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s�s-�ao=oa2o City of Zephyrhills Permit Application FaX a�a-1$aoazl
<br /> �• Building Department
<br /> Date Receivee� r Phane Cantact for Permittin —
<br /> S�"
<br /> Owner's.Wame r �� 4�]I�� ��U� �L�� Owner Phone Number
<br /> Owner's Address ���*'�' �° ��3 Owner Phone Number � , �
<br /> Fee Simple Titiehoider Name �� � Owner Phane Number �� �
<br /> Fee Simple Titleholder Address
<br /> J08 ADDRESS ���� s�`����"� ��� '�� ���� LOT# ���
<br /> SU8D1UISIQN � � PARCE�.IQ#
<br /> (OBTAINED FROM PROPBRTY TAX NOTICB)
<br /> WORK PROFOSED e ,, NEW CON5TR°8 ADDlAI:T � S{GN Q Q DEMOUSH
<br /> INSTALL REPAIR
<br /> PROP..OSED USE. Q SFR Q COMM � OTHER :
<br /> TYPE`OF CONSTRUCTION Q BLOCK �• Q FRAME C� STEEL Q "
<br /> DESCRIPTION OF WC1RK €� �1' ��t� �!' �� ��"�� T��` ��t � ,
<br /> BU3�C3tNG,S1ZE � � SQ FOQTA6E�� HEIGHT •��
<br /> OB���'Q���' ("' J VALUATION'OF TOTAI CQNSTRE7CTION
<br /> �
<br /> QEL�CTRICA� $���i�o �� AMP SERVtCE Q PROGRESS ENEFtGY Q W.F2.E.G.
<br /> t:.` t.J
<br /> OPLUMBlNG � �
<br /> . �;,_� �2--
<br /> QMECHAN{CAL $ VALUATlON OF MECNANICAL INSTALLATION �
<br /> � -
<br /> OGAS Q RQOFING Q SPECIAl.TY � OTHEi2
<br /> FINISHED FLOOR EL.EVATIONS ��� FLOOD ZONE AFiEA QYES NO
<br /> �BUIE.DER COMPANY
<br /> SIGNATURE REGISTEREp Y'/ N' FEE CURRE� Y 7 N
<br /> Address License# � �
<br /> � "ELEC7'FttG(AN COMPANY �C1'S4{�� �`f{��,�(,,. �Y d�/' t�C�
<br /> =.r SIGNATURE � <"���%�5�� �M REGI3TERED Y/ N-.� FEE CURRE� Y/N. �
<br /> Address ' - License# � (
<br /> �..„,.,•:-
<br /> P.�UMBER.,; COMPANY-
<br /> �'SIGNATURE =REGISTERED Y-/ N ` FEE CURRE� Y/N
<br /> Address license# �� �
<br /> MECHANICAt: � _ . C4MPANY
<br /> ` SIGNATURE'' � REGISTERED , Y/ N FEE.GURREn , Y/N
<br /> Aild'r'ess�� _ ' � � � � �Liaens,e# � �
<br /> .r��� - ... . . . , �
<br /> o-r�a�t3: . - . cot�,p�r
<br /> ""SIGNATt1RE�,+::: .° - � ' ' REGISTERED Y/ N FEE CURREK Y/N
<br /> A¢idress:,, - - �- � Ircerise# � �
<br /> �':':;,�.�: � .� . . ,. , , . :�Y...,�; . . . , - ,
<br /> "�RESiDENTiAE.r�s; ;Attaci%;:;{2};:Plot:�P.lans;`(2)�sefs of�Buil'ding'�Plans;{1)°set ofEne'rgy,Fortns;R=O=W.Pe�rriit,for new.construcf�an, '-
<br /> , �:,� jf � c- ;Minimum ten�.(;1Q);working�days:after-'sutimittai�date."Reqwred ansite Con`struaBon Plans;Sto�mwater Plans w/Silt Fence.installed,
<br /> ;�=r . , 8an'itary-,Facflitiest&�1,�;dumpster;�S„ife;Wqr,le Per,mit foc;§ubdivisionsllarge'pr'njeets ';.' •"
<br /> �,;i.GQMMERCIAL Attacti'(2)�completie'sets of"Bu�ldiiig Ptans plus a Ltfe Safety Page;{4}sefiof Enetgy Farms.R-O-W Perm�t for new cxrnsfruc#on. _
<br /> :- -Minimum ten(10)working days after submittal date. Required ansite,Canstruc#ion Plans,Stormwater Plans w!Silt Fence installed,
<br /> ;`;;.`�:{ Santtary�acilitfes&9 dumpster.Site Work Permiffo��atl�new projects.Al!commercial requirements.must meet compliance
<br /> ��:;'SIGN`PERMiT `AtfacFi{2)sets;ofiEngin'eerecl:Flans:f= .: . . � .
<br /> �'=F��`� *"**PROPERTY�URbEY requlred for,all.NEW ccinstruction.
<br /> ,�:. _._.__ .
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<br /> �-E?iFe�c'tionsc r z-_ < �.
<br /> � , -�Ffli<out application completely.
<br /> �' `Gtuune�.&Contra�tor sign 6ack af appiicatian,notarized
<br /> if�bver$2500;a Notice.of Commencement is requirad. (A/C upgrades over$7500j , .
<br /> � - r..�...,... ;...:r,
<br /> "`"'� .Agent(for�ttie�cont�actor)'or�Power of Attomey(fur'ttie otirner)would tie someone with notarized letter from owner authoriiing same
<br /> �:;�t3VER';THE�GCfUNTER�P6RNT11TiNG, .(copy.of contract�required} >' ;''` "` -
<br /> `:>;Re�oofs if,-sfiingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage)
<br /> . _ ., .,�:<.,<.. , _
<br /> ' Driveways-Not aver Caunter if on public�oadways..needs'ROW
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