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s�s-7ao-ooza City of Zephyrhills Permit Application Fax-813-780-0021 �
<br /> • 8uildEng Department
<br /> • .
<br /> Dat�iFteceived Phone Contaat for Permitting �
<br /> Owner's Nama �'( �`'�5 � ��� �--�c"' �l ���5 ~bwn�f t�h�one{4umber ���`� � ( �� ��
<br /> Owner's Address l �'� ,�i'' ������'L-s `�� Owner Phone Number � � s
<br /> Fee Simple Titleholder Name _� Owner Phane Number �� �
<br /> Fee Simple 7itleholder Address
<br /> JOB ADDRESS �� �'����..�`�--�"� C9 S� �`�—~��rL'z� LOT# ��
<br /> SUBDIVtStON �� � P�4RCE�(D#
<br /> (OBTAINED FROM PROPERTY TAJC NOTICE)
<br /> - W4RFC PROPQSED e . NEW CONSTR 8 AC}D1Ai.T �� SIGN [� � Q DEMC}�ISN
<br /> INSTALL REPi41R
<br /> PROP.,QSED USE. Q SFR Q COMM �� OTHEF2
<br /> TYPE':OF CONSTRUGTION Q BLOCK �• Q FRAME � STEEL Q
<br /> DESCRIPTIQN OF WORK ���� �� � �C'� �lt'�� � ��I�lG,I�
<br /> BUII�DING SIZE � � SQ FOOTAGE�� , HE�GHT ,C_,. �
<br /> QBUIl.DING � � VALUATIOiV'OF TOTAL CONSTRI7CTION
<br /> QEI:ECTRICAL $ ���' „ � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
<br /> '! C � (J(,aJ
<br /> QP[.UMBING � ...��
<br /> QMECHANlCA� r$ VAF.UATEON OF MECHANICAL INSTALLATI4N � � �
<br /> L� � �
<br /> QGAS Q ROQFING Q SPEGIAI.TY �� Ol'HER
<br /> �
<br /> FINISHED F�OOR ELEVATIONS �� FLOOD 20NE AREA QYES NO
<br /> BU{LDER COMPAIdY
<br /> SIGIdATURE REGISTERED Y'/ N FEE.CURRE� Y/N
<br /> Address -License,# � �
<br /> ELECTRICIAN . G///'� ' COMPANlf' �aG1J3LI� I� f2�/z�-�I�I�
<br /> , SIGNATURE � REGISTERED Y/ N • �FEE CURRE� Y/N.
<br /> Address ��� !c'j�� r� �f fl .�l�l��'c t l� 3 3-�� �icense# �� l��d��d��
<br /> PLUMSER,., COMPANY,- '
<br /> SIGNATURE� a��tsTEReo- Y/�N ` " FEE CURRE� Y/N
<br /> Address �-License#`� I
<br /> .. , <<. � . -
<br /> MECHi4NICAti. � COIIAPANY
<br /> � 'SIGNATURE'' � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Add're'ss��° _ License.# � �
<br /> .;��r..� . .
<br /> .: :OTHER° .-'�' ; . � ' COMPANY
<br /> �`'SIGNATUREi:>i � " � REGIS7ERED . Y/ N FEE CURREK Y/N
<br /> ' -Aiidress= - , - � ' License# � �
<br /> =<:-: , r .
<br /> r'r,RESiDENTIAL�;:; ':Attach=(2}:PtoE:Plans;`,(2)::sefsofBuit'ding�Plans;(1)'set`of'Energy.Forms;R=O-Vt!Permit,fornew.constiuction,
<br /> , ^�:.�rr;-;;.,,c,c;Minimum;a.ten{(,10)�'_w,orking�days aftec sukimittal�date. Required"onsite;ConstrucUon'Plan's;S'tormvirater Plans w/Silt Fence install'ed,
<br /> "r,:�„ " Sanitary�Facilities&1 slumpster•,,Sife_Woric:Permit far,subdivis[onstlarge p�ojects�- ��
<br /> :���.COMMERGIAL Attach�(2)�comp(ete`s`ets of'Builtling Plans pius a�Life Safety Page;(1}set of Energy Farms.R-O-W Permit for new construction.
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Saoltary Eacilities&1 dumps#er.SI#e Wark Permit fo�alE nerrv p`rojects.All c�mmercial requirements must meet compliance
<br /> ;':SIGN'PERMIT �A#facfi(2)sets.of;Engineered�,Plans:�;: . �
<br /> "`t���'� """"PROPERTY SURVEY,required for aII.NEW.ainstructlan: ,
<br /> :hDi�ections: r . .. . . ,
<br /> � Filf out`application complstely.
<br /> �" O.wner:&.Contractarsigit.backofapplica#3on,notarized
<br /> �;,_
<br /> If�over$2500;a Notice.of Commencement ls required. (A/G upgrades ov�r$7500) _
<br /> ,� !t }sY.���,-.w,....:$,•.
<br /> , Agent{fcir'Uie�conttactar}ar°Power of'Rttomey{fbr'tfie od+rner}wauld tie someane with notarized letter trom awr�er authorizing same
<br /> �.,:OVER`:THE-COUNTER:PER,MITT�NG: (copyof-contract�required)
<br /> '`�'Re�oofs.if stitngles Sewers Service Upgrades A!C Fences(Plot/Survey/Foahage)
<br /> .. ,
<br /> 's __ _.. ._._. .__.. .._ -. ..
<br /> � Driveways-Not over Counter if on pu6lic`roadways..needs ROW
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