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813-�saoozo City af Zephyrhills Permit Application Fax 813aeaoo2�
<br /> Bu{iding Department -
<br /> DaEa Received „ Phone=Cantact far�Permittin —
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<br />� Ownst's Name \� t^Q�- �l�v� Owner Phane Number `
<br /> Owner's Address `���� ��"�'`� "S�"'�'�'� Owner Phone Number
<br /> Fee Simple TItleHolder Name � ' � Owin'er Phane Num6er � �
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<br /> Fee Simple Titleholder Addresa �
<br /> �_ , �,
<br /> JOB ADDRESS 'S �� �'-'��� ��� LOT#
<br /> SUBDiVI310N � �� - PARCEL ID# '
<br /> , (QBTAIPIED FROM t+ROPERTY,TAX NOTICE)
<br /> WORiC PROFOSED ,NEW C0IVSTR ADDtAI-T � StGN Q � �Q DEMOL#SH
<br /> �:e: INSTALL � REPAIR ,
<br /> FROPOSED=USE - Q SFR Q GOMM C� -OTHEF2 � ' � '
<br /> TYPE OF CONSTRUCTION Q BLOCK ' [� FRAME C]� STEEL �Q
<br /> UESCRIPTION OF WORK ' C�a.fC�. �^ �ti^�'"t� �� �`�L (S "�`�-�"" j �*i �'T`
<br /> �UtIDING StZE � = " �"SQ FOOTAGE�� ��,HEIGHT�C:.��
<br /> QBUII.DING , $ VALUATiON�F�TOI'AL COtVSTRl1C'i'iON , ' � �
<br /> ..���y�� � ..
<br /> QELECTR1GAl ' �� AMP SERV.ICE Q RR{;�GRESS ENERGY Q Vtit:R.E.C. �
<br /> [�PLUMBING•a: $ ' . ,
<br /> � ,�:. �� . a� . �
<br /> QMECHi0.NiGAL $ � ' VALUATION OF�MECHANIGAI 1�+lSTACLATit?i+t � � ��
<br /> QGRS _ Q ROOFING Q SPEGIAi.'fY,[� OTHER - `
<br /> FINISHED FLQOR ELEVATIQNS ��� FLOOD ZQNE AFtEA C]YES �NO
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<br /> BUIlDER CflMPANY�' � -
<br /> SIGNATURE REGISTERED Y/ N 'FEE CURFten ',Y�/'N'
<br /> Address . License#'� �
<br /> EI�fC'CRICIA111- < C'OMPANY' - _ ."
<br /> SIGNATURE ' REGI3TERED Y/ N FEE CURREK'•' Y/N
<br /> Addre�s � . 4 License#:+ (
<br /> ��UMBER ' C8MRJ4t�tY . � ' ,
<br /> SIGNATURE` ' REGISTERED Y/-.N�s ,�;,F,EE�CURREN Yr/N. � `
<br /> Address Ltcense,# �;.� � ��__
<br /> MECHANICAl: ` � • COMPANY _ ,
<br /> SIGNATURE � � ''� � � " ` REGISTERED., �. Y/,N . ",FEE�CURRE�� X,hN� _ . . �
<br /> ,. ,. � .�' �
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<br /> Addeess,; . . . . , �� ' . � ltcense# ��. ., � .
<br /> , K:.
<br /> OTHER - - ` ';COMPANY ' - • .
<br /> SIGNATURE -� � " � ' � " REGIS7ERED' Y/ N�:. 'FEE CURRE� Y/N .
<br /> Address, , � . -; . , . , , .' � ' license#��� : , �
<br /> 4;
<br /> �,....s,.a: _ ... •.:�_:` i:.. .�'. .
<br /> RESIDENilAI:; ::Attachx{2),,PIotP,lans;..(2)sets=of`EluE[8ing�Plans;'(.1}sefiof Energyr�Poriris;�R=�O=W:Peririlt for new construc#Ean, ' . `" '
<br /> , ;;,•Minlmum;#ep°(:1,0)�;v,w,rking;days;al�er,;submlttai dater��Requlred onsite,Constiu'cHon�Plans;Stormwater Plans wl Silt Fence installed,
<br /> • u�.._:. .M : . , .
<br /> Sanitary Faciliyes;&:1;;durnpste_r,u;�ite Wqrk�P,,,ermit,for subdivisionsllarge;proJects�y;,_::.;;, " f :� � `" .
<br /> COMMERC#A!. Aftach{3)coiitplete sefs`iif"Biiltd3isg Plaits ptus a Cife"Saf�s#ji Page;{'f}set of Energy Forms.R-L?-W Petmtt fac new construetlan. -
<br /> Minimum ten(10)working days after submittal date. Requtred onsite,Canstruc8on Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides 8 1 dumpster.Site Work Permit for all naw�proJects..All commercial requirements_must meet compllance � �
<br /> SFGN PERMIT Attac�'{2)sets of'Engiiieered;Plans.,, -�.- . , '. _ _ . . . ,
<br /> """PROPERTY SURVEY required.for aII.NE1r'V_constructlan.
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<br /> Dtrections: ,. .. .. ,." � ' .
<br /> Ftll out applicatlon completely.
<br /> Owner&Contractor sign back of applica8on,natarized
<br /> If over S2S00,a Nottce of Cammencemen#[s required. {AlC upgrades over;7500)
<br /> t�;,�'r,',z;�,'
<br /> '" Agent(for the�contracto�)�'or`Power of Attomey�(far tFie owner)wauld be someane with notarized letter trcam owner autho�izing same
<br /> DYER'THE CCiUNTER PEttM1TTiNG - -(Front of•APPIlcat�on Only)- ` �-
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drlveways-Not over Counter if on publia roadwajrs..r'ieed`s l20W
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