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� s�$-7ao-oo2o City af Zephyrhills Permit Applica#ion Fax-813-780-0b21
<br />! � Buitding Department
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<br /> Date Roceivsd �-/,�-'��� PhonetCankact�for:Fermltttn � � � - t/
<br /> ��,
<br /> Qwner's Name �� >�� �/'�T�'y � Owner Phoae Namber �� �L/ �
<br /> I1 p� �+ / �1►
<br />� Owner"s Address �LG � �/'�' � - Owner Phone Number O lj"'� ��v�<�v�
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<br /> Fee Simple Tltlehold�ar ama � �� � Owrner Phone Number 'r� �
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<br /> Fee Simple Titleholder dress !J ���L'� ��.��
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<br /> JOB ADDRESS � s� � GG G �� LOT# /�
<br /> SUBDIViSIOPD ��„______� P.A1tCEi.ID# �"� •r�•��l "�(Jj d""'Qf"� ,(l(�-»�fJi`'�(1
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONST1t ADDIALT � SIGN` Q [� DEMOUSH ,
<br /> e. INSTALL 8 - REPAIR
<br /> PROFC}SED>USE Q SFR [� Ct}{1tIM [� �{)THER �
<br /> TYPE OF CON$TRUCTION" � Q' BLOCK " [;] FRAME ['�_] STEEL Q
<br /> DESCRIPTION OF WORK �Y l�LH��i ���'�fsr�� v�/�i _
<br /> �U1LDtNG SiZE � ��`SQ FOOTAGE���. tiEtGHT���� �
<br /> QBUli.DING $ .._���_� w:,.,..:._� _ ,
<br /> VALUATION.t3F TOTAL CONSTRUCTtON
<br /> Q ECECTRiCA� $ a4 7� AMP SERVICE Q -PROGRESS ENEFtGY Q W.R.E.C. -
<br /> I QPE.UMBING r$ -
<br /> =l� �, '
<br /> [�MEGHANIGAL $ VALUAfitON OF.MEGMANICAL INSTAlCAT10I+1 '��� ��
<br /> � QGAS Q ROOFlNG _Q SPECIA�TY [� OTHER
<br /> FINISHED FLOOR ELEVATIONS C�� FLOOD ZQNE AREA QYES. ;NO
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<br /> au��oE� coM�aHv�. l� ��11t1�� L�. l'
<br /> SIGN�►TURE � REGISTERED Y/ N FEE CURRE� Y/N�
<br /> Address � � - ,/� r,�: _ � CJcense# �;51+.�! ,'��l�j �
<br /> ,. �' �
<br /> ELECTRICIAN. �'CflMPANY�` G�IG C.
<br /> SIGN�ITURE REGISTERED Y J N FEE-CURRE� ' =Y/N
<br /> � Adtiress � � L� � � '".►"�' . , _ ; License.#,; �J.�O'�} �'
<br /> PLtlMBER ` /), COMP.ANY � :i.. �- ' - -.
<br /> SIGNATURE` � ' ��� REGISTERED X/.N , FEE:Curt�tEn- Y�/N. :� •
<br /> Address License.# +, . -.-. �� ��
<br /> � MECNANICAE: � ` �OMPAI�9Y """"�� '
<br /> ,• ... ., .
<br /> $IGNATURE ' � 5 REGISTERED, ' Y,/ N . � FEE CUFCRE� Y,/=N: : ,
<br /> Addrss"s�� • ' � . _ ` License# �- . I
<br /> � OTHER �� _ ;GOMPAMt:_ � ��. .
<br /> �, SIGNA7URE '. - • ��� �� ' �� -REGI$7ERED � Y/ N,.. FEE CURRE� Y/N
<br /> � Address - " " '" " � " llcense#•��- � �
<br /> RES1t}ENT1At;;'� Attaoti"2 uP1ot=P,lans; 2 sets.of=Bullilln� PEans; 9 set af�Ene Forin§;,�R=O=CN�Permit far`new c�nsWcUon,
<br /> ( } "{ } t:' 9 { ) ; �9Y'.
<br /> � ,, „ :_Minimum�.ten:(�10);worlcing�days.aftei:submittal'date.��:Requlred onslte;.Cbnstiucd6n-Plans;.8tortnwateFPlans w/Silt Fence installed,
<br /> ' � Sanlfary FaGlldes:&;1;dumpste_r,.Site Worlc:Pertnit for,subdiv151onsAarge;prroJect"s. ,_ � � �
<br /> C4NlMERCIAi. Attach(3)cbmpte#e�sets oF Bulldirig Plans plus a 1:Efe 8afety Page;(1}set of Energy Forins.R-O W Petmlt for new canstructton.
<br /> Mlnimum ten(10)wrorking days after submittal date. Requlred onsite,ConsUuctlan Plans,Stormwater Plans w/Silt Fence installsd,
<br /> Sanliary FaclliHes 8�1 dumpster.Site Work Permit for all new�proJeets:All commercial requlrements must meet camp!lance , '
<br /> 31GN PERMIT Attacti`(2}`sets cf`Eiiglriee.r,edcPlaiis..-� ��_ � � �
<br /> •••«PROPERTY SURVEY required for all NEW canstruc8an. _ �� '
<br /> Directians: • �
<br /> Fill out applicadon wmpletely. �
<br /> Owner&Ccntractar sign badc of applica8on,natarized ,
<br /> if aver�2500,a Natice of Commencement is required. (A/C up�rsdes over S�Soo) , i
<br /> �� A 7'z..Rt.,
<br /> Agenf(for the�a6�tractor)'ur Power of Attomey�(far tFie owner)would be someone with�notarized letter frnm owner authodzing same
<br /> DVER TFiE COtlPi'i'ER PERMII'TING - {Front of Apptication Only) `�"
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIaUSurvey/Footage)
<br /> Drivewaya-Not over Counter if on pubiic roadways..needs ROW �
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