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813-780-002p City of Zephyrhills Permit Application Fax 813asaaa2�
<br /> � �, ' Butlding Department _
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<br /> Date Recelved . - ; Phone ContacKfor Perntlttin : � ,
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<br /> Owner's Name ��� C�� �" ���'+I �C`" Owner Phane humber ,� ���� I t� t �
<br /> Owner's Addres � `� }� r h Owner Phone Number � � i
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<br /> Fee Simple Titleholder Name ��� ' -� Owner Phane Number '� �
<br /> Fee Simple Tltleholder Address
<br /> JOB ADDRE3S � 5 � l� l 1 �� �S f �'�^���� �I� � I t S LOT#� C�.�
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<br /> SUBL1iViSiON �� � P.ARCEL.ID# ' � �
<br /> : (OBTAINED FROM PROPERTY,TAX NOTICE) �
<br /> WQRK PROPl�SEQ :_NEw COt�tSTR ` ADF3/ACT � SIGN Q Q DEMOI.tSH
<br /> �� INSTALL 8� . REPAIR
<br /> PROP{}SED.USE � [�] SFR [� CON1M � 40TFiER '
<br /> TYPE OF CON3TRUCTION Q � 'BLOCK " [] FRAME ;[^� STEEL 'Q ,
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<br /> DE3CRIPTIQTI OF WOR •r' w � � !� J7��v1 M � n Vt r'71 (��'E-� F� ��e,
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<br /> Btl1lDIPIG"SlZE� St1�fOOTAGE�� , . FtE1GHT ,���
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<br /> BU�l.��NG $ � VAlUAT10{d.'tOF TOTAL CONSTRI`ICTtON '
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<br />, QELECTRIGAL $ AMf'SE#2VICE Q PROGRESS EtVERG1' Q W.R.E.C.
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<br /> QPLUMSlNG 'L_.. � ` ' i
<br /> QMECNANIGAL ($ ��� VALUATION OF�MEGNANICAI INSTALIATlOiV y�� /fQ f�� ;
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<br /> QGAS CJ Rf}QFING .Q SPECIAI.TY, � OTHER �
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<br /> ' FINISHED FLOOR ELEVATIONS ��� FLOOD ZQNE AREA [�YES NO ;
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<br /> BUILDER � � 11 L COMPANY=' ?� !'�/1'1 �.. � '
<br /> ' SIGNATUR ��Xf (/ REGISTERED Y/ N FEE CURRE� Y/N�.
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<br /> Addre�s ` ticense`# �` �
<br /> EtECTRICtAtd� < t=GflMPANY �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�`� ' Y/N �
<br /> Address ` � �. , - ` � ,. , .�License#.�- � � I
<br /> PL[JMBER ' .COMPANY ' :�,
<br /> SIGNATURE' " ,REGISTERED, Y L-N,. -•EEE CURRE� Y-/N ,
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<br /> Address C.icanse,# � � � � i
<br /> MEC}1AI+lIC�tL; . -� � � ' COMPAl+1Y '
<br /> SIGNATURE • � ' "' ' � �' '�' BEGIS7ERED , . .Y,/ N ; FEECURRE� Y./�N • �
<br /> Addre�s%� " � • a= � . � " � ' ' � ,licans.e#�� � � .
<br /> OTHE12 . - � >- � , , � tCdMPANY , , �
<br /> SIGNATURE ,� �-�- `' � ' � ` � r ' REGISTEREDf` Y/ N. FEE CURRE� Y/N.
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<br /> Address �r,` _ • ``�� _ . , ' ` _ Licerise�#��� � ' ' �� �
<br /> itESlDEN'f!A!:F„"::Attacli'(2},Plot P..laris;�.(2}'sets�-of:Bultding�Plans;(1}set of'Energy=Fortns:R=0=V1t-PerinEf for new cbnstruc#on, ` _
<br /> -Minimumstenw(-1.0)�working;dajrs`after,`,;subrinifEal`date::�RequlreiJ ons�te;:Conatiucdon=Plans;=Stortnwater`plans w/Silt Fence installed, �
<br /> ~� ���'V�Sanitary FacillUes;&K1:.dumpster^Site•Work�,P,ermitfor sutidivisions/Iarge:pruJects,� __'" ' ' � �
<br /> COMMERClAI. Attach{3)�caisiplate'sets`rif Sul[�iog Plai�s plus a�t:ife Safety Rage;{1}set of Energy Fotms.RA-W Permlt for neuv canstructlon.
<br /> Min(mum ten(10)worktng days after submittal date. Requfred onsite,Canstructlan Plans,Stormwater Plans w/Sllt Fence Installed,
<br /> Sanitary Faailides&1 dumpster.Sfte Work Permit for all new�proJeats.All commerclal requlrements_must meet campliance ,
<br /> SlGN PERMIT AttacFi'(2)"sets of"Engineered:,Plajns:�_� ::��'���,_.:�;' � - � .
<br /> ••••PROPERTY SURVEY requirecl for all_NEW con§tructiqn., �
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<br /> �olfectlons: - . . . � . _ � ` �
<br /> Fill out applicatlon completely.
<br /> Owner 8 Cantractor sign back of appl(callon�notarized �
<br /> !f over�2a00,,a NoNce af Cammencement ts requ�red. (AtC upgrades ovar 57500)
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<br /> Agent(for the�cantractor)'orPower of Atto'mey(for tFie ovuner)would be someone with�notarized letter from owner autho�izing same
<br /> BVER TNE CQtlNTER.PERN117'i1NG-. --_•.(Front af•Applicatton-Oniy) -��� � f
<br /> Reroofs if shingles Sewers Service llpgrades A/C Fences(Plat/Survey/Footage) _
<br /> Driveways-Nat avec Counter if an publlc roadwiays:.needs ROW`
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