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s�a-�aaoozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �� Bufiding Depattment
<br /> Date Recelye�d phane=Gontact�fac=Fermlttin �
<br /> 4
<br /> Owner's Name I Owner Photte Nurrtber
<br /> Owner's Address Owner Phone Number �� �
<br /> Fee Simple Tltleholdec Name Owner Phone Number � �
<br /> Fee Simple Titleholder Addrass
<br /> d08 ADDR�8S V , LOT# ��
<br /> 8t1BDiV�S10N � � PARCEI.tD# �
<br /> (OBTAIPlED FROM PROPER7Y.TAX NOTICE)
<br /> WORiC PROPOSED r {�EW CONSTR' ADDIALT C� S1GN' � Q DEMOL;ISH
<br /> �e. INSTALL 8 REPAIR
<br /> P1tOPOSED:USE Q SFR [� COMM [� OTHEi2
<br /> TYPE OF CQNSTRUCTION , Q BLOCK " Q FRAME � S1' EL
<br /> DE3CRIPTIOTi dF WORK
<br /> �UIE.DING SIZE �4 �' SQ FOOTAG£ HE
<br /> QBUtl,OtNC, � (J��F} � � VALt3AT10N:`'OFTOTAL'CONSTRt1CTION
<br /> 1 V�,L._„
<br /> QELECTRIGA�. �� AMP SERVICE � Q =PROGRESS"Et�EFtGY Q W.R.E.C.
<br /> [�PlUMBING - L.... � ' /{�� f '
<br /> �'( t/
<br /> QMECHANlCAL $ ' VALUATIONOE,MECHANICAIlNS'FRLIATIC�V
<br /> ' ��3,� ���,- �7�,�
<br /> QGAS Q ROOFltdG .Q SPECIAI.TY Q OTHER '
<br /> FINISHED FLOOR ELEVATIONS r�� FLOOD ZONE AREA QYES. NO
<br /> � ..,.
<br /> BUIE.DER ....�,�"" COMPAIdY� .
<br /> SiGNA7URE REGISTERED Y/ N FEE CURFtEP Y/N ' .
<br /> Addrea� Cicense#'�` � �
<br /> EIECTRICIAN: �CON1PAt�lY ' -
<br /> SIGNATURE �` REGISTERED Y/ N FEE�CURREK�' 'Y 6 N
<br /> Address � _ License�# � - �
<br /> ( P�tJMBER COMPANY � ,
<br /> SIGNA'TURE'� " ' � `
<br /> x REGIST,ERED Y./�.N� FEE CURRE� Y/N. -
<br /> Adclress License,.# � •�
<br /> MECHANEICAL` ` � COMPANY. '
<br /> SIGNATURE� `} ' ' ' REGIS7ERED Y,/.N - FEE CURREP Y/N -
<br /> i Address', = , ' • . . � License# � i
<br /> I� QTHER „ . , - ._ . ' ;COMPAI+IY``
<br /> � SIGNATURE,, ':: ' .� -: � •=, . ' , ` ' • - ` REGISTERED ' Y/ N,.:. FEE CUR�n : Y/N. .
<br /> k--
<br /> AddreasT ,. ��• ,- . 4 , _ . - �fcerise# � �Y f
<br /> { 4 , . r ,
<br /> RESlDENTIAL:;;, ,Attach:{2artPtot P..laris;�.(2)set`s.af:Buitding�Ptans;(1)�sef oF�Ersergy�Form's;R=O==W.Peririlt far new cons#cuctton,
<br /> r >Minimum;ten�(,1,0)��worlcing;days.�after;subtnittal date:'"Required onslte;.Co'nsfrucNon'Plans;�Stomnwater Plans w/SIIYFence Installed,
<br /> ���'�� SanitaryFacifitdes-$�.1;;dumpster3SlteWor,k,Permitfor"subdlVisionsQarge'pro]echsx_::_ :� " `
<br /> COMMERC�AL. Ai.tach{Sj•camptete sets of 8u1ltlirig Plans`plas a l.tfe Safeiiy�Pags;�(1}set of Energy Forms.R Q-W Permit#ar new cansGvatlon. -
<br /> Min(mum ten(10)woricing days�after submittal date. Required onsfte,CansUuctian Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Wor1c Permit for all new;prrrJects..AU commercial requlrements.must meet eampllance
<br /> StGN PER[YflT Attae�'"{2)"sets of Engineei�ed.Plans.t :, ..�. . ... ' `
<br /> ••""PROPERTY SURVEY reguired for_all NEW�construCkfqn. . ,:_., '
<br /> , Directtons: � - , , �
<br /> � Ffll out applicatlon completely. ,
<br /> � Owner&Contractor stgn back of applicaUon,notarized '�
<br /> if cv�r�500,a NoEice arf Cammencement 1�required. {�JC upgrade�aver�7600j I
<br /> "* Agent(for tlie�contractor)or Powie'r of Attomey(fo�ttie oJmer)wauld be someone with natarized letter fram owner authorizing same
<br /> t}VER'fHE�COUN'iER PERMifiTi�tG-• _---{�ront of•ApplicatiomOnlyj - �
<br /> ' Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> � Drtvewaya-Not over Counter if on public roadwiays..need's RdW
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