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813-780-OU20 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Butlding Qepartment
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<br /> Date Recetved �� _ ,� _ �f
<br /> - Phane,Cani#ac#�for�Farmlt#la
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<br /> Owner's Name �Z- ! /�E..?(��/� Owner Phone Number
<br /> Owner's Address Z�✓' ��� �� � � r!1/ .S� ��' ' •Owner Phone Number �� �
<br /> Fee Slmple Tltleholder Name �wL,( �2- 1 �'C?v l�� Owner Phane Number � �
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<br /> Fee Simple Titleholdar Address 5�-�� S� S�
<br /> J08 ADDRESS Sr./��� S � �� LOT# ��
<br /> SUBDIVISION �� � PARCEL ID#
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED _NEW CONSTR ADDtALT � StGN o o DEMOLISH
<br /> INSTALL 8 ,- REPAIR �
<br /> PttQPOSED..U$E Q� SFR � GOMM � OTFEER {
<br /> TYPE OF CONSTRUC'1"ION Q BLOCK " [� ' FRAME [��: STEEL C]
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<br /> DESCt21PTION OF WORK' /'/�Si'`"�//�/� /'!dr'l"G �iI/�e � �x /G'�O fi �
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<br /> BUtLDtNC�Sl2E �� � SQ FOOTAGE , , HEiGHT . � �
<br /> BUI�DING $ ��
<br /> � ��• � VALUATIOI�1`�F TOTAL CONSTRUCI'{ON (
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<br /> QECECi'RICAL . !.� ' -� AMP SERVIGE -Q PROGRESS ENERGY Q W.R.E:C.
<br /> OPLUMBING $ '
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<br /> I QMEGHANlCAL $ " YALUATION OF MECMANICA�INSTAliAT10N � �
<br /> OGAS Q ROOFING [� SPEClAI.TY C� 07HEFt
<br /> FINISHED FLOOR ELEVATIONS r�� FI.00D ZQNE AFtEA QYES ,NO
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<br /> �uz��E� caM�ar�r. ,. �°� �r.��c-�� -
<br /> SIGNATURE �Y^ REGI3TERED Y/ N FEE CURRE� Y/N�'
<br /> Addres� • � a N��F �L'icense:#���� � �
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<br /> ELECTRtCI1tN: -°GOMPANY ' " ;_ ,°�� , � _ . • �
<br /> SIGNATURE "' REGISTERED Y/ N FEE:GURREP-' ' ' -Y/'N
<br /> Addresa � ,_ � j_ .,.�� License�.#,� ' �
<br /> PLtiMB�R ' COMPANY �, . `
<br /> SIGNATURH` ' ` ' � REGISTERED Y./,.N; ,,- FEE,CURRE� • `. Y_/N. '� ` �~
<br /> Addre�s � .,License,# ��«f � � ��.
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<br /> MECHl4NICA1: ` � , COMPANY "
<br /> SIGNA7URE � ' � REGISTERED Y./.N . FEECURRE�,. ,. Y�L�N- � ,
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<br /> Address • . , � . " ` License# ' . L . � �,
<br /> OTFIER = , , . ' �GOM,PANY ;
<br /> SIGNA7URE "� � " ' - ' '` ` "' ` REGISTERED � Y/ N,. .FEE CURFtE� Y/N
<br /> Address^ ' � - . License#��'( ' �
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<br /> RESIDENi'(l4L:�r. Attacti�{2)nPlot:Platis;.{2)ssfs:cf�Bullding�Ptan"s;'{1)'sef of-Energy'Foiirts;'F2-0=W Perrriit far ciew't�nstruction, , `
<br /> - � , Minimum:ten�_(1,0)woricing�d"ays_after subriniftal'd'ate.��;Requlred onslte;:Constructld"n-Plans>Stormwate'r'Plans w/Stlt Fence installed,
<br /> ^"� Sanflary Faciliti.es&,1.,dumpste�_r,,5ite Work.P:ermit{er subdivislonsllarge:.proJects: -:. -:� ' ' "
<br /> -GOMMERCtAL Attach(3}`c�r'i�plete'sets of Bultding'Plans plus a Cife`Safety Page;{1}set of Energy Fotms.R O-W Permit far new canstrucUon.
<br /> Mtnimum ten(10)working days after submittal date. Required onsite,Canstruc8an Pians,Stormwater Plans w/SUt Fence installed,
<br /> Sanitary Facilitles 81 dumpster.Site Wark Permit'tor all new:proJects..Atl commercial requfrements must meet compllance '
<br /> SIGN PERMIT Attar`.t�{2)'set§'of EnglneeredtP..lans.,' _ �
<br /> ••«"PROPERIY SURVEY required.for all NEW 4wnstructlan.. . �
<br /> S}lree#ton�: . . , . �
<br /> Ffll out applicadon completely.
<br /> Qwner&Contractar sign back of appfication,notarizad
<br /> tf over�2�00,a NatEce af Commencement is required. (A►G upgrades over�7500) :
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<br /> '" Agent(for the contractor)'ar Power of Attomey"(for tFie owner)would be sameone with�notarized letter from owner autho�izin�same
<br /> OVER Tt1E CQUFITER PERMITF7NG --��{Front of-Appltcatton Oniy) -
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage)
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<br /> Driveways-Not aver Counter if on public roadways,.needs,ROW��,_ -� - � i�� , _ �
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