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813-7$0-0020 City of Zephyrhills Permit Applica#ion Fa3c 813-780-0021
<br /> •• Building Deparkment
<br /> Date Received �� �-- . -phone Contact for Permitting-- ' -
<br /> Owner's Name �� Y' i� Owner Phane Number —aZ
<br /> Owner's Address . � c�� U2 r Owner.Phone Numkier �� �
<br /> Fee Simple Titlsholder Name �! � Owner Phane Number �— �
<br /> Fee Simple Titleholder Address
<br /> JOB A1�DRESS �Ys�C- LOT# �
<br /> SUBDIViS10N � � P����-�� .
<br /> (OBTAINBD FROM PROPERTY TAX NOTICE)
<br /> WORK PRQPOSED � e ., NEw eoHS�rt 8 ADDIAGT [� SEGI� Q � [� DEMOLtSH
<br /> INSTALL °REPAIR �
<br /> PROP,.OSED USE Q SFR Q COMM 0 OTHER
<br /> TYPE'.OF CONSTRUC710N Q BLOCK •• Q FRAME � STEEL Q
<br /> .. a=�, sfia11 s��� �Xjp �
<br /> . DESGRIPTION 6F WORK
<br /> BUILDING'S1Z� � � � SQ FQOTAGE�,i� HE1GliT ����
<br /> QBUI�Dt(UG $
<br /> ��,. VACLIATIQN'OF'TQTAL CONSTt?tiJCT10N
<br /> QEI.ECTRICAt $ AMP SERVtCE [� F'F20GRESS ENEFtGY Q W.R.E.C,
<br /> „ � � ��� �
<br /> o���„�$��� � �� � ���--- ����
<br /> . �C1��
<br /> QMECHANICAL $ VAIUATiON QF MECHANICAL INSTAl.LATiQN
<br /> �f2�fl��
<br /> � iLJ tl
<br /> QGAS Q ROOFING Q SPECIAL.TY Q OTNER �! �I �,
<br /> F I N I S M E D F L O O R E L E V A T I O N S FLOOD ZOIVE AREA QYES NO 7'"1-'°�'""`��
<br /> '���c �..,v�,�,L
<br /> �
<br /> BUItDER �
<br /> �� at��ar+�r � o�r, � C�cv�.e�
<br /> SIGNATURE �� REGISTEREp Y"/ 'N� FEE GUF2RE� Y/N
<br /> Address License# � �
<br /> ---�--
<br /> ; ELECTRiCIAN CC}MPANY
<br /> :. SIGNATURE REGISTEREQ Y/ N FEE CURRE� � Y/N.
<br /> Address License# �� �
<br /> ,, -
<br /> P.LUlU18ER,� C{?MPANY-
<br /> �SIGNA7URE,` Re��sreaeo Y./ 'N FEE GURRE� Y/N -
<br /> Address, License# � �
<br /> ` .MECFtAPI(CAi:., ' . :. COMPANY �
<br /> SIGNATURH'' ' REGISTEREp , Y/ N FEE GURRE�, , Y/-N
<br /> Add�ess��`- ` ' � ' Liaense.# � �
<br /> a,;,;, . ,.. .
<br /> .. OTHER°�.'=c:: °. , GOMPAMf
<br /> ~'�'SIGNie1TURE.:.�r.>' .^ ' ' REGISTERED Y/ N FEE CURREK Y/N
<br /> Address.� - - . - - License# �= (
<br /> r`:?.�:<..:.:...... .- - . ,.. �. : �:,; , , -�. ,. , ,
<br /> -,... ��<-<�
<br /> ���:.ftES1DENT1A1..:.� "Ai,tact�;,(2};,PIot�Pl'arts;(2}�sets�of�Building�Plans;�('i}°set of�Energy;Forms;R=Q=W.Perri�iit,for new�.canstruc�on,
<br /> , �.�«������,.,:;.,Rn;,t rysMinim.um;;#en;(1_0,.):wo,rking;•.days afte�s.ubmittal.date.`'Required orisite;ConstructiomPlans,'Stormwater Plaits w/Silt Fence,installed,
<br /> ;��rt„ ; � Sanitary,,Facilides&1,,dumpstes;^Site;WortcP.emtitfor`�utidivislons(large;pr'ojecfs. ` � ' - - -�` ,
<br /> r,�:cGOMMERCiAt._ At#acti4(2)comptete seis of"Buitding Pians plos a Life Safety Page;{1}set of Energy Farms,R{}-W Permit for new constructlan.
<br /> _ � - Minimum ten(10).working days after submittal date. Required onsite,Constructlon Plans,Storrnwater Plans w/Silt Fence installed,
<br /> �``_ Sanitary Facffities&9 dumpster.Site Worlc Permit"fo�ail nefnr p'rojects.R!I cammercial requirements must meet compliance
<br /> ";�:='
<br /> N�:SIGN:PEi2MiT "Afta`ch°(2}"se#'s;9f;Engineerec!Plans:,r• ; .. • �
<br /> "��''" "*`*PROPERTY SURVEY required for..aII,NEW cbnstruction._.
<br /> �.}- .
<br /> �'xDirectiorisr ,,�:y=�_c:,.,• _ . , _ -
<br /> ' -=F(IC:oLYapplication completely.
<br /> ��` Ovirner 8 Contractorsign back of application,notarized
<br /> ;� - lf over$2500;a Notiae.of:Commencement is required. (A!C upgrades over$T5d0)
<br /> "'*' .Agent'(fort�e�cont�actorj°or�Power-'of Attomey`(for'the ownei)woulcl lie someone-with notarized letter from ovmer authorizing same
<br /> � .�. F,. _
<br /> ;;.r�OVER;7HE�GOUNTER'PE.RMt7;TING, (copy-of-contract�,required) � "` " � � ,
<br /> ``�Re'r.oafs if�shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Faotage) „
<br /> " Driveways-Not over Counter if on public roadways::needs ROW
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