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813-�ao-oozo Ci#y of Zephyrhills Permit Application Fax 819-780-0021
<br /> • • Buildirsg Department
<br /> Date R+aceived ~"" Phane;CoMact far°Psrmttfln � p"� �
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<br /> .Ct` (' _ , ,. �, -
<br /> Owrner's Plame Owner Phmne Plumber '
<br /> ,,r � . 1''�� �-f. —� ...
<br /> Owner's Address � ' Owner Phone'Number - .n �� '"' O ��" c�l /1
<br /> Fee Simpl�Tltleholder Nlam� Owner Phone Numbe� �
<br /> Fee Simple Tltleholder Address
<br /> I JOB ADORESS 13 3 /^Q LOT# t��1�i � !
<br />! SUBDiVISIflN PAftCEL ID# � ° .
<br /> (OBTAINED FROM,PROPERYY TAX NOTICE)
<br />� WORK PROPOSED , e j`N TALL�8 REPAIR' C� SIGiV� Q �Q DEMOLISH
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<br /> i PROP05ED.U$E Q SFR Q COMM � OTE�EE2 �
<br />�I TYPE OF CdNSTRUCTION �] BLOCK ' Q FRAME [� STEEL Q
<br /> I� DESCRIPTION OF WORK N �f��C ���n a ' LJ�-� C- U i n
<br /> , ��.. t -�e�c�
<br />, BUtlDli�G SlZE �i �'SQ�FOOTP�GE ` �� , � , HEtGHT K3 l .-� _
<br />�', BUII.DING � ��� WALUATION`t'1FyT0'tAl�ONS7`RUC'i'IOiV
<br />�� QELECTRIGAL $ " : AMP SERVICE Q PRtOGRESS ENERGY Q W.R.E.C.
<br /> QPUtlitIBIN� _� �� .
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<br /> QMECHANiCAL $ ' 'VALUATlONOFtMECtfANlCA�.lNS'fRLLRTIC?N
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<br /> C]GAS Q RQOFING ;[� SPECIH�.TY C� OTHER I
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZQNE AREA QYEB. Fl0
<br /> e���o�� ����aMr� �' , ��ce �t�� . .�r:c-
<br /> SIGNATURE REGISTERED Y/ N 'FEE CURRE� � Y/N"
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<br /> Address • � Ltcense#'r� �
<br /> El�CTRICIAEl;, f - C�MP�4filY - _.
<br /> SIGNATURE '� REGI3TERED Y/ N FEE'GURREK� �`Y/N
<br /> Addees� � � , License#��� �
<br /> PLUMBER � CQ€4tP.A�+IY •
<br /> S(GNA'PiDRE'.�� ' , REGIS7ERED Y./,.N.�. :, -FEE;CURRE� ' Y./N. �
<br /> Addre�s ` lscense.,# � - �
<br /> � MECHANlCAI:' � � � � CO�t1PANY. , � � '
<br /> $IGNATIJRE�� � ' " � REGISTERED ,,Y./ N _ FEE CURREA: Y/N
<br /> %'Y'• _ I • _ � � " „ a .= ' . " ' n .� , Y "'"'� II
<br /> Address - , License# I
<br /> F<, � . <
<br /> � Q�HEEL a - , ' , ,COMP�NY � .—L�C•
<br /> � SIGNATURE-".::`'� '" � " ' ' �� REGIS7ERED - Y/ N.... ;FEE CURRE� � �Y/N
<br /> � Addres� :�::: _ . W�: y �Ctcerise#�1 � e2 �a j � �
<br /> RESlDENTfAt:� " ;Attacti'�2},�Ptaf_P;lans;�;(2}`sets':of�Biiilii€ng�l?lans;(1)set of?Energp�Forri�s;R=O=W=Peritsit fcir new oonsWctEon, ' `
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<br /> 1,.,;;..Minlmum;teny{-10)��„worliing;:days,atter;submittal'date.`,'Required on's1te,-Construc8on<Pians;Sto►mvrater'Plans w!Silt Fence installed,
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<br /> __. Sanita'ryFacflities;&,�1:,dumpster�Site,Wo�,1c�,yPermitforsuddivlsions/Iarge:p.rojecM;v_ ;,;'`:,� _ �
<br /> CQMNIERCIAL Atfach{3)�coinpleta sets`of 8utlding`Plans plus a E.ife Sa#efy Pege;{'i}set of Energy Forms.R-O W Petmlt iar aew construc�an. ' __, _
<br /> Minimum ten(10)working days after submittal date. Required onsite,Canstruckion Plans,Stortnwater Plans w/Silt Fence installed, --
<br /> Santtary Facilitles&1 dumpster.Site Wor1c Permlt for all new:projects:All commercial requlrements must meet compllance � -
<br /> SIGN�PERMIT AttacFi{2)sefs�af Eiiginear,ed P.,laris., �. �, F - ,
<br /> •"«PROPERTY SURVEY required for,all NEW car�struction.. , � .
<br /> Dlraetlon�: ., , . _. , . , .
<br /> Fill out applicatlon completely.
<br /> Qwner 8 Contractor sign back of application,aotartzed '� �
<br /> If aver�:508,a Nottc:e of Commencement ts required. {AtC t�pgrades aver ib7500j
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<br /> `" Agent(far the�cantracto�)br Powe'r'of Attoriiey(for tFie owner)would be'someone writh notarized letter from owner authorizing same
<br /> OVERTHECQUNTER.PERMI'fT1NG. .. -{�rontofAPPllca�onOniy)- ' . _-�- _ :;_';
<br /> Reroofs if shtngles Sewers ServiCe,Upg[ades�•�4/C-�• =S�Fences(Piot/Survey/Footage) , . : " , `, � �{ _
<br /> . � .._... '.�a�. _ -...- ,f y`- ' - .. .. �.r � , • .. . ' , � ...
<br /> Drtvewaya-Not over Coun`'#er if an,piiblic roaciways.:rieeds ROW' . 'r� , . ', ' = .. , �
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