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<br /> s��-�saoa2a City of Zephyrhills Permit Application Fax-813-78p-0021
<br /> • Building Department
<br /> Date Rec�ived � Phone Contaat for Perrnitting -�
<br /> Owner's Name �� /� Owner Phone Number , ��.�� 7/ ��
<br /> Owner's Address v �.�� ��/'� Owner Phone Number � �
<br /> Fee Simpie Titleholder Name �� � OwneF Phane Number �- _ �,
<br /> Fee Stmple Titleholder Address
<br /> JOB ADDRESS � �� S� i I !"'j t LOT# ��
<br /> su�oivisiort I � Pa�zc��.�o# Z- �i- - t� ' d S"fJ0- 1
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED e .. NEW COt35TR 8 ADDIA�T � S1GN Q Q DEMC}LISH
<br /> INSTALL REPAIR
<br /> RROP,.QSED USE Q SFR Q COIUtiV! Q _ OTHEFt '
<br /> TYPE':OF CQNSTRUCTION Q BLOCK • Q FRAME 0, STEEL [�
<br /> �s j Q �/
<br /> DESCRIPTION OF WORK � + (ll r' ,� P( 1 ►1 l��ip U?� {%�r `����I I
<br /> BUILDING SiZE � � SQ FOOTAGE I U ' HEtGHT •��_--___�
<br /> 0����`���� � �D VALUATIOTV�LIF TOTAL CONSTRIJCTiON
<br /> � ���
<br /> ..�,�ELECTRIGAL �� AMP SERVtCE � PROGRE5S ENEf2GY Q W.R.E.C.
<br /> �,
<br /> QPLtlMBiNG � �
<br /> QMECHANtCAL �s � VALUATION OF MEGHA[+!lGAL INSTALLAi'ION
<br /> {�,GAS Q RQOFIfUG �ECIALTY [_'� QTHER
<br /> FINISMED FLOOR EI.EVATIQNS ��� FLOOD ZONE AREA DYES NO
<br /> -.BUtLDER CONlPANY
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br /> Address -License# � �
<br /> � �"ELEGTRF,GFAF! COMPANY
<br /> _'SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Y Address - License# � # �
<br /> " F�;�±"«
<br /> �cut�eER.,, � co�r�aMr
<br /> SIGNATURE REGISTERED Y•/�N� FEE CURRE� Y/N
<br /> Address � License# �� � '
<br /> .'.MECEii4EtIGA1: { .COMPANIt
<br /> `'" SIGNATURE"' ' RECaIS7ERED , Y/ N_ FEE CURRE�� , Y/N '
<br /> aaa�ass4-. � � v � �i��nse.# � �
<br /> ��:�::,.,:. „ ...
<br /> 7
<br /> � o��tt� =��� , , - co�nP�r 0 d'1�.r �Q+��� .��
<br /> '�°{SIGNATURE:���:>; .� � REGISTERED N �e cur�en' ,/N _
<br /> �aaaresg r�, �' .Z`;. S v�.��i E/"n- •'f i,/ �1 .� ..� • License# ��.T.����� � �
<br /> .`{',�,: ,:. . _ ,. .: _ . ,
<br /> ...§,_, .;_ ,,�, .
<br /> ���,��REStD�NT1AL�;�,::'Attach`{2}"Ptof�P.lans;.'(2}b's`efs�af�Building�Ptans;{1}°se#of Ene�gy`Forins;R-0-W Perm�t for ne_,w.consfruction,
<br /> � �� �'x<:��.--•Minimum;,tenc(;10),working'';,days aftee sutimittal�date.'�Required'onsite;Constr`'uction Plans;Stormwater Plans w/Silt Fence installed,
<br /> - ;�.�':��r,, � �._:> , �. . , = . � �
<br /> ' SanitarytF;acilEties°r&�u'l,:dumpster;.Site;Work Permltfor.;§ubdivisionsllarge`p'rojects ' � -
<br /> ;"�GOMMEREtAl, Attach�(2}`coriiplete"sets of'Building P(ans�plus a L'ife Safety Page;{9}se#of Energy Forms.R-O-W Permit for new constructian.
<br /> �-:� : Mlnimum terr(10)working days after submittal date. Required ansite,Construction Plans,Stormwater Plans w/Silt Fence ins#alled,
<br /> Sanitary Facifitles&1 dumpster,Site,Work Permit faF�afl>neinr projects.Ai1 commerciai requirements.must rr�eet eomg[lancs
<br /> �'r:''.SIGN:PERMIT "Atfach(2)sets;o€,Engineered;Plans:��� :- � •
<br /> ��_��' "'""PROPERTI!SURVEY reguired for,.aII,NEW canstrucGon.. _
<br /> ��Dice,ctlons: ` +• ., . .= .. �
<br /> Fill out applicatian completely.
<br /> . , Owner-'&Gontractor sign`back of appticallon,natarized �
<br /> ��.`� �If over'$2500;a Notice.af'Commencement is required. (A!G upgrades over$7500)
<br /> �,:.,. ;.�.,.�.,.�....:..
<br /> <<., _. .Agent_(fo'r'ttie�confra�tor)°or°Pouuer•of:Atiomey.(for tt►e.awner)would be someane with notarized letter from owner authorizing same i
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<br /> '`�`OVER�.THE�GOUNTER�PERMITTINCy� (copy,of-cohtr'act:required)�" ; `� " �
<br /> '�"3Reroafs if shingles Sewers Seroice Upgrades A/C Fences'(PIot/Survey/Footage)
<br /> Drlveways-Not over Counter.ff on public;roadvirays..needs ROW`;_
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