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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> . Building depactment
<br /> Date Recetved -t,.�. ��-' � � Phone:Cantact�for�PerntiQtln [J�� � � _ �!'...�
<br /> Owner's Name ��g D Y"" �`-��G� R�-� Ownee Phone Number
<br /> Owner"s Address CO��6 �/I�.�'�/"' �l �.5� �6��r ` Owner Phone Number � �
<br /> Fee Simple Tltleholder Name ���i, t�� ,� SG�'��i'� Owner Phone Number 'r� �
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<br />' Fee Simple Tltleholder Address �Z� � �' l�`� � �''��'�� G� � �`�'!h r�� r`�s '�C �'��/
<br />, JOB ACIDRESS LOT# ��
<br />' SUBDtV1S10N � � PARCEL ID# ��G �z-I O 1 � ���P �` �'/
<br /> , (pBTAINED FROM PROPERTI!TAX NOTICE)
<br />� WORK FROPOSED _NEW CONSTR ADD/AlT � S1GN' `Q Q DEMOI.iSH
<br /> ��e, INSTALL 8 , REPAIR
<br /> PROPOSED.USE Q SFR: Q COMM [� OTHEE2
<br /> TYPE QF CON$TRUCTION � Qµ BL.00K ' [� FRA E [[�] STEEL' Q
<br /> DESCRIPTION OF WORK /�P��
<br /> BUILD1NiG SIZE C �' SQ'FOOTAGE�(/��` . - HEIGHT�C��
<br /> �, _. � �
<br /> D����a�N�' � � ��y `� VALUATION�.1F TOTAL CONSTRUG'I'ION '
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<br /> QECECTRiCRL ,- �$ ' � AMP SERVICE Q PROGRESS ENEFtGY Q W.R.E.C.
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<br /> OPLEIMSING '$ � ` -
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<br /> [�MECHANICAL $ �' � V/1�UATIQN OF MECHAt+�ICAC tNSTRLLATiON ��� J ��� ,
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<br /> OGAS ROQFING ;Q SPEGIAI.`fY �„_,� OTHER
<br /> FINISHED FLOOR ELEVATIONS �_----� FLOOD ZQNE AREA QYES NO _
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<br /> BE�IE.DER COMP7WY� ' .
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y'/N�
<br /> Addreas _ License#"i 1 �
<br /> E�EC7RICIAN, = ,`COMPANY��': : , .. . � . .
<br /> SIGNATURE� '� REGISTERED Y/ N FEE CURRE� '� � �`Y/N
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<br /> , - . ` :* , , Ucense#�� • �
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<br /> Addre�s '�
<br /> PCUMB�R ` COMRANY � ' t,.�. � .
<br /> SIGNATURE` A REGISTERED Y/..N,. . ;,FEE CURRE�•_ YY N: •
<br /> Address License.# � ,- • .� �
<br /> MECHAN1CAi: COMP,At�tY . . �
<br /> SIGNATURE � � " � Re�is7eRen Y./:N . ',; FeE CUwtEn- , Y.L�N. �
<br /> Address' ��t . - .� ` License# f` .-... �
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<br /> OTHER ��� �� iCOMPANY ��,�C ,�opt�t�f7 LG G
<br /> SIGNA7URE � =:I'R� : '"� � ' � � ' " ' " REGISTERED N,.• FEE CURRE� � Y/N . I
<br /> Address �L?J��Ji,� " °'��lz,. <r, �.2...•f� P'�i�!Lt 5 ��.i���� -Licen'se# �G'fJ�..31��� - � �
<br /> �,;.-. -; .� .,,.r, . . .. ;._,.. ..� ., ' .
<br /> ,,....:,., ..,.. ..,. .
<br /> RESlD�NTIAL'::� :Ait�ct�'{2}nP1ot=Plaiis;�{2}sets=of:Bullairtg�Plarts;`{-1)"sef of.Eoergyw�Fairns;°R�W Per'rTil!fcir new consWction, ,
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<br /> -- �Minimum;ten;(1,0):woricingxdaysvafter:submiftal'd"ate. �Requlred onsite;:Constiuctlan=Blans;'3tormwater Plans w/Sflt Fence installed,
<br /> �.::'�,'�:,...,.:_,. .,.. , .� �
<br /> SenitaryFacllides-&;1;,dumpster•ySite�Worlc:Permltforsu6iiivislonsAerge:projects ___:: ;, ._ ��
<br /> COMMERCII#t. Attach(3)-cb�iipiate`sets of'Buiidiiig Plaits ptus a'life Safety Page;(1 j set of Energy Forms.R-t1 W Petmlt#or neW canstnsction.
<br /> Minimum ten(10)working days after submlttal date. Required onsite,ConsUuctian Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities$�1 dumpster.$ite Work Pemtit for all newproJects:_All commerGal requlraments must meet oompliance
<br /> SIGl�I PERMIT Attac�{2)siats of Eiigliieered�Plaris.: ..., ,. � � -
<br /> •""PROPERTY SURVEY uired for all NEW constructlan. . - ~
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<br /> Dlrestions: ,z�"' .,�, � �
<br /> Fill out applicadan completely.
<br /> pwner 8�Gantractor.sign back of appltcatlon,notarized
<br /> if ovsr a..^500,a Notice af Commsncement ts required: (AtC npgrades over 57500j
<br /> " Agent(for the�oontracto'r)i�r Power of�Attoiney:(for ttie owner)would be someone with notarized letter from owner autharizin�same
<br /> aVER THE COUNTER PERMi'Gi'fNG. - -.���(Front of�Application 0nty)_- " - •
<br /> Reroofs if shingles Sewers •�: Servic�i Upgrades A/C Fences(PIoUSurvey/Footage)
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<br /> driveways-Not aver Counter if un public rosdways:.needs`ROW s�
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