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s��-7$4-aa2o City af Zephyrhills Permit Applicatian Faac 813-780-0021
<br /> • Building Department
<br /> � �
<br /> Date Received � phone Contaat for Permittin -� � •- 1
<br /> Owner's Name t� 1J • Qwner Phone Number I �
<br /> r .
<br /> Owner•s Address � � _ Owner Phone Number „ _ �
<br /> Fes Simple Titlehoider Tiame Qwner Phone Number � �
<br /> Fee Simpte Titteholder Address
<br /> JO$ADDRESS � �� � r ` OS V �' LOT# ��
<br /> SUBRIV1810N �� � PARCEL ID# F l.l1 " t '
<br /> (OBTAINED FROM PROPERTY 7AX NOTICE)
<br /> W{}RK PRt}POSED NEW CONSTR ADDlA�T �� StGN Q Q DEMOLISH
<br /> � INSTALL 8 REPAIR
<br /> PROP..OSEQ USE Q SFR Q GOMM �r 07HER
<br /> TYPE`OF CONSTRUCTION Q BLOCK • Q FRAME � STEEL Q
<br /> DESCRIPTION-OF WORK � � � C� ��J
<br /> /
<br /> BUILDiNG StZE � � SQ FOOTAGE�� HEI�SNT •
<br /> �•,
<br /> '+«""'�LQ��� $ � VAC.UATION'OF TOTAL CONSTF2UCTION
<br /> :QELECTFtlCAL �> __� AMP SERVtCE � PRQGRESS ENEi2GY � W.R.E.C.
<br /> QPLUMStNG (�>—� -���4"�
<br /> L � �
<br /> �MECNANlCAL $ VA�UATlON OF MECNRNtCAL INSTALlAT14N �
<br /> QGAS Q ROQFING Q SPECIA�TY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> ,
<br /> -BUIE.DER CQtVIP,�tdY
<br /> SIGNATURE � REGISTERED Y'/ FEE CURRE� Y N
<br /> Addre�s S _ � �� � "License# � --�
<br /> ELEGTE�I,GIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> � Acldress - License# � 4 �
<br /> }: -
<br /> FLUMBER.,_ GOMPAA��!!Y
<br /> SIGNATURE REGISTEREp Y•/'N. ' FEE CURRE� Y/N
<br /> Actdress License# � �
<br /> NtECHl1NICAE:" . , COMPAIVY �
<br /> SIGNATURE'' REGISTERED Y/ N FEE CURRE� , . Y/N .
<br /> AiidressL � - License.# � �
<br /> �-r;'�xs, � ._. .
<br /> �. a..rt��tt° °�� - � � ' ` co�nF� �
<br /> �°SIGNATURE:»'�_ .� - � REGISTERED Y/.N FEE CURREK , Y/N
<br /> _- Address.:.. -�; , .,� ��, � , Cicerise# � �
<br /> ;.
<br /> �,:.RESIDEtdT1Al.w'r`At#ach':;{2):Plbt�:P:lans;=(2=};sets�of�Buitdiiig�Plans;(1-)`set of Ene`rgy,For'iris;R=O-StV Pennit,for new.constrvction, A .
<br /> ���'� �;:�a,�,`�,;,t;;.; -_:Minimum�ten�(.1q.);working's:days:afte�subrriittaGdate. "Requiied`bnsite;•'`Con`stru;ctionPlans,`Stormwater*Plansw/SiltFenceinstalled,
<br /> � � �� Sanifary=�Facilities:8�{;1;;dumpster:,.Site�:War,k-Reimitfor:subdivisionsAarge;p'rojects
<br /> -.�:G014lMERGIA! AttacFi�{2)`complete`sets of"Butlitirig Plan`s ptus a�ife 8afefy Page;{1}set of Energy Forms.R-O-W Permit for new constn�cfion.
<br /> , Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwaker Plans w/Silt Fence installed,
<br /> � Sanitary Eacilitles&1 dumpster.SPte Work Permit for�ail�aew piojects.Ait commercia!requirements must meei compiiance
<br /> �.=SIGN<PERNli?' '"Attach'�(2}set`s:;af,Engineered Ptans:� � �
<br /> " ""**PROPERTY SURVEY,required_.for,all NEW construcUon. ,
<br /> ��:Rirectioris: ;:=zc.; , ., ,
<br /> ' � Fill.out:applicaUan completely.
<br /> " , Owner&ConVactor sfgR 6ack of appticatian,notarized
<br /> � tf over.$2500,a Notice of:Commencement is required. (A!C upgrades over$75Q0) -
<br /> �._.,.�..,„�;���
<br /> `"' Agent(for'th'e�cont�actor)�orPower�of Attomey(for'the awne�)woult!be someane with notarized letter from-owner authorizing sarne�r�" ;•°':'"':.`,
<br /> .
<br /> 'OV.ER:tHE COUNTER;PERMii'TiNG.-: .(copy.af=contraet-required) , ;� .f'•' ��� , Fi '
<br /> ,�,,:.
<br /> t E. � � , , . .,r:.�, � ',
<br /> ''Re�aofs if sliingles Sewiers � Service'Upgrades'A!C 'Fences(Plot/Survey/Faatage) ;; , • � �' -
<br /> ... _ __ .._.._._ ..� ._.1... _. < �._..._ ,� .-.. , ' .r.�.� _ i . _ _
<br /> ' Driveways-Not over Counte�if qn.putilic`roadways:.neeiis ROVU . -, -� • -- �` " �' ��~' _'� "" '-'
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