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<br /> 813asaoozo City af Zephyrhills Permit Application Fax 813-780-0021
<br /> Buitding Qepartmen#
<br /> Date Received � �`r-C ' �'' � . Phone�Con#act<far�Perrritttin ��� � ,/ /�7��`
<br /> Owner's Name Owner Phone Number ,,�Sa7 - y�7Z '
<br /> Owner's Address Owner Phone'Number � �
<br /> Fee Simple Tltleholder Name ��" ��� � Owner Phone Number �— �
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<br /> Fee Simple Titleholder Address
<br />� JOB ADDRE$$ �— � � LOT# ��,��
<br />, su�oEv�s�o� �- � ��cE�.ro# � / d�. � 4 /d U 0 D
<br /> , (OBTAINED FROM PROPERTI!TAX NOTICE)
<br />{ W4RiC PROPQSED � NEVv COt�STR ADDIAc.T � SiGN � � DEMOLlSH
<br /> e- IPISTALL 8 REPi41R
<br /> PRQPQSED.USE Q SFR. � COMM � -QTHER ��zi/'r�,'{�
<br /> TYPE QF CONSTRUCTION' Q" BI.00K " Q FRAME [� STEEI. Q
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<br /> DESCRIPTION OF WORK S '`
<br /> i BUIt�DlNG SIZE SCi FOOTAGE��. .,HEt HT���_� _
<br /> QBUILDING � � VALUATION`OF�TOTAL COiySTRUGTiON
<br /> QELECTRICAI. � :�$"� AMP BERVICE Q PROGFtESS ENERGY Q W.R.E.C.
<br /> �
<br /> QPLUMSING � '
<br /> I � � � �
<br /> �MECNANICAI. $ ,/ �,� ,,,�,� VALUATlON OF MECHANICA�1l+iS7AlLATION "'� � �
<br /> !"<���L'4' ,C%t,J •
<br /> QGAS Q ftQOFtNG .Q SPEC11�t.'tY � OTHER,
<br /> FINISHED FLOOR ELEVATI4NS r�� FLOOD�ONE AREA QYES. iV0 ,
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<br /> r - �ui�a�� ---- w- - - -- --- - --- --- - �����,_____..— �__ _._ _- ---- -- - - - - --
<br /> $IGNA7URE REGI3TERED Y/ N FEE CURREA Y/N
<br /> Address Gc9nse# � I
<br /> EIECTRIC1At[�1 ,.COIYIPANY "-
<br /> SIGNATURE "' REGISTERED Y/ N F�`cuRRe��� Y/N
<br /> Addre�s � _ License# �� �
<br /> PLUMBEi� COMRANY .: `
<br /> SIGNATURE` ' , _REGISTERED Y.L�-N.. , EEE,CURREA - Y/N • '
<br /> Addre�s �[cense,# � �
<br /> MECHANtCAI:' � �- ��� COMPANY - f 1- � C=— , .
<br /> SIGNA7URE L.t�' REGISTERED , Y N . FEE CURREA N
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<br /> ,., �o�.. �j _ `j � � ' ucense# I . �
<br /> Addreas� � .
<br /> , ,
<br /> OTHBR � - � . . . ':COMPANY _ .
<br /> SIGNATURE ''�v ' � � � REGI$TERED Y/ N... �FEE CURFtE� Y/N•
<br /> ,aaat�� , . . . . _ _.. . . , _ . - � �:t�nss#.�- �� , -
<br /> RESIDENTIAI:°� :Attacti�(2}nP1ofPlans;:(2}sets:of8iiildliig�Plarts;(1)setaf'EnergyFoiins;R=O=W�Peririiffornewconstruation,
<br /> ��-- � :Minlmum:ten,�(:10),working;days affer,:submitfai date�_Required onsite,:C6nstrucBon�Rlans;Stortriwater`pians w/Slit Fence installsd,
<br /> `�� Sanitary Faciildes_:&;1.dumpster>$Ite Work,Pertnit;for,subdlVisions(large p,rojects.�. .'.:s � '
<br /> COMMERCI�U. Attach{3}�cbmplete sets of�Bu3tilirig Plans ptus a k.lfe Safety Page;{1}set a#Energy Forms.R d W Petmit far new oanstnscUan.
<br /> Minimum ten(10)wo�Icing days afker submittal date. Requtred onsite,Constructlon Plans,Stortnwater Plans w/Silt Fence instatled,
<br /> Sanitary Faailities&1 dumpster.Site Work Perrnit tor all new,proj'ects..All commercial requlrements.must meet compliance �.
<br /> SIGN PERNIfT Attadti'{2)"sets of`�isgineered;Plaiis.: - .°� � • � � �
<br /> "'"PROPERTY SURVEY,reguired.for,all,NEW arnstruct3an.. -.
<br /> Dlrectlon�: .
<br /> Ffll out appUcatlon completely.
<br /> fJwner&Contrackor sign back of appltcaUan,notarized '�
<br /> If avsr�2540,a Watica af Cammencement is requlred. (A/C apgrades aver$7500)
<br /> � �n,�•-:;..,,,,
<br /> '" Agent(for the i;o�tractor)or Powe�of Attomey(for Uie owner)wauld be someone with notarized IeBer from owner autharizing same
<br /> DYERTHE COUNTER.P-ERMI?RIt1G -.-(FronEafiApplicatton On{y)� �
<br /> Reroofs If shingles Sewers 5ervice Upgrades A/C Fences(Plot/Survey/Foatage)
<br /> Drivewraya-Not aver Counter If on public rosdways..need's ROW
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