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e��-�eaoo�o City af Zephyrhills Permit Application Fax$13-780-0021 i
<br /> Buiiding Depatfrnent
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<br /> �ate Recsived . = Phane:Coritact for AarntittEn
<br /> Owner's Name c7 �n '�� S Owner Phone Number t b ��t_..
<br /> Owner's Address � Z � l . ��� Owaer Phbne Number �� �
<br /> Fee Simpl�Tltleholder.Name r � ' Owner Phcne Number � � !
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<br /> Fee Slmple Tltleholder Addrass - �
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<br /> JOB ADDRE$S � �Z.. �� y�-. LOT# �
<br /> �
<br /> SUBDiVIS10N PARCEi.ID# � � I
<br /> - . (OBTAINED FR4M PROPERTY TAX NOTICE) +
<br /> WOi2K PitOPOSED. : NEW'CONSTFt ` ADD/AI:T � S1GN [� �[� DEMOL.ISH {
<br /> �e. INSTALL � �REPAIR " �
<br /> PROPOSED�USE . � SFR Q COMM � -OTHER ' . .
<br /> TYPE OF CQNSTRUCTION Q' ' BLOCK " Q �RAME C] STEEC 'Q �
<br /> DESGRIPTION OF W4RK-' ~ `��'+, O lSl" �.� �`n
<br /> Bt!li.DING SlZE � `SQ``F007'AGE ' . , ,HEIGHT �� '
<br /> �: I
<br /> QBUII.DING , $ � _s-� _ ; ,
<br /> �;. ,_, .�. . . _.
<br /> 1�f, �_�. VALkiATION`OF TOTAL CONSTRUGTION �
<br /> ,-1 �
<br /> QE�ECTRICAL `-� � AN1P$ERVECE Q RR{)GRESS ENERGY Q W.R.E.C. � �
<br /> QP�UMSING � �� '
<br /> [,,,�MECHANtCAL $ V,4lUATIQN OF,MECNANICAL INBTALLATIOiV "v° C �� � �
<br /> ' Jd
<br /> QGAS Q RC?QFINC� Q SPECIRL.Ttf [.�� OTHER
<br /> FINISHED FLOOR ELEVATIQNS r�� FI.00D ZQNE AREA [�YES NO
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<br /> BUI�D�R COMPANY' ,
<br /> SIGNATURE REGISTERED Y/ N 'FEE CURREP Y/N j
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<br /> �argg� - Ltcense#` ``
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<br /> ELEC'T'ttlCIAN,� . • � .,COMPAAP!!Y" . • I
<br /> SIGNATURE � � REGI8TERED Y/ N FEE CURREM ' "Y/N- '' � � I
<br /> Address . � ' �
<br /> , ' . Llaense.# ( , � �
<br /> PLUM�ER ' , � COMPAAlY - �
<br /> SIGNA?URE` �' ' , ,REGI$TERED YI..N,. ,;:".,FEECURRE� Y:/N. � ,
<br /> Address ' License# r.•�'. � - ��. - �
<br /> �MECFiA[d1C14t:' O C.OMPANY 1..� . • �
<br /> SIGNIiTURE ` � REGI87ERED YJ.N � �=eE cuwt�n. Y./�N , , •
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<br /> Addreas' . , - _. . ,�, .. , ° ' � " � Ucense#�� ���
<br /> . �
<br /> QTHER ,°. . , . . ` ,'°COMPANY� � ,
<br /> SIGNATURE- - ' ° , . j" '
<br /> ''� `-°`�� �` " '` ' REGISTERED"° Y/ N.. "FEE CURRE� Y/N
<br /> Address, .. „_ ,. -- � " , license#"r� . . '�= '
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<br /> ��s�o�Nna:,,.�-;�cn��2}>�tot���ans,�i2}sefs:of;eu�ai�i�;`�ia�s��('E)•'sef of�Energy;Fortns;_-R-O-W-Pertr%It,fbr new constrvctian,,, - _ ,� .... " ` - i. t
<br /> ���-Minimumrten°,(:10);worliing;d'ays-a�ter,;submlEtal�date:;'Requtietl onslte;:ConsUiicUon�Plans;�Stortnwater Plans w/Silt`Fence`installed, �
<br /> ...�.�.J::�.� � . .
<br /> • Sanitary�Facilltles'&�.1,sdur�pster,Slte�Work:Pemnit_for;sutidiyislonsllarge',projects:�_;:;.;;�,'-, ,. � � � - .: �
<br /> COMMERCtA!» Attach(3)'coinplete sefs°of Bii[Iding Plarts„plus a�t�€e Saieip Page;{1}set of Enengy Forms.R-C1-W Parmi#�far nerv'oons#ruct�on:: ���� .
<br /> Minimum ten(10)working days ai#er submittal date. Requtred onsite,CansUuctlon Plans,Stortnwater plans w/Silf Fence installed,
<br /> Sanitary Eaailitles&:1 dumpster.S(te Wark Pertnit for ali new�proJecfs:,All commerctal requlrements_must meet campllance�"��• �° � ' ' • -
<br /> >$tGN PERMIT Attac��{2}'set's�of'Eiiglii'eered=Plaiis:,,,:-�E• :- . ,� _� : - . - , � � .. . .� � ".
<br /> ••'"PROPERTY SURVEY r ,uired forall,NEW c:onstrucdan.._ "�-----
<br /> _ eq . ._ .. . ; _ ..
<br /> .Dlrecfions: ���x.-�' .� � = ' -.. .. -
<br /> Fitl out applicaUon completely.
<br /> Owner&Goniractor slgn back of appl(cation,notarrzed ,
<br /> tf over 5,2504.a Natice af.Commens�ment ls reguirad, {A/C upgrsdes over 37s0o) „ :;.
<br /> .. ,�,,,�,,:,;,::y,, . I. _,�_
<br /> Agent'(for the=contractor)oPPower of Attomey'(for ttieyowner)would be�1someone with notarized letter from owner auttiorizing�same I
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<br /> ; ' OYER3HE:CQUN7ER;RERM1?F7'tNG-_,.�ti,;.,..(Front;of�APPtk:a�on�Oniy}�.�_ .� � , , ., - . . , . , _ . � - �
<br /> Reroofs if shingles Sewers Service�Upgrades A/C� • Fences(PIot/Survey/Footage) . ,. " - - _
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<br /> Driveways-hlot over Gounter if an�publlc roaduraiys:.�ieed's ROW' ' � " � , . � , � � - -� '
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