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e�a.�8o-00�o City of Zephyrhills Permit Application Fax 813-780-0021 <br /> r , Buitdtng Department <br /> Date Recelved Phane Gontact for�PermltEin <br /> Owrner's Name N Q. �1� C7!� e- Owner Phaae Number 13-��( t � t,1�g� <br /> Owner's Address �2-J� ��/a. � � Owner Phone Number � K�� <br /> Fee Simple Tltleholder Name �� � Owner Phane Number �� � <br /> Fee Simple Tltlehold��Address <br /> JOB�R,t3DRESS �2�I �1,$ �� ,� {� LOT# �� <br /> sveoivis�oa � � PARCEL ID# �S -� �-�.( -O�—p - E o o�d.— c.> o� <br /> , (OBTAINED FROM.PROPERTYTAX NOTICE) <br /> WORK PR4POSED ��NEYv CONSTR Ai�DlAI.T �� StGN' Q Q DEMQi.tSH <br /> e INSTALL 8 REPAIR <br /> PROFOSED�USE Q SFR Q COMM �� QTHER <br /> TYPE OF COhISTRUGTION C] BLOCK " Q FRAME ' [� STEEC [� <br /> S <br /> D�3CI21PTION OF WORK C.,S � �--� ,� <br /> �UILDIAIG SIZE �� ,_,,� SQ FQOTAG� � l� S H�I.GHT ��� <br /> �8�������'' � $ �j,d((��=— VALUATtON?'tOF TO'TAL CONSTRIICTION <br /> QEI.ECTRICAL }$— � ��p g�R�G� Q pROGRESS ENERGY Q W.R.E.C. „ <br /> L. <br /> [�PLUMBING ($—' � ' <br /> � <br /> QNIEGNANIGAL $ VALUATIaN OF:MECHANlCAL i3�1STALlATlON <br /> ��_�'. <br /> OGAS [� RL?OFING 8PEC1AI.TY �� QTHER <br /> FINISHED FLOOR ELEVATIONS S��� FI.00D ZQNE AREA QYES NO <br /> �Ui�DER COMPANIt' <br /> SIGNATUItE REGI57ERED Y/ N FEE CURRE� Y/N <br /> �,ddress Llcense# � � <br /> I EC�C7RiCFAt�t � COMF�AidY <br /> ', SIGNATURE � REGISTERED Y/ N FEE CURRE� � 'Y/N <br /> Address License# �� � <br /> �' P�UMB�R . � COM�ANY . <br /> SIGNATURE'' REGISTERED Y/,N FEE CURRE� Y/N � <br /> Addr�ss trcense# � ,� <br /> MECHAAIICA�: C.OMP�W1f ' <br /> I $1GNATURE � � REGISTERED Y/ N FeE CURRE�. Y/N . <br /> Addre`s's � ' „ - . � . � . License# , <br /> , � . <br /> ' ��7�- ` <br /> O'iFlBR ' . _ :�.�.�Q�_ ;COM�PAPIY � <br /> � �IGNATURE REGIS7ERED Y/ N... FEE CURRE� Y/N <br /> �ddre�s �... cc,'s,•.l ��� ti'cense# �C.0� �S� t `i�-=��_ <br /> �. , . <br /> RESlQEP��lAI:', �Attacti{2}:Fiat=Platis;.(2}'sets.o€YBu1l�ingPlans;(1)'sefaf`Energy;Farms;�R-O-W�Perrnitfarnewc,bnsfrt►ction, -" , <br /> _ _; =MlNmum.ken;(•10)>wo,rlcing;days=after.,submiltal`date.<Requlred'onslte,Cc�nsfiuctionRlans;StormwaterPlansw/SIItFence'installed, <br /> "Sanitary Facilitles:&:.1-,dum,pster.Site 1iVork�PetmiCfor;sub;divisia��/large�proJeot�. �_".... __ "� ` � <br /> COMMERCtAL Attach(3)camplete se#s'of 8ulliliiig�Plans plus a L�fe Saf�s4y Page;{1}set cf Energy Facros.R O-W Permi#for newi canstns�tton.. ; ~ <br /> Minimum ten(10)working days after submfttal date. Required onslte,Constructian Plans,Stormwater Plans w/Silt Fence installed, , <br /> Sanitary Faoilities&-1 dumpster.Stte Work Permit for all new•proJects:All commercial requlremen�must mest compliance ' ' <br /> StGPI PERMIT AttacFi{2)sets df Etigineered=Plans:, . . � ' ' <br /> ••'"PROFERTYSURVEYr , uireclfor.all_NEWconsVuctian. ��' <br /> __.. ___ .. ... ..............e4 __�. . � � . <br /> Direc#ions: . � - ' ' - -' <br /> Fill out app8catlon completely. <br /> Owner 8�Contractor sign back of applEcaUon,natarized <br /> tf aver$2600,a Notice of-Cammencement is required. (/VC upgrades over bT500) __ <br /> " Agent(for the contractot');or`Power ofAffor`riey-;(for tFie owner)woultl be someone with�notarized letter from owner authorizing same <br /> DVER THE CCitfNTER.RERM1T71NG-. -� •{Front-af�Application Only)� � ; ' � " � <br /> , Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvay/Footage) _{ . ., <br /> I Drivawaya-Rlot over Counter if on pubtic roadways:.needs ROW � <br /> / <br /> 1 ,� <br /> __..? �: <br />