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$,�a-7so-oo2a , City of Zephyrhills Permit App�ication Fax-813-780-{}021
<br /> a ` ` • ' , �-� Building Department
<br /> Date Received , phone Contact for Permitting �
<br /> Owner`s Name Owner Phone Number
<br /> Owner's Address �" Owner Phone Number �— �
<br /> Fea Simple�Tittehotder Name �� � Owner Phane Number �— �
<br /> Fee.�'iimpie Titieholdec Address
<br /> JOB ADDRESS LOT# ��
<br /> St7BDtVISfOP1 � � PARCE�.ID#
<br /> (OBTAINED FRQM PROPERTY TAX NOTICE)
<br /> WORK PROPOSEd e .. NEW C4NSTR 8 ADQlALT � SiGN Q � Q DEMOLlSH
<br /> 1NSTAL� REPAIR
<br /> PROP.OSED USE Q SFR Q COMM � QTHER
<br /> '�YPE'OF'CONSTttt1CTION Q BLOCK • Q FRAME [,� STEEL Q
<br /> ., �
<br /> DESCRIPTION OF WORK
<br /> B[11CDING'S►ZE � � SQ FOQTAGE�� HEIGHT •�� �
<br /> QBUILDING � � VAI.UATtORf'OF TOTA�CONSTRtlCTtOtV
<br /> QELECTRICAL �> � AMP SERVlCE Q PRC?GRESS E(�tERGY Q W.R.E.C.
<br /> QPLUMBING �� �
<br /> QMECHANICAL � � VALUATfON OF MECHANICAL INSTA�LATION
<br /> QGAS Q FtOOFING Q SPECIAITY � QTHER
<br /> FiNISHED FLOOR ELEVATIONS (��� FLOOD ZONE AREA QYES NO
<br /> L
<br /> �.SU1i.DER COMPANY
<br /> SIGNATURE REGI3TERED Y-/ N FEE CURRE� Y/N
<br /> Address License# �— �
<br /> 'rl.�°n`tG�t� -
<br /> 'ELECTR[CIAN ��r `J��� �������i'Z-E��,i'� GQMPANY
<br /> SIGNi4TURE .�� ���� REGISTERED Y/ N FEE CURRE� Y/N.
<br /> i74-y� �1.3-��a� ,
<br /> �az1
<br /> Ad ress - License# '
<br /> :,
<br /> �N in'�'�,
<br /> CUMBER, CONtPANY �
<br /> � .,.. �.�,�• rv�..�,�
<br /> S��GNA�RF� REGISTERED , Y/ N: FEE CURRE� Y/N
<br /> T,i�;F, G�£:LG.
<br /> Address z � License#`
<br /> .. j�_��n-� -
<br /> ` MECHANICAC � COMPAi�IY
<br /> ' SIGNATURE"' � ' � REGISTERED ; Y/ N FEE CURRE� Y/N
<br /> At'!d`re'ss-� `` q ' L-Ieen&@.# � �
<br /> .'i`p.��,� ,. . _ . . .
<br /> �. o�aE�� `�p - co��,a�+nr
<br /> "'`SIGNATURE:, � ; ^ •' � REGISTERED Y/ N FEE CURREK Y/N
<br /> - �Adtiress r . �. . - . _}: LicenSe# � �
<br /> :-4: . �
<br /> ::':::RESIDENTfP+t:-j�s 'iAttacfi�,(2j<PIot:P.lans;{2);sets oE•BuiiclirigTF'lans:(1�}'set ofi�Energy.Forms;R=Q:VY Perri�it for new.constructian, '.
<br /> - �^� u,•:� Minlmum��tern,(}10)..woriciqgldays'afte�="sutiitmittal:clafe.�Required"on'site,'Canstniction Plans,'Stormwater Plans w/Silt Fence installed,
<br /> •�'; ; -,�.,::: „. .
<br /> ,. �:..:•.�ti:......._. , . -
<br /> � Sa�1ta..ry,Facitities;&41;dumpste.r,,.Sife„WorkPermitfor.subdivisions/large�projecfs' ' � _.._.� - --
<br /> r�'.GOMMERCtAl. Attach{2)'c�ii�ptete�se#s tif'8iiiti3ing Ptans�pius a't�ife Safety Page;{1}set of Enecgy Farms.R-O-W Parm�t#ac new construc�on.~
<br /> - Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> ` Sanitary Faa(IiUes&1 dumpster.Slte Work Pertnit fo�`all new projects,All commercia!requiremenis must meet compliance
<br /> y:;3tGNsPER�111T -Attacti'{2}sefsof,Engineered:Plans:_� „ .
<br /> •""*PRORERTY SURVEY required for.all,fVEW construction. .
<br /> -�:�Diiections: > ,-._ , , ,
<br /> "-�FiU�.out application completely.
<br /> .. �Owner:8�Contra�tar sign back of application,notarized
<br /> ` `If over$2500,a.Natice of Gommencemenf Is require8. (AIC upgrades over$750d}
<br /> ';,..,_, �..�: ,.-, :.,.,;;
<br /> . „ Agent(for'kli'e cont'ractor)'ar Power of�Attomey(for tFie owner)wbuld be someone with notarized letter from owner autharizing same
<br /> �`;:{9VER:T'NE COlJNTERuPERMti'FING., .{capy_of con#racE required)` '' �
<br /> ,."`Re�oofs.if'sFiingles 8ewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Driveways-Not over Goun#er if an pubtic'roadways:.needs ROW �
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