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813aso-ooao City of Zephyrhills Permit Application Fax 813-78Q-0021
<br /> , t Building Dapartment
<br /> Date Received . -:: Phone�Caetact far PermEt#in �I � . c�' � - ��a �
<br /> Owner's Name 5L� �fi DL�C1�✓ Owner Phone Number
<br /> owner's Addre�s 3 �'lo lJ� �/✓�'�r 7 .��b' " Gwnsr Phone Numbsr �- � ,
<br /> Fee Simple Tldehalder Name �� � Owner Phane Number � ��
<br /> Fee Simple Tltlehald�r Addres� •
<br /> JOB ADDRE3S -��� l,J/ G /�'S'r,.-�� C/� LOT# ��
<br /> SUBD1ViS10N �_ �� PARCEL ID# 'v Z~ 2-l' v1l " b,�lo U - O C�O p U-�Zo cs
<br /> . (OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED- t NEW CONS7R ADDlALfi ��` SIGN' Q Q DEMOLISH
<br /> INSTALL 8 -, REPi41R ,
<br /> PROPOSED:USE Q SFR Q �COMM [� OTHER , .
<br /> TYPE OF CQiNSTRUCTION C]' �'BLOCK " [� FRAME �� STEEC [,�
<br /> ti ,,/
<br /> DESCRIPTIdN OF WORK• � t ,G-�/7�/ � �(�G� �C/+�Gt'� '� ,,�L%�' �
<br /> BUIi.DtNG SlZE � �'SQ'FOQTAGE� 3 � . HEIGHT C'� �
<br /> `-"'�-�«���C`' ' � VALUATION fJF TOTAL CONSTRUCTION �"
<br /> � •,�",�o. a o •
<br /> QE�ECTRIGAI $ AMP SERVICE Q FROGRESS ENEFtGY [� W.R.E.C.
<br /> .�_� �
<br /> [�]PLt1MBtNG ^'� �
<br /> QMECFiANtCAL $�������. ` ' � VALUATtQN OF:M�CHANtGA�INSTALU.lT10N ��I��� ���
<br /> Q�5 Q RQOFING Q SFECIA�'rY � OTHER•
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD zONE AREA [�YES r NO
<br /> BUI�.DER G1 11 COMPANIf'" !��� �r •y�G-`���'� �u /�'C'
<br /> SIGNATURE � •^� '"L REGI&TERED Y/ N 'FeE Cua�n Y/N
<br /> Address ' Lfconse#'� �
<br /> E�ECTRlCIAN: ,, , - :=COMPAPIY " ` - � `-
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�- -�'`Y/N�
<br /> r = , [��"'"
<br /> Address � ' , , , License,#.�• . �, . �
<br /> P[.UMBER ' � COMRANY , 'L ..
<br /> SIGNATURE�' - � � , REf31S.TERED Y./�.N, . ,��:Fee cul�n Y•/N -•'_
<br /> Address ` Licerise,# �� y �.
<br /> MECFflRAIFCAL` � }, . � . " � , ' , . -
<br /> - 'C.OMPANY
<br /> SiGNA7URE� ' ' " ' �`" � �� REGISTERED � �',.Y,.I N . �,. FEECURREP: YI�N �
<br /> r. , , . .
<br /> Address: _ , _ � ,. , . : :�_ .. � . . . ` Cicens,e#��� � ,
<br /> OTtiER "� -, -_ � ° - - � ` '',`GOMAANY � � ,, „
<br /> SIGNATURE' �_. ��'.,. . � . ,. .. r,.-�,+,�.. ,>::a.� ; �
<br /> ''�"'`REGI3TERED ' " Y/ N;.. `•FEE CURRE� Y/N
<br /> Address ,: .. .- . .. : ., . Llcense# �� '_'_' �".Y, .
<br /> ,,-.._ ._... t, 4 .� .- ., : ,:. . . x
<br /> REStRENT1AL'..::'��Attach•(Z):;Rtot�Pian's;�;(2)sefsiofi{Buildingi Ptans;{1)set oE:'Energyr:€oirn's:'R=O=W Perinit far new coi�shvation,, . _ . . ' -
<br /> -_,� ;,}f_,Minimumeten�(�:10);woriiing�days-after;submlttal'd'ate.i'Required onsite;:Constiucticri�Plans`,'8tormwater�Plans,w%SI�IYFenceinstalled, � '
<br /> Sanitary Facilides&1 durnpster-SiteUVpr,k�.P,ermit;for,su6cltvislons/large�projects;;.;._:..��:�.. , • �. f�. �, , _ •
<br /> COMMERGlRl. A##ecfs{3}c�rimptete sefs"af 8ultdlog Plans'plus a'Ufe Safeiy Page,`{1}se#of Energy Forms.R-O-W Permit for ney+i�cai►strvc�tion.,-. � =- .
<br /> Minimum ten(10)worktng day.s after submittal date. Requfred-onsite,CanstrucHan Pians,Stormwater Plans w/Silt Fence installed,
<br /> k,. .,i
<br /> Sanitary Facilides&1.dumpster.Site Work Permit for all new,projects:.Atl comrnerciat requlrements�must mest aompilance��� � ` � " �
<br /> .SIGN PERMIT Attacti{2)sefs"a`f Eiigirieerisd%i?latis:;;�>�i���; -,. , _ _ .- � , - � . � ., �,�,,�. �
<br /> ...» ._._.._..__� ._.�...,.__..,,,..��9,,._._...�..,....,.,� EW ccnstructian..., ., _ .. ` - - -
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<br /> lY SURVEY r uired forap N ;f]:,, , , .
<br /> � Dtrectlaris: . ..� � . . . __ , , �_ _. , . ,
<br /> FIII out applicaUon wmpletely.
<br /> Qwner&Canhactar_stgn back of appitcatlon,natarized
<br /> If over t+2S00,a NoNce+df Commancement 1�reguired. (A/C upgrades ovec 57500)
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<br /> :•.>> :�F;..x,.., , ._ ._ �
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<br /> " Agent(for tFie contractor)`or'Powe�of Attor'riey'(fbr tFie'owne�j would tie someone with notarized letter from owner authodzing same
<br /> DVER'fFtE"CGtlNT.ER;PERM!'i'TfNt's._.. ....(Frontof=APPlication-Oniy)�.._, ., , ">`.' r . , . . - _ . . ,...., .
<br /> Reroofs if shtngles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage)
<br /> _._,,..., ,. .�,.�__ _. ._... _. ._ _. .�, _ _ _,; . , -. . : .Q.a. , .
<br /> Drivewaya-Not over Counter if on publla roedways:.rieed's ROW � � � � '
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