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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Butiding Depadtnent -
<br /> Date Etecelved + - ,: PhanejGontact far Rermtttln 8+�„� ��. — �d l
<br /> l�wner's Name �� �'f�✓ �!. �e Owner Phane Number �`3 b �P o� "��.�.
<br /> Owner's Address ��� 7��� �/ �'C� ��, ' Ownar Plione Number
<br /> Fee Simple Tltleholder.Name � Owner Phane Number �� �
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<br /> Fee Simple Titleholder Addresa Li �� _
<br /> JOB ADDI2ESS ���fo ll�`''� �.`�", � � e�`h�l �� �, ����f o� LOT# �_,��
<br /> sueo�visioN ����b���'i������ PARCEL ID# 1 ��r �1 .G'>�11y 1�CdC3 dIGSl3
<br /> (OBTAINEO FROM PROPERTY TAX NOTICE) �
<br /> WORK RROPQSED � NEW'CONSTR ADD/AlT � S1GN` Q. = Q ' DEMO�ISH
<br /> � -e. INSTALL REPAIR �A
<br /> PROPOSED:USE �� Q SFR Q COMM �� �C?THER � '
<br /> TYPE OF CON$TRUCTION Q- BI,OCK " '�] FRAME .� [� STEEL [;�
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<br /> pESCRiPTION OF WQRK` N ��?OG�G� 9� t�° •��N�I � Ll� �" ut" i � G''0"/�
<br /> Bi11LD1NG SlZE �� ( S4 FCOTAGE E.��: : ' .,.HEIGHT ���r�
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<br /> �s�«���� • �- � VALUATION�C)F TOl'AL CONSTRUC'i'ION
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<br /> �ELECTRIGAL. � � AMP BERVICE `Q PRtOGRESS EMERGY Q . W:R.E:C. ,�
<br /> QPLUMBiNG' f�� ` � - •
<br /> QMECHANtCA! $ �-y VRLUATION OF,MECHANIGAI.INS'fAi.LATIC?N
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<br /> QGAS Q ROQFING ,Q SPECIAR.TY � t)THEFt � `
<br /> FINISHED FLOOR ELEVATIQNS r�� FI.00D ZONE AREA QYES. NO .
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<br /> eu��a�� cot��a�r;. - - . _ �
<br /> SIGNATURE REGISTERED Y/ N 'FEE CURRE� Y/N'
<br /> Addre�s � License�#��� �
<br /> E�.ECTRlCIAi�1 COMP{WY ` - , � -
<br /> SiGNATURE '' REGISTERED Y J N FEE:CURRE�� '`Y/N
<br /> Address - , � . .. . license#:� . , . �
<br /> P�UMBER'' , GOMPANY - - . ;3 -
<br /> SIGNATURE' ` � REGISTERED. Y./.•N,� •.FEE CURREP Y/N. ,
<br /> Address License.# r.. _ , � �, �: ,
<br /> I' MECHbNtCAt:" - � , COMP.ANY �`3-�fR�. ftnl�.{��t5����1�
<br /> SIGNATURE ' �'��`�' � REGISTERED Y,/ N .FEE CURRE� Y/�N ,
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<br /> . .�. _ .y���t - I�n� � ; �h�1ls 3� - , .. . � ��������� .
<br /> Addre�s£ -- ' License# � . , .
<br /> OTFI�R �� � ';GOMPEWY �4 _� ,
<br /> SIGNATURE � - � " � � - ,rtEGISTEREo' � , " Y/ N:,.. FEE CURRE� Y/N
<br /> �ddress� . " .. ,, ' . ,� . . .` � . ., - . - Licetise#�.� � - �,�< .
<br /> , . .�<,.�.,,: �; >.�� �, �
<br /> RESlDEN�9A1;,;�: •Attsctit(2)uptof:Plans;.(2}sefs=of+B�a1k11ng�Ptans;`(1}_set,af:EriergyrForir�s:=�R=O=W'Perrril#for'newconsWction. ; " ' .
<br /> p;, Minimumrten_(;1,0);uuqriiingydays�efter'�subinlftal'date:�:Required onsite,pG�"nsUucNon�Plans,�Stormwate�"Plan's w7 SOt Fence installed,
<br /> r Sanitary Facilftl,esf&�:_1.,dumpster�5lte;Work,Permitforsubdivisions/large�;proje.ck`s: �<,` :- __ ' ` � '* �"
<br /> CQMMERCtAt. Attach{3}-oomPiete sets�of Buli�lag Plans'plus a Life Safetp Page;{f}set of Energy Forms.R-O-W Permtt fac new constcuctton.
<br /> Minfmum ten(10)worktng days ai#er submithal date. Requlred onsite,CanstrucNon Plans,Stortnwater Pla�s w/811t Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permik for all newproJects:°All commercial requirements.must meet comppanee ` � "
<br /> SI�H P�RMfT AttacFi"(2)§efs of Eng,i`neer.edrPlaiis.,,. ;-:= u _- � � ' ' � �
<br /> , •••"PROPERTY SURVEY requireci for all NEV1l oon,s.trucGan._ _ • _.
<br /> !}Eiactlons: � ._ - � - . , _ .
<br /> Fill out applicatlon completely.
<br /> Owner&CcmtracMr sign back of applEcatlon,notadzad .
<br /> !f ovar b2500,a Notice af Commencement Is required. {AtC tspgrades ovar ST580)
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<br /> MY1 . � •� �» - '
<br /> Agent(for the contr`actor)or"Pouver of Aktomey�(fti��tFie owner)would be someone with notarized letter from owner autho�izing.same
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<br /> OVER TNE CCtUNTER.FERMITTIEtG.. - tFront af Applica#ton On{y) "' -
<br /> Reroofs if shtngles Sewers -'•� Servic�i Upgrade"s A/G���-= Fences(PlodSurvey/Footage) ` - � � • � '
<br /> Drlveways-Not over Counter if on'pubtic'roadurays..iieei!`s ROW • �
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