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<br /> s�s�so-oo�o City af Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department
<br /> Date Receive r ,, I1 / �
<br /> I 1� � lY Phane Cantact far Permltting g� '`-��`! -
<br /> Owner's Namb � '�" Owner Phane Number I,S�S,� �.V'g 1�
<br /> Ow►ner's Address � l � u 1` OwnerPhane Number �� �
<br /> Fee Simple Titleholder Name �- � Owner Phane Number �� �
<br /> Fee Simple ti�lehoider Address
<br /> J08 ADDRES� � � � + �,�� LOT# � 0�
<br /> sug��vislo� --tCi��tt� �n?t�2S PARCELIQ# - �- o�l' ���J " O�bOt3 -c� {�Q I
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WQRK PE24F i SED e NEtN CONSTR 8 ADDIA�T � SlGN Q Q DEMOC.tSH
<br /> INSTALL REPAIR
<br /> PRQP,QSED t1SE Q SFR Q COMM � QTHER
<br /> TYPE'OF CON!STRUCTION Q BL.00K • Q FRAME 0 STEEL Q
<br /> � t l
<br /> DESCRIPTION OF WORK �" � � � ` L{ � eG4� �
<br /> ,,,.. i
<br /> Btt11.DtNG SIZf ���� � SQ FOOTAGE. �� HEIGHT C„_,,, , �
<br /> �BUILDING � r���f��y,.,�(� VAItlAT10tV OF iOTAI GONSTRUGTIOi�!
<br /> � 1 :�.�c� .�
<br /> DELEGTRICAL $ AMP SERVICE Q PROGRESS ENEl2GY Q W.R.E.C.
<br /> QPLt3 `BING $
<br /> -�-r ��3�
<br /> �MEC ANICAL � � VAIUATEON OF�UiECHANiGAL INSTALLATION
<br /> QGAB Q RQQFING Q SPEGIA�3"Y � OTtiER
<br /> FINISHED FLC10R ELEVATIQNS �_� FLOOD ZONE AREA QYES NO
<br /> � ���
<br /> BUElDER �'L
<br /> SIGNATURE �r RE,C�ISTERED Y/ N FEE CURRE� Y/N
<br /> Address . "'f -�. License# I
<br /> �
<br /> �},," � { ' ' �, ' �� ► � (,.r c ` f�
<br /> ELECTRICIAN �j�;jW�� I r��ONtPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �Cicense# � �
<br /> PLUMBER COMPAA!!Y
<br /> SIGNATURE REGIS7ERED Y/ N FEE CCIRRE� Y I N
<br /> -l�ddrxss - _ - - -- �° License��:�- ---- - �
<br /> MECHANICAL COMPAtdY
<br /> SIGNATURE REGISTERED . Y/,.N FEE CURRE� Y/�N
<br /> Add�ess . Licens,e.# � �
<br /> OTNER " ' CONt,PANY
<br /> SIGNATURE:� REGISTEReD Y/.N FEE CURRE�� Y/N .
<br /> Address � License# �� I
<br /> 11Hi-Ftfiiiii+hFt .
<br /> RESIDENTIAt.' Attach•{2).Plot Plans;{2)sets�of Building�P3aas;�{1)'se#of Energy Forriis;R-0-W:Perrriit.far new.canstructian,-
<br /> �� �Minimum.ten(10)working;days after submittal:date. 'Required'onsite,Constniction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary.Facilities&°,1.dumpster;Site Wark Permit for subdivisionsllarge projects _ �T_ _____ _ �__
<br /> COMMERCIA[._ _A#fach_{2)comptefe-sets of-BuitclE�g Plsns�pius a�.ife Safet"p t�age;{1}set of Energy�orms.R-O-W Permit far new construction. ,
<br /> Minimum ten(10)working days after submittal dake. Required onsite,Canstruation Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary Facilities&1 dumpster.Slte Work Permit far al!new pmjects.AI!commercial requirements must meet cornptiance
<br /> S1GEt PERMIT Attach(2}sets of�Engineered Ptans. , -
<br /> `"*"PROPERTY SURVEY required for.all NEW.construction. ' : - '` . ' '
<br /> Directions: � + _ � ,
<br /> Fill out application completely. ,
<br /> . Ownec&��ntractor sign,back of applacation,notarized
<br /> lf over$25L�0,a(dotice of Commencement is required. (A/C upgrades over$7500)
<br /> "' Agent(far tt�e cont'ractor)arPower of Attomey(for ttie owner)would�be someone with notarized letter ftom owner authorizing�same
<br /> ;•OVER'Piif C,CfU� ER PERMiTTING . (copy of�contract required} ��' �
<br /> � Re�oofs if shingle� Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> �;t.:�.�.:....,..r_�.- - -----=-'.r�.�: ...-_, .._:.___ •=:'�-•�,
<br /> - Driveways-Not over CoUn�e�if�on pu�ilic�ro�dways..nee��,�01N � :���� '`�' ? , ''•• ;�'
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<br /> .,. ,i , y %ar•:
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