAL,$%.:��AttaoFi'(2')„P1Qt�Plans;i-(2)sets_of'Bu�IdfnglPlan"s;(1)sett`of?Energy°Fortns;�R=0=1N�Peririlt#or=newcon§tructton,; � - '
<br /> „ Minimum � Q rt - a.��,x.y.-�, ..� ,g.�_ . �..�.�,_, ,..�, .. _ . -
<br /> �r�_.�;���,.,�a,f,a,�ten:;(10)aviro,r141ng�tl�ys�aiter'submiltal:date:,�R;equired onsite;'Con'stiucdon.Plans;.Storniwater-Plans w%S`tk Fence installed,� �
<br /> "�' Sanita FadUdes,�&�1 dum ster zSite WorkmPertnl,t for sutidivisions/la,��e,': �ro ects;�,s-�,-,::��; `;'--��'�"�_.,,'.", �_ 'A , `��:`r ° , - �-_
<br /> ry` ,� , >. s E ,.�b. �s.f.:,�_�u:,.,:,;� . .. ,L�.�:�9 �p µ��,:.;__rk,.�:.
<br /> COiNt�ERCi ° Attech(3)�eort►plete'sets'of'Buildfng'Plans plus a Life Safety"Page;(1j set�of Energy Forms.R O-W Parmit for neW construotlon.•'t •
<br /> Mlnimum ten(10)working days after submittal date. Required onsite,ConstrucNon Plans,Stortnwater Plans w/Silt Fence Installed,
<br /> Sanitary Fadlitles 81 dumpste�.Site Work Permit for all new�projiscts::All commercialSeS�ulr�aments must meet.campllance`'` �� ' -
<br /> .�SIGN PERMIT AttacFi"(2)`sefs of`Eng,i'neeredsPlens:t��:s��� :�'s �-.�:s:�<a-:.�._ , _ . ° - - ,
<br /> - ••••PROPERTY SURVEY required fpr all_NEW cons#(ucUon._.:., . - -
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<br /> DlrAotlon�s .._�,,s�,,,;;,.,�.>,._, .. .,.,, :
<br /> FIII out ap�licadon completely.
<br /> Ouuner 8 � ntr�ctor slgn back.of appltcaUon,notarized
<br /> If over 5�'�0,a Notice;of.:Commencement Is r�quired. (AIC upgr�des over ST500) , .._
<br /> �m::,°:�.�'�:s:�;�H.',>._
<br /> " Agent(fo i the oontractor)o�Podirer of'Attomey{for the=otiiner)`�nrould be someone virith notarized leiter from owner authorizing same r
<br /> OVER.THE.CqUNTERiPERMITTING��•-�;�-(Front-of-Application-0nly) ---- ' "'- "
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage) - ` j
<br /> ..t�:iie9'..,�. •_ ;r`�9�'ii�3'�`'
<br /> Dr1V�Wa I -Not over Counter If on public roadways:.need`s ROW
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