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813-780-0020 City af Zephyrhills Permit Application Fax-813-780-0021
<br /> BuAding Department
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<br /> Date Received � ; ' ` :.� Phone�Cointact-far.�Parmittin � �-'{,�1 — ta� y{ �
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<br /> Owner's Name �V 1�V ���J Owner Phone Number
<br /> Owner"s Address "I�.si Q�.J � l. , ��� �-1 y c�� OIOl7 , Owner Phone'Number � �
<br /> Fee Simpi�Tftietiolder Name f � Owrr�er Phone Number � �
<br /> Fee Simple Titieholder Address
<br /> JOS ADDRESS �`t� � t.�ti,���,i t I�}���,I t�1• V � �}�j � � �LOT# �� .
<br /> sue��v�sior� �,C�l��i(L�G{t,��-�.� . P�c���o# ��-r�1f?-o�1 ��X�[o- C.�03t�- �(3�'SL�
<br />, (QBTAINEC FROM PROPERTYTAX N4TICE)
<br /> WQRK PROPOSEO , _e : NEW CONSTR � ADDI,41_i` [� StGN' Q Q DEMO�ISH
<br /> INSTALL 8 , REPAIR
<br /> FROPOSED:USE Q SFR Q COMM � OTHER
<br />�i TYPE OF CONSTRUCTION Q" 'BLOCK ' Q FRAME � STEEL Q
<br /> DESCf21P110N OF WORK' � tV� �{,�� tY}��t�� t-
<br /> 8U1lDING St2E � "�Q FOOTAGE E� . NEIGN'T
<br />, OBUIt.QlNG �i � �/ALUATION tiF�TOTAl.CO(ySTRl1G'i'tOtV `
<br /> QELEG7RiGR1. � ' � AMP SERVICE Q �PROGRESS ENEFtGY Q W.R.E.C.
<br /> OPLUMBlNG r� '` '
<br /> .L�,{t r����
<br /> Q MECtiANiCAL ($ �� VALUATION OF';MECHANICAS.lNSTALU1TiQN.
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<br /> [�GAS Q ROOFING .Q SPEClALTf � OTHER-
<br /> FINISHED FLQOR ELEVATIONS �� FLOOD ZONE AREA [�YES. ,NQ
<br /> BUILDER COMPANY
<br /> SiGNA7URE REGISTERED Y/ N FEE CURRE� ,Y/N
<br /> Adttrs�s CEcense#'1 �
<br /> ELfCTRtC1APt � . COMI�ANY
<br /> SIGNA7URE � REGIS'TERED Y/ N FEE�CURRE��' `Y/N
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<br /> Address ' , License# �� ,
<br /> PLUMSER ,� COMPANit �u� �� �
<br /> SIGNATURE` ` � ., REGISTERED YJ.,.N, FEe CURREn =/N. - -
<br /> Address - . , , .l�cens�# � . _�.
<br /> MEGHRMlCAl:` ' ' - COMPANY. '
<br /> � S{GNATUiZE � � ` � REGISTERED Y./ N FHE CURREP . Y/-N ,
<br /> Address� - � � , � � - .. License# 1 .- • �
<br /> OTNEEt � . . ;;�COIVIP�!1l+IY l ' -
<br /> SIGNATURE' "'-"'• .. � ` °' ° ' REGISTERED"�' ' Y/ N;.... FEE CURREn Y/N�
<br /> Address �4�, ' _ _ . . � " 'I.icense# � ` - � ' .
<br /> . . . ...� .r,, .
<br /> �... �..; �, .:�-. „ .. . . . . .. ,
<br /> Ft�SlDENTfAL.;� :Attaoh:(2},Ptot_P,lans;•,(2)sets-ofkBiiiitlii►g7Plans;�(1}sefof'Eriergp:�orms,R=t}=WPerinitfc�risewctinstruction, �
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<br /> ~. ,•.,s�-.Minimum:ten.,(�10)�wari4ing?;days;after;subintitai date:�:Required onslte,:Con`strucHon Rians;Storrnwater Plans w7 Siit`Fence instai�ed,
<br /> ..,_.�:.: . .
<br /> Sanitary Facflides;&,�1,;dumpste,r,:Stte Work�,P.,ermit;#or`subdivisionsAarge:priiJecfs�;:Y•;, ::�- ' � �-
<br /> CQMM�RCIAR. Attach{3)�i�inplete�sets of�Bti3liiing�Plans plus a I.ife Safety Page;(1}set of Energy Fonns.R-Q W Permit tor new canstruc�loo.�
<br /> �I Minimum ten(70)working days after submittai date. Required onslte,Construction Pians,Stortnwater Plans wi Silt Fence instatled,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit fnr all new projects..All commerc(al requlrements,must meet campliance `
<br /> SIGN•F�EE2MiT Attach'{2)-sets of�Eiigiiieered.Plans.� :.�: ` � - - -
<br /> ' ""PROPERTY SURVEY required for,al.l NEW construcUon. _
<br /> Di�ectloas: ,°.. , , �
<br /> Fill aut applicaUon completely.
<br /> , Owner 8 Contractor sign back of applicatlon,nota�ized '�
<br /> � N over�2500,a Notice af Cammencement Is reqaired. {A!C upgrades aver�750Q)
<br /> , ,.:M r.:1. ,;•,
<br /> '" Agent(for tiie'contractor)or Power ofAttoriiey(for`tFie owner)wauld be someone w(th notarized letter fram owner authorizing same
<br /> � OVER�TME.COUNTER.PERNIITLFNG: ..;; -{Frontof-Appllca#onOnly}' -
<br /> Reroofs If shingles Sewerr ,��,Service�Upgrades A/C� 'Fences(Plat/Survey/Footage)
<br /> �... .._. .. ;, : � � _ : . - .
<br /> Drlvswaya-Nat over Caunter tf�on publlc,roadvuays:.needs f20VY ;
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