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: ,/�813-780-0020 City of Zephyrhills Permit Application Fax-813aao-oa7�
<br /> '` '� Butiding Department
<br /> Date Eteceived � Phane�Conkactfor Permittin
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<br /> Owner's Name �� / �'" � � x ��v�S�� � Owner Phone Nurnber �` '� � �1 � � � 7'`y'
<br /> Owner's Address � ��Z �A1�, �'�" �ru�E2w E.rS ��A' pyrner Phone Number � �
<br /> Fee Simple Tltleholder Name � - Owner Phone Number � �
<br /> ,i .
<br /> Fee Simple Titleholder Address
<br /> .�oe Aop�ss 3 �?U� " �6�v y�ilz�z y �t-�'. LOT# �_�
<br /> SUBD1ViSION �� � PARCEL ID#
<br /> . , (pBTAINED FROM PROPERT1f,TAX NOTICE)
<br /> WORK PROPGISED _NEW CONSTR ADDJAIT C,� S1GN 'Q Q DEMOLISH
<br /> ~.�:e. INSTALL 8 , REPi41R
<br /> PROPQSED=USE Q SFR [� GOMM � OTHER �
<br /> TYPE OF CONSTRUCTION" Q BLOGK ' [] FRAME � STEEL �]
<br /> DESCRIPTION OF WORK 6 �U �'P sV� � '�''�� /Y)U t�l L�T Z I
<br /> St71LDI1�1G SIZE �� �'SQ FOOTAGE C��. HEIGHT�E�_____�
<br />� [�]BUIGDING $ - . .
<br /> VALUATION OF`TOl'AL CONSI'Rl7CTION
<br /> [�ECECTRICAL $ ���U p. � � AMP SERVtCE Q PRt:7GRESS ENERGY Q W.R.E.C.
<br />�� QPLUMBtNG '� � "
<br />�
<br /> MECtiANICA! � � VAl.UATtON OF'MEGMANICA�.Ii�tSTAl1AT10N 'J,.�» J� � 3"��
<br /> � � ,.__��������� �f� l
<br /> , QGAS Q ROOFING .Q SPECIAt.TY [� OTHEF2
<br /> ' FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA [�YES. NO
<br /> I � _ '
<br /> �
<br /> 8t3t�DER COMPANY'� � . �
<br /> SIGNA1'URE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres� � �� Gcense# � ` �
<br /> �LECTRICIAN;. , . '� � „ � :�g�'L{-�LC—�t�21 c ,
<br /> I ,�'GOMPANY :- -;�' ' ; !'=. �
<br /> SIGNATURE � ��`�'L`'�s %�v g c�2 r "'� REGISTERED Y N ��-cur�n �' °�'Y/N "
<br /> Address � � : , , ' j - License`#,� • ; - - ' �
<br /> PLUMBER ` COMP:Afi+iY � ,
<br /> SIGNATURE ' ,RE�iSTeREo. Y/.,N . �,,-;,,FEE;CURRE� + '' Y/N. -�:_ ,
<br /> Address .. .License.#��- : � i �
<br /> MECHANtCA1: ' � � ' COMPIWY , .
<br /> SIGNATURE � - ' � ' ' REGISTERED Y,/ N . ' FEE CURREt�. Y/_N' ,
<br /> Addrsas y -� " � - � , , , License#'�. .-, , . � ,
<br /> _�TNER .____._�-- - --- -=- _ .A - ._--__ 'GOMPANY � �
<br /> $IGNAYURE �� �4�` ' "' � ` � REGISTERED�� Y/ Nz. FEE CURRE� Y/N
<br /> Address . _ , �� � ; : , , � � , ` License#�r " I
<br /> . .,,,._.. - �. '
<br /> RESiDEfiIT1At: Attactit{2},Plo#iPlan's;(2�sets�of:Buitdi`iig'Ptans;{1}sefof'Energy'Foin�ts;��R=O-1N Perrnit for'new construistian,
<br /> ; :•Minfmum�,ten„(�1,0),woricing;days,at#e.r.'submi.ttal d'ate:�:Requlred on`slte;.Constiucdon-Plens;'Stortnwate'r Pla�s w/SIIt Fence installed,
<br /> +''".�Santta�jrFacilltles.:&;1,dumpster;Site WoticP,ermlt,#or�subdivislons7large>projects:�_�_;: �:: - ' - -
<br /> COMMERCiAt. Attach{3}�comptete sets of Buit�ing Plaits ptus a I:ife Safefy Page;{1}set of E�ergy Fotms.R O-W Petmit far neuv constnscUon.
<br /> Minimum ten(10)working days after submitMal date. Requlted onsite,Construc8on Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitacy FaclliUes&1 dumpster.Site Wotk Permtt for a41 new�proJecfs..All cammercial_requlrements_must meai camp8ance
<br /> �StGN PERMIT Attach(2}sets of Ei►giiieered:Pians:�.,� _,`:<�� , ... .�• '
<br /> "'"PROPERTY SURVEY required.for all.NEW canstructlon.
<br /> D)rectlons: . . , - . ``
<br /> Fill out applicaUon completely.
<br /> Owner&Contractor sign bacic of apgilcatlan,naNarized
<br /> if over 52500,a Notice of Commencement is required. (A!C upgrades over 57500)
<br /> ,,-� .,::..,�, .
<br /> `" Agent(for the�cbntractor)�'or Power of Atkoiney'(for ttie�owner)would be someone with notarized letter from owner authorizin�same
<br /> �VER THE COUNTER PERMi'TTiNG -, •(�ront of-Applicat�omOnty)- �
<br /> Reroofs if shingles Sewers Service Upgrades AJC Fences(Plot/Survey/Foatage)
<br /> Drtvewaya-Not aver Counter if on pubiic roadways..needs ROW �
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