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s�aa8o-oozo City of Zephyrhills Permit Application Fax»613-780-0021
<br /> . ' • � Building Department
<br /> Date Received phone Gontact far Permitting • –
<br /> Owner's Name � �!5 pwner Phone Number . ����' `�J" �3'���
<br /> Owne�'s Address �J�G `�r�°� r �� ��--- Owner Phone Number �– �
<br /> Fee Simple Tltleholder Name � ��'� P'7` � �� � Owner Phane Number �— �
<br /> Fee Simple TitleholderAddress � d� j� � � �`�' �--~�'�..�–
<br /> JOB ADDRESS c�'�t � L07# ��/
<br /> SUBDIViSIQN f/�`'����� �� �^'�� PARCEL ID# _
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> W4RIC PRQPOSED e . NEW CdNSTR 8 ADD1At,T � SiGN Q Q DEMOLESH
<br /> INSTALL REPAIR
<br /> PltOPOSED USE Q SFR Q COMNI � OTHER
<br /> TYPE'OF CONSTRUCTION Q BLOCK �- [� FRAME � STEEL Q. �
<br /> � f/ .
<br /> DESCRIPTION OF WORK ����� � �/"L7 B r�✓ ��G� G�� T h � /�=�G�" � ``��"
<br /> BUILDiFIG SIZE �� k ��-- � SQ FOOTAGE ��� , HEIGHT -� �
<br /> .,.
<br /> tLDING $ + � � A'?� VALUATION"OF TOTAL CONSTRUCTION
<br /> r
<br /> QEI:ECTRICA� � _� AMP SERVtCE Q PROGRESS ENERGY Q W.R.E.C.
<br /> 0
<br /> PLUMBING � � � �� `„ t^'z
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<br /> QMEGHANICAL $ VAI.UATION OF NIECHANICA�INSTA�LATION
<br /> [��as 0 s�ooF��v� Q Si'ECIAI.TY �� o����
<br /> FINISHED FI.00R EI.EVATIONS �______� FLOOD ZONE AREA QYES NO
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<br /> BtlILDER � i COMPANY (��–�C �''^''3'-�-�''�
<br /> SIGNATURE �" REGISTERED �/ N FEE CURRE� Y/N
<br /> Address License.# �� ^�
<br /> 'ELEGTRIGFAN -_ COMPANY `
<br /> SIGNATURE REGISTERED Y/ N � �FEE CURRE� Y/N
<br /> ;:;. �
<br /> . Address . License# ��
<br /> P.CUMBER., COMPANY. �
<br /> SIGNqTURE ReGisreReo � � Y-/�N . FEE CURRE� Y'/N
<br /> Addre�s , License#�:� ��
<br /> MSCHANICAI:' � , . COMPAFIY �
<br /> SIGNATURE' � REGISTERED , Y/ N - FEE.CURRE� Y/N -
<br /> Aild�ess�r � � License.# � �,
<br /> >r<<,;,:.� , . ,
<br /> .. .O'�tiER�� `?�. COMPATdY
<br /> '`-81GNATURE3�} �' " - • - � REGISTERED Y/ N FEE CURRE�' : Y/N �
<br /> AddressX�,. �._ License# � T�
<br /> e:��;RESIDEN�A1..}�;. '�Attach,(2)±:PIof:Plari`s;:(2);sefs=of`Building=plans;'(9}�setof�Energy:Forms;;R-0-V4l.Perr`rii#for'new.construction,
<br /> - �a`„--����<<r-�:.Minimum,ten,;(,10):.v�iorking';days aftersu6rriittal�da#e.�Required�ori`site;Can`sUiiction'Plans;Stotmwater�Plans w/Silt Fence installed,
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<br /> �- SanitaryaFacliitiesw&,,lidumpster.•,SiCe�Wack Perr'nit for;spbdivisionsliarge p'rajects' '
<br /> '�?:GOMMERGIAL Attach(2)'compiefe'sets af'Building'P�ans pius a Life Safety Page;(1)set of Energy Farms:R-O-W Permit for new construction:- -
<br /> Minimum ten(10)workfng days after submittal date. Required onsite,Construatian Plans,Storrnwater Plans w/Silt Fence installed,
<br /> :"A`'-- Sant#ary Faaiities&9 dumpster.,Site Work Perrr�l#far-aN�new-p'roJects.A11 commercial requirements must meet compliance
<br /> .,.; . .,. . .
<br /> �.:�.SIGN•�RERMIT "Attaoh(2)'sets;of;Engineered'Flans.��� , - •
<br /> �"�:� " *'"'PROPERTY SURVEY,cequired.foc aII,NEW.ccinstructlon:.. .
<br /> .y._. - •--
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<br /> ';;Directions: r.•=, _- . .
<br /> "' " ,Fill;out°application completely.
<br /> �� Owner:&Cantractor sign.3iack of appllcatian,notarized
<br /> t;.
<br /> �. If over$2500;a Notice of Commencement is required. (AIC upgrades over$7500)
<br /> �� *"` AgenY{for'th'e�cont'ractor)�or�Pawer of Attomey{for'tfie oi+vner�waalc!be someone witl�notarized letter ftom owner authorizing same
<br /> <i';OVER':7HE COUNTER?P..-,ERMIT,TING.., ._ (copy_of-contract�,required) `
<br /> �'Re�oofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drfveways-Not ove�Counter if on.public'�oacJways:.neeBs=ROW- •� --� - ,-.,.,.>.,, ,.,.,,a:�•,... ��.,� � _ ._ ...� ,._w _
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