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813-�ao-oo2o City af Zephyrhills Permit Application Fax 813-780-oa2�
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<br /> Buiiding Department .
<br /> Date Recelved . �: Phona=Gantactfor�Pemt[ttln :
<br /> Owner's Name ' Owner Phone Nurnber 1 .!�� �l�} --� �a �
<br /> Owner's Address �0 '�y �d~� Owner Phone Number �� '�
<br /> Fee Simple Titleholdar Name Owrner Phane Numbe� � �
<br /> Fee Simple Tltleholder Addresa
<br /> , Jd8 ApDRESS �D�� �' LOT# ��
<br /> SUBDiVISiO1V �� � PARCEL.�D# � , �
<br /> ,. , (OBTAINED FROM PROPERTI!TAX NOTICE)
<br /> WORK PROPO&ED : NEW CONSTR Apt}lA�T � StGN � Q DEMOLtSH
<br /> ���e. INSTALL 8 �. REPAIR -
<br /> PROP05ED�USE Q SFR [[� CON1M , �� {7t'i-�ER J
<br /> TYPE OF CONSTRUCI'ION � Q ' '� :BLOCK " Q FRAME " � ���
<br /> ,;�] °STEEG ' [� �
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<br /> DESCRtPTION OF WORK l�J� ' C.._.. .� "t�'�l_ � �c�'7'� � �
<br /> BUlIDfNG'SFZE ` " �`SQ FOOTAGE��. • . .,.,,NEtGtIT� �wr____�
<br /> �����'����' � ��, � ' �--�� VALUATiOi�i t�F�l'OTAL-CONSTRUCI'ION
<br /> QEI.ECTRtGAL , �$ �` � AMP SEI2VICE 0 PR{1GRESS ENEI2GY Q W.R.E.C.
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<br /> QPLUMBlNG: $ ' �'� '7
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<br /> MECHANICA! $ . ' VALUAT[ON OF�MECNAi+fICAt.ItVSTALI:ATlON G'"'° `
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<br /> , QGAS Q ROOFING Q SPECIAi.TY � OTHER
<br /> FINISHED FLOOR ELEVATI4NS ��� FL.00D ZQNE AREA QYE$. NO
<br /> �_..._..--- 7
<br /> BUtF.DER COMP/WY= "
<br /> SIGNA7URE ' �/�`�.._, REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�$ r License# i �
<br /> ���cx�{cii�i: : , .=coM�a�rr � . r. .. , .
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<br /> SIGNATURE � REGIS7ERED Y/ N FEE CURRE��� =Y LN'
<br /> , Address� ' ` . - License#:��� �
<br /> � P�.UMB�R"�_ ,CQMPANY , .� ' .�,aC , '
<br /> SIGNA7URE`' � ' � REGI3TERED,. Y/,-N� ;FEE CURRE� Y:-/N. '
<br /> , Address , � License,# �^ � ' � � -
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<br /> MECHANICAt: . , � COM,PANIC '
<br /> $IGNATURE • � "' ` REGIS7EEtED.,. Y,/ N � FEECURRE� Y;/�N . ,
<br /> , Address°< � '` " � � , . � - ' � ' License#�� � - ' � -
<br /> � O'fHER �- - ' �`� ' � . . iCOMPl1T+lY '- ' - -
<br /> i SIGNATURE � �• ��"`�' '` � ���t' " ' ' ' REGIS7ERED'' Y/ N; �FEE CURRE� Y/N
<br /> Address„ „ . _ ,{�"� � �i . � � . , ticense#��� � � `) ,
<br /> ' ' .J.., .. ..+�. ..'�i�'(:.:: f,. 'sr.<: :, ,.._.. ' ;, . ; , ' , � .
<br /> RESlDEtdTiAL;:::-�Attac,Ft{2}nPtot:P.lans;.�2)`sets=of'BuElilingy'Plaos;�{1}sefafsEnergy�Farins,,R-0=WPermltfornewconstructton, , .,
<br /> -� �•�Minimum:ten;�(1.0);worlcing;days�afte�:"submittal date::�;Requlred onsite;<-CionstiucUon Rlans;�Stomnwate�'Plans w/Sflt'Fence instatled,
<br /> 1 `5anitary�FaciltUes;&rl,dumpster�Slte�Work++Perm9kfor;su6divisionsQarge'projects;-� �: '� ' ` �'�• -
<br /> GOMMERCIRI. Attach{3}`aoinplete s'efs'of Building Flaits�plus a�ifeySafiety Page,�{1)set of Eiiergy Forms.R-d-W Permtt for nernr construc�on. _
<br /> Minimum ten(10)worlcing days afker submittal date. Requfred onsite,Constructlan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Factlides&1 dumpster.Site Wor4c Permit for all neiarproJecfs..All commerclal requtrements must meet compltance ' �
<br /> SIGFi PERNDIT Attadi"{2)'se�ofEiiglneer,ed Plans:"--� � � ` -
<br /> "•""PROPERTY SURVEY reguired for all,NEW,a�nstructian... -
<br /> Directions: � .r , _ .. __ ., .
<br /> Ffll aut applicaUon completely.
<br /> Owner&Contractor stgn back of appitcattan,notarized � ,
<br /> if over 52500,a Natice of Cammencement is required. {A/C upgrades over�7500)
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<br /> '" Agent(far the contractor)'or Power of Attamey'(fo�tFie owner)would be sameone�with notarized letter from owner autho�izing seme
<br /> OVER'THE COUNTER PERMITTING-� __. .(Front af-AppticatiomOnly}- - � ' .
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIaUSurvey/Footage)
<br /> Driveways-htot over Counter if an pubflc roaduvays..needs RdW
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