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e��s-�sa-oo2o Gity of Zephyrhills Permit Application Fax-813-T80-0021
<br /> = Building Department
<br /> n. .
<br /> Date Received Phor►a Cantact for Permitting � -
<br /> 4wner's Name �i'1` Z � h/�f Owner Phone Number .
<br /> Owner's Address Owner Phone Number �� �
<br /> Fee Simple Titleholder Name � � Owner Phone Number � �
<br /> P-
<br /> Fee Simple Titleholder Addcess
<br /> , � �__�__�
<br /> JOB ADDRESS =/s� (� I" 6�1 (at � ��/' �OT#
<br /> SUBDIVISION � � PARCEL ID# .
<br /> (OBTAINEp FROfN PROPERTY TAX NOTICE)
<br /> WORK PFtOPOSED . NEW CONSTR ADDlALT � SltalY Q Q DEMOLISH
<br /> e INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q CflMNi � OTHER
<br /> 7YPE"OF CONSTRUCTION Q BLOCK '• Q FRAME � ST.EEL Q
<br /> DESCRIPTION CIF WORK �e-t�l�C� /�-Cc�Tf� Co,� yt�it� . S L.J 1��� �n�F rc11 1��� �
<br /> �UILDING SIZE ��� SQ F40TAGE� , HEIGHT •��
<br /> �SU!lDING �9>�� VALUATION'OF TOTAL CONSTRUCTION
<br /> . ELEC7RICAL $ AMP SEF2VICE � ���� Q W.R.E.C.
<br /> QPLUMStIVG �_--_r-� � ��,� � �.` t1� ! �` C �
<br /> QMEGHANtCA� � � VALUATIOh4{}F MECHANICAL INSTA�.LATIOI+! �� f SQ���
<br /> ��11
<br /> QGAS Q R4QFti�IG Q SPECIAF.TY � OTHER
<br /> FINISHED FL04F2 ELEVATIONS � FLQOD ZONE AREA OXES NO
<br /> BUILDER C0INPANY
<br /> SIGME4TURE REGISTERED Y'/ N FEE CURRE� Y%N
<br /> Address �Cicense# �- �
<br /> � 'EI:ECTi�ICIAN � � COMPANY' ,
<br /> SIGNATURE REGISTERED Y/ N •' �FEe cuRR�� Y/N.
<br /> : Address� License# C,�
<br /> �� �
<br /> x E�;:,;_'
<br /> PCUMB�R.,_,, � �COMPANY- �
<br /> � 'SIGNATURE REGISTERED " Y/iN': "� FEE CURREK' � Y/N
<br /> Address �License#-�� �
<br /> • ',MECHIAIVICAC' COMPANY
<br /> '`'SIGNATURE�' " REGISTERED , Y/.-N F��cuRREn• : � Y/N .
<br /> Address-� . - . • .. . . Licens,e.#�� �
<br /> ,.a,,;'s,;; . . � ' �
<br /> >:�:O7HER; , ' � C:OMPANY �"tt`.�' � ��� �•/�
<br /> '�`'SIGNATURE-.:;�_.> •r r ',��°�-S ��� REGISTERED � . Y/.N FEE CURREK Y/N
<br /> �Address:�.: ��- , � � License# r� �
<br /> �.. '.6: �,:%.*' _'.' t:-`_ s �.. .
<br /> ''�`µRE$iDENTiAL:>�,; ':Attacla;;(2)`:'PIbt:P.ians;�,(2j:sets ofii8uilding�Pians;(1�)`set of Energy�,For'rris;;R;O=W:Pe.,miit-ftir new.const[uctEon,
<br /> ��„ _.. ., .. � � _._,._. ,
<br /> ;m,-,;��;�-,.>_;,.�....�Minimum�,tenw(1Q),wto,rking;days:after'submittal�dafe.�Required,onsite;Gonstriiction Plans,'.Stormwater Plans w/Sllt Fence installed,
<br /> � ..� %.. . San3tary Facllit�es�&;?1=dumpster•,_Site{Wor,k Pecmit t'ar..sGbdlvisionstlarge'pro�ectfi' , ' �, - t �
<br /> :�.M:COMiNERGIAL Attach(2)'oomplete sets of'Btiildirig'Ptans'plus a�Life Safety Page;(1}set of Energy Forms.R-O-W Fermit for naw canstructian.
<br /> � - Minimum ten(10)warking days after submlttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> ;;;''.,+ Sanitary Facill�es&1 dumpster+Site Work Permit for-all•new�p�ojects.All commercial requirements must meet compliance
<br /> ���:$IGN;R�RMIT "AttacFi'(2)sets:of;;Engineered;P.lans:�7 � > >
<br /> �:-�,;;?�` ,, "*""PROPERTY SURVEY.rEquired,for aII:NEW.construction.. ,
<br /> ;;Qirections: ,<.�:°.._ . � .
<br /> - '� ''Fi4l:out application completely.
<br /> Q.uvner:&Contraitor sign.back of'applica6o»,notarized
<br /> " _ 'If over$2500;a N'atice of Commencement is recquired. (AIC upgrades over�T500) _
<br /> - k�.,. ., . ...Fx,;
<br /> ��`*'' ,Agent�{for�tti'e`�corit�actor}�prPower of Attomey{fbr'ttie owner}woutd tie someone with natarized lettec from awner autharizing same
<br /> ::�`OVER:THE COUNTER;'.PERMIITING', .. (copy_of.contract required) �` �
<br /> `i'i�eioofs if stiingles Sewers Service Upgrades A/G Fences(PIoUSurvey/Footage)
<br /> Driveways-Not over Counter if on public'roadways,.needs ROW �
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