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a��-�ao-oo2o City of Zephyrhills Permit Application Fax 813-780-OQ21
<br /> Buitding Departmen# ,
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<br /> Date Recelyed pl�one�Contact for}Fernttttin
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<br /> Owner'�Name Ownar Phone Number ��'�'`T �-I 5R�
<br /> Owner's Addres� � I.2� � � ` C,�'� ��S 3�5�pwner Phane Number =.�� �
<br /> Fee Simple Titleholder•Plame Owner Phone Number � �
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<br /> Fee Stmple Tltleholder Address
<br /> JOB�4DDRESS � LOT# C�
<br /> SUBDtViS10N � � � PAitCEL ID# �
<br /> , , (OBT/11NED FROM PROPERTf.?AX NOTICE)
<br /> WORKPitOPOSED •-NEwCONSTR ADDIA�.T � S1GN� Q- �Q pEMOkISH
<br /> ���e. INSTALL � . REPAIR � �
<br /> PROPQSED.USE Q SFR, Q CQMM [� �t}THER
<br /> TYPE OF CONSTRUGTION" y Q 'B1.0'CK ' Q FRAME [� "STEEL Q
<br /> � � ,� �`�' 1� ( ,, ('�
<br /> DE3C�IPTION O�WORK-' '' "1� `����� 1..� T'� ',ti ('��
<br /> BUtlDlNG S12E "� ,� SQ�FOOTAGE��, : �,HEIGHT .���
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<br /> BCl1kDING $ � 7� � � VAICIATiON�OF�TjOTAL CON3TRUCTiON �.
<br /> QEI.ECTR[CAL � � AMP SE#tVICE Q PROGRESS SNEFtGY Q W.R.E.C.
<br /> QPLUMBING $ . `
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<br /> I Q{1AECHANtCAL $ VALUATlON t3F MEGFiANICAI t1�STALCATIt?N �'� ��T �
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<br /> I� QGA3 Q RC?OFINt^,a _Q SPECIAI.`TY � OTHER �
<br /> FINISHED FLQOR ELEVATIQNS r�� FLOOD ZOfVE AREA �]YES. _.ND
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<br /> I �Vi��GR � yL34i�lV77 �VV� �V" • 4���
<br /> � $1GNI�7IJRE REGI3TERED Y/ N FEE CURREA Y/N
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<br /> ! Addres� � Cicense# � �
<br /> ELEC7RICiAN: ,-: �>COMPANY =�
<br /> SIGNA7URE '� REGISTERED Y/ N FEE CURREK`' ' `Y/'N "
<br /> Address � i ; _ , Ucense# �`. �
<br /> P�UMB£R � = COMRI4NY - �
<br /> SIGNATURE' � ' �.REGISTERE0. Y/--N.., ;FEE.CURREP Y./N -
<br /> AddreS8 ` � t .liCepse.# i . -��- (
<br /> MECHANIGAI:' , , : . CQMP/WY - � '
<br /> StGNATURE° � ' ` � REGISTERED , Y,/,N. . . FEE CURREA . Y/:-N - - ,
<br /> Addreas�`�`-.�': . � . +- , ' _ _ � • � ,License# �� I
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<br /> OTMER � � ' � ' ':GOMPANY �
<br /> SIGNATURE .-, .�'"�- � "' ' ' ' ' • ` � "' REGISTERED ' Y/ N_... Y`FEE CURRE� Y/N.
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<br /> Address� - � , �� _ . .- � � � �Lic�nse#�� �� , . �
<br /> r �;,. .. . . `e„..i',' =: � p�^ru�,�e,::t - �'- -- •i � . :_ ,.d.. '� . .
<br /> RESlDEN1'IAL:;�c, , �Attacti;{2},Ftaf.P,laiis;:(2}sets�afBuilding23?Eans;{1}sefofEnergy�Fo`rins;>R=O=WPericiltforisew�c6nstruaHon,
<br /> 4 =,�,; ,Minlmum;tem(�10),workin'g;,days,aite,r„subtnlftal`date.�":R:equl�ed onsite,�Con's`trticdon�Plans,Stortriwater Plans w%Silt`Fence installed;
<br /> Sanitary Facllldes��1 dumpster,;Site Work�P„ermit for:su6divisionsllarge.projects`;9„•;,":�• �� � � � - _
<br /> COMMERCIAt. AtEach{3}complete"sets`bf Bultdtiig Plan's`plus a`Clfe Saf�ity Page;'('!}set of Energy Famts.R-O W Permit fof new cans#n�c8on.�
<br /> Minimum ten(10)working days after submfttal date. Required onsite,Constructian Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes&1 dumpster.Site Work Permit fpr atl naw.projects:.All commercial requtrements_must meet campliance �
<br /> SIGPI PER[�1fT Attac�{2}"sets of`E'rigl_r'i�r`,edsPlans.: .,., - <. .
<br /> ""PROPERTY SURVEY requlred for_all„NEW cans.truction.. , �
<br /> Directtans: . � "
<br /> Fill out applicaUon completely.
<br /> Qwner 8 Conhactor sign back of appltcation,notarized '�
<br /> , !f ovar�!�00,a tdotice of Commencement ia requirad, {�11C apgwad�s aver�7500) �
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<br /> ia.:.y.4 .
<br /> � '" Agent(far the contractot)'or PoMrer of"A4komey(for ttie ov�mer)wauld be someone with nata�ized letter fram owner authorizing same
<br /> '� OVER 7HE CQUNTER.PERMII'TtNG - {Fmnt-af�APPllcatian Only) . ` "
<br /> ' Reroofs if shingles Sewens Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> � Drivsways-Nat over Counter if an public roadurayis..need's ROW
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