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a��-�eaoo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> " . 6uitding Department
<br /> Date Received phone=Contactfor-Parmtttli� '
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<br /> Owner's Name �e�-�-'�'',,,�' t ' ��� �.. Ownar Phone Number gl� �aQ"�7�'�
<br /> Owner's Address •T(�,,�Z �---q{'C� �� Owner Phone Number - �- ��
<br /> Fee Slmple Tltleholder Name �^ � '� Owner Phone Number � �
<br /> Fee Slmple Tltleholder Address ��i S�. (� ��Lti ,.� 2� � "`� 33 Sy�2
<br /> JOB ADDRE8S �Z Z--`t�'�� t�r 2 h ` (S L 33.5"`� Z LOT# ��,.�
<br /> suso��v�s�aa� � � �,aRCE�.io# � � �
<br /> , (OBTAINED FROM PROPERTY,TAX NOTICE)
<br /> WORK PROP03ED � NEw CONSTR ADDlALT �. SIGN� `Q - [� DEMOLtSH �
<br /> e INSTALL. 8 , REPAIR
<br /> PROPQSEDrUSE Q SFR Q COMM [� -QTHEi2 ' '
<br /> TYPE OF CONSTRUCTION Q 'BL.00K ' Q FRAME � STEEL Q
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<br /> DE3CRIPTION OF WORK �e- '�o� U S i� i✓t�b C�f ' 1dc� �.4 �� ���� �E'-�
<br /> SUILDIPIG SIZE � � SQ FOOTAGE ���� HEIGHT���� _
<br /> QBUt�DlNG � VALUATION`OF TOTAL CONSTRUCTION
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<br /> QELECTRIGAI. -$�'-" � AMP SERV#CE Q -PROGRESS ENERGY Q W.R.E.C.
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<br /> QPLtlMSlNG ��� `
<br /> [„�MECHANlGAL $ ,,, VALiJAT10N t�F'MECHA{�lICAl.lN9TAlLAT!{7t+!
<br /> �.,��.
<br /> QGAS Q RQOFIE+tG _� SPECtALTY �] CITHER
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZQNE AREA QYES. PIO
<br /> , �aui�a�� �--�.'�_�� -'`� co�pa�nr � ` t,�.t;� �
<br /> � 5 �S L�'C
<br /> �, SIGNATURE ['�� � REGISTERED Y/ N FEE CURRE� Y N
<br /> Address ��? t-e�h� �f': � t--N �t`7 t�-t,. S�{3 Eicense# ��(-3 Z`7 7�`-� �
<br /> E�EC7RICIAN . C`OM#�A�Y ` -
<br /> SIGNIa1TURE '� REGI3TERED Y/ N FEE CURREK�' Y/N
<br /> Address ' . , License# � + � �
<br /> P[.tlMBER , COMPANY
<br /> SIGNATURE' ` ,REGISTERED- Y./-N-. -_EEE.CURRE� Y-/N
<br /> Address Licepse,# ��- ��
<br /> MECHAt�ICAE: ' � � � GOMP,ANlt � - '
<br /> SIGNA'PURE �� ' REGISTERED Y/ N . FEE CURRE� Y/•N
<br /> Address`� - . � �. . ` � .. . �- License# �� �
<br /> OTHER '*' � � � . ;COMPANlf,
<br /> SIGNATURE �"_"'� � �. ' "` ' "" ` ' ' " `' REGISTERED' Y/ N;,... FEE CURRE� � . Y/N
<br /> Address � n � ticense#��— �
<br /> � . _r� .. Y .�.h.�..,.•... ,��. :, .G.. . . .
<br /> RESIDENTIAL:;; :Attacli"(2):P!o#�P,lasis;.(2�sefs-of�Bullding:!?ian's;(1}set ofEiiergy;Farms;RA�W�Remiit 1�r new constructian, ,
<br /> -_ , Minimum�ken;(10)�working days,aftersubm�ttal d`ate.;:R'equired onsite,ConstrucUon-Plans;�Stormwate�`Plens w!SIIYFence instaUed,
<br /> ��� �Sanitary Facilides&;1;dum.pster-�Slte Worlc3Permit tor subtliVisiq�§Qarge.proJecYs:�._;`;:;; "
<br /> - G{21V{MERCOAt. Attach{3)�comyslefe sets'of Bulliliiig`Plan'plus a�I.ife Safe�ty Page;�(1}set of Energy Forms.R Q-W Petmit for neuv oonstnsctlan. � `
<br /> Minlmum ten(10)working days after submltNal date. Required onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence lnstalled,
<br /> Sanitary FaclliUes&1 dumpster.Site Wark Permit for all new:proJects..All comm�rGal requiremenks�must meet comppance
<br /> StGN PERMIT Attacit{2)"sets of Eiiglneered.Plaris.: � � . .. �
<br /> ••'"PROPERTY SURVEY requlred for_all NEW constructfon. . .. �
<br /> Dlreattons: . . _ . , <
<br /> Fill out appiicatlon wmpletely.
<br /> 4wnar&Conhactar sign back of appficallon,natarized '�
<br /> if ovar a�500,a Natice of Comrnencement i��equirad, {AIC a�sgrades over S750dj
<br /> '4=;;,:.,,;
<br /> '" Agent(for the!contractor)'or"Power of Attomey�(far tFie owner)would be someone with natarized letter from owner authorizing same
<br /> dYER i'FFE CCIUNTER PERMITFtNG , (Front af•AppEica#ion Oniy} � Y '
<br /> Reroofs if shingles Sewers - =� Service Upgrades A/C � Fences(F'lot/Survey/Footage)
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<br /> Drivewaya-Not aver�.Counter if on pubifc iaaduiays:.needs l�OW
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