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s��-7eaoo2o City of Zephyrhills Permit Application Fan-$13-780-0021
<br /> N � . � Building Department
<br /> Date Received phone Gontact for Permitting.'� --
<br /> �wner's Name �i4� Owner Phone Plumber - .'��-'"7��$�
<br /> (�Owner's Address p"YY��""�, C Owner'Phone Number �� ��
<br /> Fee Simpie Titlehoider Name Owner Phone Number �— �
<br /> Fee Simple Titleholder Address
<br /> �'JOB ADDRE$S o/'/ O A LO7# �i�
<br /> suB��vis�at� �aixc��.��#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PRQPOSED e .. NEW CONSTR 8 ADD1Al.T �� SIGN Q Q DEMOLlSH
<br /> INSTALL REPAIR,
<br /> PROP..QSED'USE - � SFR Q CQMM � 4THER _
<br /> TYPE"OF COPISTRUCTION Q BLOCK • Q FRAME [�. Sl'EE� Q.
<br /> II DESCRIPTIpN�OF WORK � � S'/i4J� � D I �
<br />' Bt311:111t3G SlZE � r p '�i j t� � SQ FOOTAGE�„� HEIGHT • `�
<br /> QBUtI.D[NG � � ,�asg i 6�I VALUATlON�OFTOTALCONSTRUCTION
<br /> P �
<br /> :QEi:ECTRICA! � � AMP SEftV10E Q PF20GRESS ENERGY Q W.f2.�.C.
<br /> QPL.t1NIBING r> � f{' �D�.•
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<br /> QMECHANtCAL �i � VAIUATIQN OF MECNAIVICAL INSTALLATt4lV . , �1���i����
<br /> � r �l���
<br /> QGAS Q R04FENG Q SPECIAG'fY � 4THER �L� ��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ���/
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<br /> — .8J1����- --- - - - - - - � ; �O�ti�ARiY.�-� �C1� "- -- -- -- - - -
<br /> ' SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address -License# �— �
<br /> ELECTRlG1AN ., CC}MPANY
<br /> �. SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> , Aiidress - License# � �
<br /> PCUMBER.,., �CO�![PAl�IY .
<br /> SIGNATURE REC�ISTERED Y•/ N,� , FEE CURRE� Y/N
<br /> Address License# � �
<br /> '.MECHAFi1CAt; ' COMPANY
<br /> '' SIGNATURE'' � � REGIS7ERED , Y/ N FEE CURRE� Y/N ''
<br /> ' Add'r"ess�� License.# �� I
<br /> ;s;, , .,
<br /> , ;.OTHE,j,t'•�'`'.�,- `� ' � ` � COMPANY - -
<br /> „�`'SIGNATUREa,;c-� •^ - � REGISTERED Y/ N FEE CURREK , Y/N
<br /> Aaa��ess�. � - . . . .,. . tice�se# �� �
<br /> Gy�' N
<br /> RESIDEN7IAl.�:,x '"Attacfi="2;Ptof=Rlans;`'�2`"sefs-of`Buifir3iiitl t?Eans; 1•'set afEner F�*j ��;� .: �' . .
<br /> � ;.,. ,..
<br /> •.� _ ,(.,) { }� g� ( } gy' orms;R=Q=t1V Perriiit,fur new,canstructiori;
<br /> _ .,:•,��`'R.;;�-��,.•.-.,.Minimum�..tert(�10)o_w,orking�days;afte�.su6riiittal�iiaCe.'Required�onsite;Con`str`uctionPlans;°Sto[mu'vaterPlansw/SiltFenceinstaUed,
<br /> � .'' � '�,h.,S�nitary Factlities�&1 dumpster:Site Waek Permit fac.subdivisionsflarge:projeats'-- ` � - - - --,
<br /> �;`,.COMMERCtAI. Attach�°(2}complete sets af'Baililing�Ptans�pius a Life Safety Page;(1)set of Energy Forms.R-O-W Permitfor new constructian.
<br /> ,;�4;=°_ ,� Minimum fen(10)working days after submittal date. Required onsite,Construc#ion Plans,Stormwater Plans w/Silt Fence insta,lled,
<br /> '8anitary Facitities�1 iiumpster,Site,tNork�Permit'fo��a1F-new.projects.Afl corrii»ercial requirements must meet compliance
<br /> '�iSIGN�RER�IIT "Ai#acti(2):sets:of;Epgineered�Ftans;���.:�;�:� : � - • �. .� ,�, '' .. , �
<br /> � """PROPERTY�SURVE �ke uired for;al4NEW canstruction. - ' � '; ' ' � '
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<br /> �;;+�` - - -
<br /> � �„Diiectioris: �: - . ,.
<br /> ��- Eill-out:applica6oncompletely.
<br /> " �i3wner'&�t�ontractor sign back of appllcatian,notarized
<br /> I�f over$2500,a Notice.of:Commencement is required. (A/C upgrades ov�r$7500) _ .
<br /> '*'' Agent.(for'tlie cantractor.)ror°Power'of:Attomey(for'#1ie owner)would tie sameone wittt notarized tetter hom owner authorizing same
<br /> ''OVER:T.HE�COUNTER._P,.,ERMITTING.�. ., .(copy-of contract�required) rt" �`
<br /> �F..;-. .
<br /> � ;���Re�oofs-if stiingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> !i y Driveways-Not over Counter if on public roadways..needs ROW. � "rt �`�'�'�""��� '" �'
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