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813-�so-aozo City af Zephyrhills Permit Application Fax-813-780-0021
<br /> � Bullding Department
<br /> Date Recetv0d �
<br /> -'�•j�J'"�� 7 Phane Contaat for Psrnsitting ~ -
<br /> Owner's Name ( (`��� Owner Phane Number � �-�' l`��a
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<br /> Owner"s Address j �Q Owner Phone Number � l ,,������'✓
<br /> � �__ ,,.... ....,�
<br /> Fee 5imple Titleholder Name Owner Phone Numb�r
<br /> Fee Slmple Titleholder Address
<br /> JaB ADDRESS ��-L �.S � LOT# �
<br /> SUSDIVlSION � � PAi2CEL iD#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPQSED e .. NEW_CONSTR 8 ADDIAI.T C� SIGN Q � Q DEMOLISH
<br /> INSTALL REPi41R
<br /> PR�PC?SED USE Q SPR Q CQIUIM � OTHER '
<br /> TYPE''OF CONSTRUGTION Q BLOCK • Q FRAME 0_ STEEL Q
<br /> DESCRIPTiON OF WORK
<br /> .� f „
<br /> BUILDING,SIZE � � SQ FOOTAGE " /c,?' � 1 � HEIGHT •C� �
<br /> 0����'���� I`" �� Q��� VALUATiON�C7F TOTAL CONSTRUCTtON
<br /> L_..- --��'
<br /> .:QELECTRICAl. � � AMP SERVICE Q PF20GRESS ENERGY Q W.R.E.C.
<br /> QPLUMBtNG ra�
<br /> L ,
<br /> QMECHANICAL $ VALUA7IQN{�F IUtECNANICAt�INBTALLAT{ON�. � �� ��"�
<br /> 11' �
<br /> QGAS Q E2tJQFiNG Q SPEGIAlTY � QTIiER ���L/� �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO ' �
<br /> � �``� �
<br /> BUI�DER �t� COMPAtdY �`=JC_R=.,� e../3
<br /> $IGNATURE �f REGISTERED Y-/ N FEE CURRE� Y/N
<br /> Address "License.# �� �
<br /> :; 'ELEG;t121G(AN COMPAt�FY
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N.
<br /> Actdrass - License# �� �$ �
<br /> FLlIMBEJt,: C�MPANY
<br /> SIGNATURE REGISTERED ,' Y•/'N - FEE CURRE� Y/N
<br /> . Address ' License# �— �
<br /> _,�'NlECH11P11CAE: � COMPANY �
<br /> " 'SIGNATURE'" ' '� � � REGIS7ERED , Y 6 N: FEE cuRRen Y/N
<br /> Add�ess��� � � � � � L•icense.# � �
<br /> -��ii�,� . .,. . ,
<br /> : o��R°. -=: � , . GBtdIPA�IY
<br /> '�SIGNATURE;�;:;::, , - -�� ' � . - � REGISTERED Y/ N FEE CURREN Y/N
<br /> Address..4:, :4 �4.7 J' - ._, y ` • License# �� � �
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<br /> �;.#..,:..,... __ . . - ,�,.4 . _ . . • ,
<br /> z.:riRES1DENTIAL`�;:;';Attacti;;(2}:,PlotuP,lans;'(2}tsets�of Building;Plans;{1�}`se#of�Eoergy�Forms;,R=O;�V.Petin9t far new,canstruction, �y
<br /> ?'�, `h: ;;;�.,a.n„c=y�Minimum��tenc(,1Q);iniafking�days:after su6mitta):date. :Requlred"onsite;Gon`striic�on Plans,`Stormvirater Plans w/Silt Fence installed,
<br /> ss' � � Sanitary,Factli6es&�1�dumps#er•;,Site,Wor.k Fertnit for'subdivisionsllarge;pioJects' _ �� � �
<br /> ;�'.COMMERCIAl. Attach(2}�compiete"sets of'Butlding Ptan's plus a l.�fe Safety Page;(t)set of Energy Forms.R-C}-W Permit for new constructton.
<br /> - Minimum ten(10)working days after submtttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> "" � Sanitary Factlitles&�1 dumpsteraSite Wotk Permit'lyir�atl-neiiv piojects.Aif commerciai.requirements rnust meet compliance
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<br /> ��;.81GN:PERMlT "i4ftach(2}sefs of;Eagineei�ed`Ftlans::�= F.,,: - , � s
<br /> �`'��" ' "'"PROPERTYSURVEY.r,equlred_for,.aII,NEW constructian. ,
<br /> _ .___ .,.,... !
<br /> wDirectioiis:- ,�.:,,._-,���, ,,
<br /> �`+ �Fill:out.applicatlon completely.
<br /> 4wner&.Contraetar sign_tiaek.af appticatian�notarized
<br /> " � '�I�f over$2500.a Notice of Gommencement is required. (/�!C upgrades over$T500)
<br /> ��,:.. . -{_::.-.....,���;��,�
<br /> _ _�Agent(for`th'e'�cont�actor)`or�Power•of:Attomey(for'ttie owner)wauld�tie,someone with notarized letter from owner authocizing same
<br /> ;:.: , . ., ,. , -- - .--
<br /> ,.OVER.TNE�COUNTER�PERMI'�1'ING..�:.,�_.�craPY..of-contract•required) " -_� . , �. ..,; : , � . .
<br /> �='Re�oofs if sfiingles ' Sewers ., ' Service Upgrades.A/C � Fences(Plat/Survey/Footage) ' ��� � - �
<br /> ._ .. .._ ._� '__. _r_,_ _ ' < <. � _. : , r ,
<br /> ,._ .,.__,,. .._ ..�_._ . . . „ ,
<br /> � Driveways-Not over Counter if on pub(ic'�oadways;:needs ROW � � ,. ,� ,' __ � .
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