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a�3`�ao-ao2o City of Zephyrhills Permit Appiication Fax-813-780-002'i
<br /> , • Building Department
<br /> Date Receive�d � ,� 1� Phone Contact far Permitting ' �� — �
<br /> Owner's Na �e �'� � Owner Phane Number
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<br /> Owner's Addi�ess � l 5 J � Owner Phone Number � �
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<br /> i �Fee 5imple �tleholder Name �— � Owner Phane Number �
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<br /> Fee Simple iitleholder Address
<br /> JdB At3DRESS + LOT# ����t��
<br /> suBarvis�a� �--�1�'C,.v�,�.����'►Z� PARCE�ID# -��' i - �1'7C� -0�00�- c�
<br /> (OBTAINED FRpN1 PROPERTY TAX NOTICE)
<br /> WORK PRQPOSED e NEW CONSTR� ADDIA�T [� SiGIV � Q DEMO�ISH
<br /> I INSTALL REPAIR
<br /> PROP.05ED USE Q SFR Q COMM 0 OTHER
<br /> TYPE OF CO� STRUCTION Q BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTIO OF WqRK k �
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<br /> BUILDENG SI,�E �ot�t�e� � SQ FOOTAGE� HEIGHT I d y_�
<br /> �8u��'�;��' � ��O� VA�UATION C?F TOTAL COtVSTt2UCTlON
<br /> DEL � AMP SERVICE � PRO�RESS ENERGY Q W.R.E_C.
<br /> ECTRICA� $
<br /> �PLUMBIN� $ „ ��
<br /> �ME' ��_......,,_, ...,, ���
<br /> CHANICAL $ VALUATION OF MECHANfCAL INSTALEATkQN %�
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<br /> �GAS Q RQQFIRIG Q SPEClALTY � QTHER
<br /> FINISHED FLOOR EL.EVATIONS F�OOD ZONE AREA �YES NO
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<br /> BUILDER �' �'��---'---._-. COiVIPANY *^-l�� � �1U.� '�`Q
<br /> SIGNATURE �/ /,/"" REGIS7ERED Y/ N FEE CURRE� Y/N �(,Q
<br /> Address `�-"t ��� o�. ,! License# �� ��o�����
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<br /> E«c�r��c�a� �� `���� co�p,a�,Y L:��l �Pt c.
<br /> SIGidA7URE'' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address y '(�' �}(y„'. License# �� �3�—1.���
<br /> PLl}ii�BER E � � C0�11PANY ��+1 t"" l�� t��t. Y�lCtht,.4�-�. �-
<br /> SIGNATURE( �-- REGIS7ERED Y/ N FEE CURRE� Y/N ���
<br /> A��tress� . � {�, � �� �� - License# �� ��� � ��
<br /> M�c�r�va�ca�.f � co��m,t��r �.�.i�l '�C.
<br /> SIGNATURE REGISTERED . Y/ N FEE CURRE� Y/N
<br /> Address "Y�� '�i,�'} f�� License# ���� t t�� �
<br /> 4TFiER � COMPANY
<br /> SIGNATURE: REGISTERED Y/.N FEE CURRE�' Y/N
<br /> Address • License# � �
<br /> 1�tii-hf�tiiii+H
<br /> REStDEPtTl,4t! Atfach-{2)Plof P.lans;{2}sets of Building Plans;{1)set of Energy Forms;R-0-W,Perrriit for new construction,
<br /> • Minimum.ten(.10)working days after submittal dake. Required onsite,Canstructian Pians,Stormwater Plans w/Silt Fence installed,
<br /> Sanitar,/Facilities&1 dumpster,_Site 1�^lork_Permit_f�r.sG+�dlvisionsll�rge-prajec+s --- --- -------- - --�--`
<br /> -CO�iC���+ffCi�i Attach�{2}complete sets of Building Ptans plus a�ifs Safety Page;{1}se#of Energy Forms.R-Q-W Permit far new construction.
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.$ite Work Permit fot a!I new projects.Ail commercial requireme�ts must meet campliance
<br /> SIGN AERMI� .4ttach{2}sets of Engineered Plans. , ,
<br /> '*`*PROPERTY SURVEY required for all NEW consVuctian. �
<br /> i�i - -
<br /> D3recfians: :
<br /> F(II out application completely.
<br /> Owner&Contraetor sign,back of appiicatian,notarized
<br /> 1#over$2500,a Notice of Commencement is recyuired. (AJC upgrades over$7508) '
<br /> "" Agent(fo'�'the contractor)orPower of Attamey(for the owner)would be someone with notarized letter fram owner authorizing same
<br /> OYER THE COUNi'ER PERMI'RING tcopy of-contract required}
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Driveways-Not over Counter if on~pubiic roadways..needs ROW'.,;� • � ��� - - -"` " �" `" • ?,
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