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��a-7aaoo2a City af Zephyrhills Permit Application Fax 813-�8o-oa2�
<br /> Buffding Departmsnt
<br /> Rats Receiv�d >. Phana�ConNact'for Permlttin �j� �3 — �7a'�`
<br /> Owner's Name � ���"�� �''Owner Phone�lumber ���"�� ! '�7S�
<br /> Owner's Address ��,5 � S�r r�� Owner Phone Numbar � �
<br /> Fee Simple Tikletioldar Name �, �� Owner Phane Number �� �
<br /> Fee Simple Tttleholder.Address
<br /> JOB AD�RESS S �� ��• LOT# ��
<br /> StlBDIVISION � � ' P!ARCEL ID# ' " •
<br /> (OBT9INED FRdM PROPERTY.TAX NOTICE)
<br /> WORfC PROPOSEO NEw CONSTR , ADDtALT [�,] S(GN' 0 � DEMQ�ISH
<br /> 'e. ;INSTALL 8 FtEPAIR � w
<br /> PROPOSED=ti$E Q SFR � CON1M • Q OTHER " `
<br /> TYPE OF CONSTRUCTION '�� BLOCK " [� FRAME � .� 'STEEL` �Q
<br /> . , f .
<br /> DE3CitIPT10N OF WORK, .?; T�i"�� a� �a alc �^��i �"H�•• �c -
<br /> �tllLi3tNG 81ZE �� �'SQ FOOTAGE � �I . NEIGHT�,��
<br /> , ;. . �: .
<br /> QBUI�DING , �$ --� � -�- :. .:. ,.
<br /> L2 C3�� VALUAT{ON�`OF TOl'AI��CONSl`RUCT{ON �
<br /> :� L �J
<br /> QEI,EGTRiGAL ,� � AMP SERVICE Q PROGRESS Ei�tERGY Q W:R.E,C. ,�
<br /> QPLUNIBlNG `; ',{;g� ' 1��,`?J'�D
<br /> � � - �8t 7�
<br /> [�MECliANIGAL- $ . VACUATION OF;It+IECFlAPlICRI tPlSTALLATItQtV �.�� , ,
<br /> QGAS � RQOFII�iG Q SPECIAI.TY �� OTHER " '
<br /> FINISHED FLQOR ELEVATIONS �� FLOOD ZONE AREA QYES ,NO
<br /> �au:�aE� co�n�a�nr:. . � � .
<br /> SIGNATURE REGIS7ERED Y/ N `FEE CURRE� ' Y/N�'
<br /> Addre�s � • ' � , L`icense#"�� �
<br /> �
<br /> E�fCTRtC111N: � �=CCIMPA�IY - . - . .
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�°' , "�Y/N �_
<br /> Address . � ' ' < ,, , License#,�. • J � ,
<br /> ; PLUMBER ' � : COMP.ANY r; .. •
<br /> SIGNATURE' ' , ,REGISTERED- Y,L.N,�, . :FEE CURRE� Yl N
<br /> Addr68S 11CBt1$6�# � ' v�•
<br /> MECNAPt(GAt:� ,� . - CQMPANY ` �._ �, � `
<br /> SiGNATURE `` • � " � � � REOISTERED Y,/.N,. . , :_,�,FEE CURRE��. Y/rN • � „ �
<br /> Address'�' � " . . . � _ � � ' License# � �
<br /> , �.
<br /> OTHER � /� i'� < � "CONIPAI±IY ' ` I�"• ��+G�fau�.s� ts s �,t� C .
<br /> SIGNA7URE *`•� '=`` x `�y��� '�: ` �'REGISTERED'" �\ ' �Y/ N.:.... ;FEE CURRE� Y/N
<br /> Addre�s 3. �'t�;,�;cSO.il�•Avt"2 . '�+�fa�- f°;�`'��'Y ^ Licerise# ,CC� O �g37(.7 � ` ' 'I ' �
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<br /> RESIQEN'FlAt;_ - ;Attacti'{2}.RlofPians,.(2}'sefs=of�Bu1lding�Plans;'(1)"sefoE�Eriergy�For�ns;�f2-0=W`Permlt#ornewconstcuatlon, ., "
<br /> .,-. .,. .. , ...
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<br /> -• • Minimum�ten�(�1,0);workingydays��ft�r;submittal-date.:Requlred onsite;_Gon§ttuctlon=Plans;Stormwate'r P1ans w/Slit Fencelnst�iled,
<br /> ���� Santtary Facil(Ues-;&;1.,dumpster:Site•Worlc:PermPt;forsubdiylsignsllarge.�proJects:,�,-`.-,-,�: �- "': ' = -
<br /> COMMERC#A!. Attach{3)�eomplete sets;'of°Biilltliag Plaris'plus a Ltfe Satety Page;{1}se#o#Energy Fccros.R-�-W Permtt Foc new canstru�tion.
<br /> Minimum ten(10)working days after submittal date.:.Requ(red onsite,Canstructlon Plans,Stormwater.Plans w/Silt Fence installed,
<br /> Sanitary FacillHes&1 dumpster.Site;Wark•Permiffor all new projects..All commerclal requirements.must meet compAanca " �
<br /> SFGN PERMFT Attact�"{2)sefs of`Engfirieer,ed;Plans:�;.� -}. ,-- � '
<br /> """PROPERTY SURVEY requfred;for aU�NE4'V canstrucdon..
<br /> �irections: -. � y � ' �
<br /> FIII out applicatlan completely.
<br /> 4w�er&Contractar stgn back of appticatlon,notarized
<br /> if over�2500,a NatCce af Cammencement is�quired. {AtC upgrades over$7508}
<br /> .���,+�f SYY,i�'•'�
<br /> " Agent(for the ciintrao4or)+or'Pbwer of i4ttomey'(fa�tFie ovrner)wauld be someone with�notarized letter from owner autho�izing same
<br /> DVER THE Ct�UNTER PERMt'iTlNG.. , .(Front at•F+PPllcatton Oniy)- - �
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) •
<br /> .. _ _ _ , r..�. ��.v,�.w-. __. x. �.. �.:r�. ...... ��_�... ... . .... . ... ,. - .
<br /> Drlveways-Nat over Counter if on public roadways:.need&ROW;�.;�3 - - '%: .•� _�:' :>. ',<� �
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