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813-7eo-oo2o City af Zephyrhills Permit Application Fax-813-780-0021
<br /> 8u!lding Department -
<br /> �• -� • '
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<br /> Date Recelved .
<br /> , �/� �Rhone<Contactrfor�Permlttin � � . �
<br /> Owner's Name u t^�'-�'1 �X�� ��e� Owner Phane Number ��� �d`�����7
<br /> Owner"s Address �����. /7��-�L^��� ��� Owner Phone Number � y�
<br /> Fee Simple Titteholder'Name � � Owner Phone Number �� �
<br />� . .
<br /> Fee Simple Titleholder Address
<br /> JOS ADDRES5 ����'`� �� P7;� �-�� � �t,�, �, �t�;11� ��, ����f LOT# �_.�
<br />� SUBDIVISI4N � � PARCE!ID#
<br /> (OBTAINED FROM,PROPERTY TAX NOTICE)
<br /> WORK pROFOSEQ �NEw`CONSTR ADDIAIT [�` S1GN [� Q DEMOl.lSii
<br /> INSTALL REPAIR •
<br /> PROP{?SED�USE � Q SFR Q COMM ' � •QTF{ER '
<br /> TYPE OF CON$TRUG'170N Q � BLOCK "'Q FRAME ` � STEEL Q
<br /> DESGRIPT{ON t3F WORK '�`�2+�s.�cL .}�.�C.. �eM°e,,, e�v�� S�:M� L OC.*(�}'-i"':�`�i�. � '��
<br /> i BUIlDlNG SIZE '�� � SQ F003AGE !�� : ,,HECGH,7' ����
<br /> QBU{t.DiNG � � VAlUATION�C.1�TO'1'AL CONSTRUC`i`IOi�! '
<br /> QEL•ECTRIGAL �� AMP SERVICE Q FRQGRESS ENEF2GY Q W.3�.E.C.
<br /> „„ , ,,.„
<br /> OPLUMBING � � � �
<br /> MECHANICAL $ � o�., VAtUATtON OF MECHANtCAL It+iS:TAILATtON "U`C"
<br /> � � ,��� ��
<br /> C]GAS Q RQOFING CJ SPEClAI.TY, [[�] QTHER � �
<br /> FiNISHED FLQOR ELEVATIONS ��� FLQOD ZONE AREA QYES ,h10
<br /> BUILDER COMPA[�tY�
<br /> SiGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � l`Icense#'� �
<br /> ELECTRICIAN; , COMPANY - '
<br /> 31GNATURE �' REGISTERED Y/ N FEE CURRE�'' �=Y/N �
<br /> {, - - (��
<br /> Address � , EiceriS�e'#.i` . .� �
<br /> PLUMBER COMPANY , ' .
<br /> SIGNATIlRE` `" � REG13TERED Y_/ N•. .�. EEECURREK ' Y./N. -�
<br /> Address •License# � . . �
<br /> MECMANlCEU: ' ' ' CQMP/WY, „�tiY' C�+ :�'' �� 1 et�y�,,,�t, �<. '�' t�.,�,
<br /> SIGNATURE� � REGISTERED ,� Y./ N . ,FEE CURRE� . Y/,�N - �
<br /> Addre�s�'*, .'��?3 �z�.s� (,�lr�t,.c�,�2�,;� �a�o�'�,,,,.icc5 licanse# �� t�3 fb �
<br /> 1�.G.�- 1 Q, `,�
<br /> .,f . � .�. $
<br /> OTHER . ' _ , " `' ';CQMPANY ' ,
<br /> SIGNATURE '.:�;., .= "� � �_ . ' ` ' `' ' RE�isT���`''� � �Y/ Nv r: : .��ee Curt�n � Y/N
<br /> Address _ . . I.. - .}�: : - - - ' �cense# �` �
<br /> .,,,. , .. .. , .. ,. .
<br /> RESfDBNTiRL';�• Atta'ch(2),PJot Pians;>.(Z}se!'s�.of�Bufidi�g�Piaris,"{1}sef'of'Energy�Fonr►s;R�t?�-W'Perimlt far nsw cdnstnic#1on, . :
<br /> � .Minimum�,ten�(�1.0)?working�d"ays.after.:submiktat`da#e:vRequlieii orislte;_CbnsiiucHon'Pians;StoRnwater'Plans w/SIIt Fence instaqed,_,___._v
<br /> �` - ``Sanitery Fecllttles;&r;1;dumpster:Site�Wor}c:Permlt�#ur-subil6Vls!gi:rflarge projccfs:�-, ::;,: - - . �_ ; -__-�--— . -, .
<br /> �.--:.
<br /> `-`Ct}Bli�Il��tCl"P1R. ` Attach(3)�coc�iplefe'sefs cf Buildirig'Flans'pliis a l.lfe Safety Page;{1}set of Energy�Farms.R-O-W Permit for nev+r cons#rucftan.
<br /> Minimum ten(10)working days after submithal date. Required onsite,Construc8an Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Factli8es&9 dumpste�.Slte Work Permik for all new projects.All commercial�equirements.must meeY campliance �
<br /> SlGN PERlHlT Attacti{2}sets`"ofEoglrieer.edrPlaris:`.<-::;., _: ' .
<br /> "•"PROPERTY SURVEY,reyuirecf for a16NEW can.s.tructlan. � - � � � ' �
<br /> plrectlons: , . _ � ,
<br /> Fill out applicadon completely.
<br /> Owner 8 Contractor slgn back of appl(catlon,notarized
<br /> If aver y2S00,a Notice of Commencament 1s requlred. {A!C upgrades aver$7500)
<br /> .. ... <<�.:;.,...
<br /> Agent(for the con'tractor)�or-Powe�'of Attomey�(for tlie owner)wauld be someone with�notarized letter from owner autha�izing same
<br /> OVER THE CCtUN'iER.PEt2MlT"E'tAlG _-...{Front of�AppllcatlamOnly)•- � -
<br /> Reroofs if shingles Sewer,s Service Upgrades A/G Fences(PlodSurvey/Footage)
<br /> Drtvswaya-Not over Gaunt�r-.if on,publ[c�rc��.duy.ay�..�eeds�ROW,. -_. A .. . ,L_ ,„ .,.. , ..-,, � .
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