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a�3-�ao-oo2a City af Zephyrhills Permit Application Fax-813-780-0Q21
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<br /> Date Etecetved -- Ehone-Contactfor•Pemittfiit
<br /> Owner'a Name Owner Phone Humber � ���'�`_�_��
<br /> Owner's Address !J� /f� Y� � �Owner Phone Number '
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<br /> Fee Simple 7ltleholder Name � Owner Phane Number � �
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<br />, Fee Simple Titleholder Address II
<br />' JOB ADDRESS / // LOT# C�
<br /> SUBdIVIS10N �� PARCEL ID# �
<br />� (OBTAINED FROM PROPERTY TAX NOTICE�
<br />' WBRiC PROPC>SED _NEW CONSTR ADD/ALT � SIGN' 'Q `Q DEMC?LISH
<br /> INSTALL 8 REPAIR
<br /> PROPOSED:USE . Q SFR Q 'CQMM Q OTHER
<br /> TYPE OF CON$TRUC710�N" Q� BI,OCK " Q FRAME [�� STEEL �
<br />' pESCitiPTION OF WQRK' - e/y � "�+.J
<br />� BUILDFNGSlT.E :�'� � SQ FOOTAGE '� � HEtGHT-��
<br /> Og���'����' $ � �� VALUATiOtV�OF 1'OT°AL CONSTRI7CTION
<br /> QECECTRiGAL �$ ' , " ��� AMP SERVICE � PROGRESS 5NEi2GY Q W:R.E:C.
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<br /> �PLUMBING �;s �
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<br /> OMECHANtCAL $ VALUATlON O�tV1ECHANICAL il�lSTALLATIt�N: '"�
<br /> OGAS � ROOFlNG � SPECIA�.7Y C� OTHER
<br /> FINISHED FL40R ELEVATIONS ��� F�OOD ZQNE AREA [�]YES. NO
<br /> 8U[�DER .° ��L�>� COMPAhtY- d ` '� ` �/ . `�a!
<br /> SIGNATURE ,.�+ REGISTERED Y/ N FEE CURRE� Y 7 N' .
<br /> Address '� 5 'l.f' I.� 'C :5�,�-�"�,�j -Cicense# IC.:�Gr,,,/ 3 Z��i %�"✓ �
<br /> ECECTRICIAN;, :CBMPANY ` � -� �x ' -
<br /> SIGNATURE �' REGISTERED Y/ N FEE-GUR12E��'`•' �Y/N. '
<br /> Addre§s �. ' , , ticense,# ,�'� � •, �
<br /> P�UMBER ` COM,P,ANY , , � . .. �,
<br /> SIGNATURE' ` � REGISTERED - Y/..Nr '�-: _.FEE CURREA - Y./N. =
<br /> Addrass ,�_L'icenser#�I, , = .. .. ` ��
<br /> � MECHANtGA#: � , COt�PAN1t - . � . ,
<br /> ' SIGNATURE ' "' ' BEGIS7ERED. Y,/-N , ; FEE CURRE� . Y./:N � - ,
<br /> Addre�s�' ' . �- . � . . Licanse# �`. � .
<br /> OTHEFt . � - . � .. � ` ",GOMPA�IY ' . � -
<br /> SIGNA7URE s - �� ' REGISTERED ' Y/ N... �FEe cuw��� Y/N
<br /> Addre� 1tL,,,�= ;��� - ,�, � ���s�' �licen'se# �iGG �'��.GI � 7��
<br /> RE3tDEtdT1AL�° Attach"{2)„Plo#�PIaoS;:{2)`sefs.of:Butlding-Plans;`(4}`sefaf:Energy�Fomts;"R=O-W Piaririitfcir'newconstruatian, . ,
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<br /> � M •• IVlinimum.ken�(•10),worlcing;days,aftec"submlCtal`dater Requlreil onslte;.Constructton'Plans;`$tormwafer Plans w/Sllt'Fence installed,
<br /> `��� Sanitary FaGlltles�8�l,;dqmpste_r,-Site WorlctPermlt for subdivistonsflarge;projects,�s:� . ' -
<br /> COMMERCIAL Attach{3)comPtet�se#s of Bul[ding Plans plus a Life�Batety Page;{1}set af Energ}t Forms.F2-O W Pertnit#or nev+i c�nstruaUon.
<br /> M(nimum ten(10)woricing deys'after submittal date. Requlred onsite,Construcdan Plans,Stormwater Plans w/Slit Fence installed,
<br /> Santtary Facllitles&1 dumpster.Site Work Permit for all newproJects:,All commerctal requlrements,must meet compllance �
<br /> ' SI�H PERMIT AttactS"�2}'sets bfEnglrieer:ed;Plaiis:� �-•:�� '. ^",-; -
<br /> """pROPERTY SURVEY reguired for all,NEW_construcUan..
<br /> pirectlons: � � `
<br /> Fill out applicatlon completely.
<br /> Owner 8�Contractor stgn back of applfcatlon,nofarized
<br /> � tf aver�2500,�Wattcs of Commencement is reqaired. (AtG.upgrades over.5TS00)
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<br /> '" Agent(for ttie iiontractor)or Power of'Attomey(for tFie owner)�would be someone with natarized letter from owner authorizing same
<br /> dVER THE Ci�tlN7ER PERMi'PTING.. ..- (Fron#of-Application On1y) - " �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/�ootage)
<br /> Driveways-Not over Counter if on pubiic roadways`..rieeds ROW'
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