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�3�?$°"°°2° City of Zephyrhills Permit Application Fax-813-78Q•0021
<br /> .,�4y.�� � Building Department
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<br /> Date Recelved � .phone Gontact for Permittiag '
<br /> Owner's Name '� Y r L- Owner Phone Wumber
<br /> Owner'sAddress O �U �'1pz t,.,: � O��iane�a Number �^ �
<br /> Fee Simple Titleholder Name �- � Owner Phane Number �� �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ���� � LOT# ���
<br /> SUBDIVISIQN �� � PARCEI.iD#
<br /> (OBTAIMED FROM PROPERTY TAX NOTICE)
<br /> WORK PRQPOSED ,. NEW CONSTR ADD/AI.T [� SIGN Q Q DEMOC.ISH
<br /> INSTALL REPAIR
<br /> PlZOP..OSED'U3E 8FR Q COMM 0 QTHEF2 ;
<br /> TYPE'"OF CONSTRUGTION BLOCK � Q FRAME 0 STEEL Q.
<br /> , DESGRIPTION OF W4RK ��S�L� W��� V� � J..�''�}
<br /> BUiLDIN�,SIZE � � SQ F80TAGE C� HEIGHT �� �
<br /> ��u{�'���G � ����, (�� VAIUATlON=OF TQTAL CONSTRt7GT10N
<br /> QEI.ECTRICAL $ „ . � AMP SERVICE � PROC:F2ESS ENERGY Q W.F2.E.G.
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<br /> QPI.UMBING �>�
<br /> QMECHARIICAL �_� VA�UATlON OF MECHANtCAI tNSTALLAI'it)N ��C_�%2,}
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<br /> QGAS Q R04FING � SPSCIAI.TY � OTHER �!a „ �P, tp�.�}
<br /> FINISHED F OR ELEVA IO S FLOOD ZONE Af2EA QYES NO
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<br /> .BUILDE CQIVIPANY L�,�/�LS t! �
<br /> SIGN�4T E REGISTERED Y-/ N FEE CURRE� Y l N
<br /> Address -Liaense# �������t7�_�
<br /> . 'ELEG,TF2IGIAN . , COMPANY .
<br /> -"SIGNATURE REGISTERED Y/ N �FEE CURRE� Y!N.
<br /> Acliire - Licerise# �^ � ��
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<br /> PtUlU18ER.,., CQMPANY
<br /> SIGNATURE REGISTERED Y•/'N . . FEE CURRE� Y/N
<br /> Address License#`�� �
<br /> �,' MEGHAWIC,t1t:' , � ' COMPANY - - •
<br /> '' :SIGNATURE'� ' ` REGISTERED , Y/ N .; , FEE cURRen . Y/N
<br /> Address'� � " - Licens.e# � �
<br /> '�a;i�;.� � - .. _ .
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<br /> ,,`�`SIGNATURE;i,�.;=�x� -�� � - � " - REGISTERED Y/.N FEE CURREK Y/N
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<br /> .. ri5:��;'c:.,i?� � _ �e� �. _., - . . � . , �
<br /> Address; - :r; _ �� � - License#
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<br /> `:°RESIDENTIAL.:;,°' ;AttacFi;(Z}rPtotRfiari's;=;(2,)=seFs>of�Building=PCaris;{1)�setof�EnergY;Forins;',;R=01(U.Peiinit:#drnew.consirucGon,, LL
<br /> >'.� �,�n3;;^��>- •- �Minimum ten.(t10,pworking;days�;afte�-su6iriittal.date.�Required�on`site;'GonsWction Plans;Storinwater Plans w/Silt Fence installed,
<br /> ;,.s �r.,,: .,:;c'h'.� �. - .
<br /> �=b;� ' Sanit�ry;FaciHties�&1�dumpster,Site_Wor,k:Rercriit for;subdivisions/large;pr'_ojects` ' , � - ,
<br /> :.xs':�< :.., .... .,,.,.�_w;,,..,,: ;..._:.: r � =� � -
<br /> �F,r.GOMMERG1Ai. Attacfi�j2}Acomplete sets Qf"Buitding Plans ptus a VLife Safet}r Page;(1)set of Energy Fotms.R-O-W Permit far new constrvction. "-
<br /> � � Mlnlmum 4en(10)working days after submittal date. Required ansite,Canstruc8an Plans,Stormwater Plans w/Silt Fence insta_Iled,
<br /> - Sanitary Faciiltles&�1 dumpster.Slte Wotic Pemtit fa��a!l-new pEbjects.Ali cammerciai requirements.must meet compliance
<br /> '�=�=:;SIGN�RERMIIT i4ttac?i"(2)`sets,of=,En9(riee[ediRlans:;e"+ � � .
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<br /> "�"' PROPERTY'$IJRVEY required for,all NEW ctinstrucUon. ,
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<br /> f;��.D�irections: _ _ � ...,
<br /> �.'-= �,�...x� .
<br /> ` Fill;out�application completely.n
<br /> ;;k,�_ . =�vuner'&�Cantractor stgn,tiack af application,notarized
<br /> yy; if ove[$2500;.a Notiae�of.Commencement is required. (A/C upgrades over$7500)
<br /> �'�'*:; A enY for`the�cor�tiactor:°or Power of'Attame fo"r'ttie ov+rner woutii"be someone with notarized letter from owner authorizin same
<br /> 9 � _ . ) Y� � ) 9
<br /> �'`yOVER'>THE`COUWT�R�PERMII'TING,'- (copy_of-contract<required):-��"` " � - -
<br /> +?�, �..........
<br /> �,?'•Re�oofs:if'shingles Sewers Service Upgrade's A/C ` Fences(plot/Survey/Foatage) _
<br /> �Driveways-Not aver Counter if on'.public�roadinrays.:�needs ROW^� �
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