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a��-78o-ooza City of Zephyrhills Permit Application Fax-813-780-0021
<br /> 8uitding Depattment
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<br /> Dats Rscstved � Phoae�Contact�for Parmitfin
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<br /> Owner'�Name .� ,`� ��"i`` �fil�-L Owner Phone Numbec L`'�� �� }
<br /> Owner's Addrass ��� � Owner Phone Number �— �
<br /> Fee Slmple Tltletiolder Name � � � Owner Phone Number � �
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<br /> Fee Simple Titlaholder Addres� -
<br /> JOB I�DDRESS LOT# ��
<br />�i SUBDIVISION �� —�� PARCEL.ID#
<br /> , _ (OBTAINED FROM,PROPERTY,TAX NOTICE)
<br />� WORK PRt�POSED _NEW CONSTR ADDJALT Q StGN 'Q [� DEMOLISH
<br /> ;e. INSTALL 8 REPAIR
<br /> PROPOSED=U$E . Q SFR Q `COMM Q •OTHER
<br /> TYPE OF CONSTRUC'1'ION Q ' BLOCK " 'Q FRAME �-] STEEL Q
<br /> DESCRIPTION OF WORK' * � � ( � � � ��'` �"'" C'�� �
<br /> BC7ILDINGSiZE �` ��' SQ'FOOTAGE��. HEIGHT ��-_--_� I
<br /> �����'����' ��� VALUATION:QF TOTAL CON89`RC'1CTION, `
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<br /> QEl'.ECTRICA� �'��� �' � AMP SERVICE Q `PRC}GRESS ENE}2GY Q W.Ft.E.C.
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<br /> QPLt}MBING. � � I
<br /> QMECHAidICAL �$ � f�� s.� VALUATION t3F`NtECHANICAt,lhlSTALLATlQN �'��`r/�
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<br /> QGAB Q ROQFING Q S3'ECtA�'1'Y [�] QTFiER•
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYE$. NO ����
<br /> BUiIDER COMPANY�� `
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N"
<br /> Addrsss -� ' �� - Ltcen'se# I � ' ��
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<br /> ELECTRICIAN: GOMPANY` - , , , _ , ,. - , „ - .
<br /> � SIGNATURE �' REGI3TERED Y/ N FEE cuRRe��' '-'-�Y L N - I
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<br /> Addre�s • . �, . Ucense.#.;�-- •� �
<br /> P�UMBER , COMPANY � � � -. :J :�� .
<br /> SIGNATURE , REGISTERED Y/,-N�. , FEE.CURRE�� Y/N. ' ,• �
<br /> Address License.# � .Ar� J -� -
<br /> NlECMANICAI: , COMPANY !,� s?z-. ...,�-�'��t..
<br /> SIGNATURE ' REGI57ERED Y./ N . � ; FEE CURRE�,� Y./.�N> >
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<br /> Address'�'`` • • - License#,�. �
<br /> OTHER = - - � � � GOMPAAIY . _ , ,
<br /> SIGNA7URE �:. � " � ' " " " ' ' REGISTERED ' Y/ N.,. "�FEe cuRt�� Y/N
<br /> Addre�� ,\ y . + - ` � ` • - License#�� ' " (
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<br /> RESiDENTiAL = :Attactit{2)ui?lot�Plaiis;{2)'sets°-of=8utlding�i'tans;'{'I)sefofiEnergy>Fartns;,F2=0-W�Parmltforrsewcanstructton,
<br /> -- �� .Mi,nimum;ten;,(;1,0)working;days afte�'submittal"date::-Requlred onsite;.C`onstrucU6n Flens,'Stormwater Plans w/SUt Fence tnstallsd,
<br /> ���} �Senttary FacdliNes&�=•1;,dumpster.Site Work�kPermit;tor,sutiiiivislons/large:.projects,:.,_:;s�,_ � . - `
<br /> CO�IINlERC1At. A##ach(3)�cornptete'se#s'of Suilding'Plans plus a Ctfe SafeCy Page;{1}set of Energj/Forms.R 4-W Patmfti fa�new canstructlan.
<br /> Minfmum ten(10)working days after submittal date. Requlred onsite,Construc8on Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary FacUiBes&1 dumpster.$ite Work Permit for a0 new projects.:AU commercial requlrements_m�st meet aompllance
<br /> SIGN PERMIT Attach"{2}'sets of EnglneesedrPlans:; �-:�:•`� � �� �
<br /> ••"`PROPERTY SURVEY uir�d,for all NEW canstructlon..
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<br /> Dirsctlon�: F - -
<br /> Fill out applicaUon completely.
<br /> Ownes&Cantcaotor sign back of app{fcatlon,notarized
<br /> if ovar$2500,a Notice af Commencement la reguired. (14iC upgrades over 57508j �,
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<br /> '" AgenC(for the c:oatractor)or Power of Atfomey(far Uie owner)�would be�someone with notarized letter from owner autho�izin�same
<br /> dVERTHECCIt3NTERPERMITTING--•�• �(Frontof�Appiication.Oniy)V-'•- - ,:
<br /> Reroafs If shingles Sewers Service Upg'radrss A%C Fences(PIoUSurvey/Footage)
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<br /> Drivsways-Not over Counter if on public�roadwiay§..needs ROW �� �
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