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a�s-�so-oa2o City of Zephyrhills Permit Application, FaX-s�sa$o-oo2�
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<br /> Building Department 4'
<br /> Date Received " Phone Contact for Permitking –
<br /> Owner's Name � � 6 <l l��' ���V Owner Phone Number ��� ' � �s �" �3 �
<br /> Owner'`s Address 5 z 3 �` � ��?��� D�'"" Owner Phone Number �— � �
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<br /> Fee Simple Titleholder Name �� � Owner Phane Number �— � �
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<br /> Fee Simple Titleholder Address
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<br /> JOB ADDRESS �� 3 t' � �Z"�'��� ��� LO7# � ?
<br /> ' �,�- ?��a�Z � ' CTU3U -tJUSCll>--jj ( -� tJ �
<br /> SUBDIVISIOtd �� � PARCEL tD# �
<br /> �; ' (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> �� WORK PROPOSED e NEW CONSTR 8 ADD1Al.T � SIGN [� C] � DEMO�ISH '
<br /> ;i ' INSTALL REPAIR �
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<br /> � PROPO:SED USE Q SFR _ � CC}N1M � OTHER j
<br /> r; TYPE Q,F CONSTRUC710N Q BLOCK Q FRAME Q STEEL [� �
<br /> �� , . `'��.�''V� Cl (��S'C2 j.�/)2t �-j S'�L�fc.
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<br /> �� DESCR�PTION OF WORK '
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<br /> �+ BUitAlNG SiZE �^ �� SQ F007AGE�� NEIGHT �
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<br /> f; t 8���"Q��� $ VALUATION OF TO'CAL CONSTRUCI'ION �
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<br /> � � E�ECTR1Cla� �$ ,�,jS-1fi AIU1P SERVIGE � PROGRESS ENEF2GY Q W.R.E.C:
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<br /> � QPLUMBING $ ,
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<br /> � �MECtiANICAL �� VALUATIOiU OF MECHANIGA�INSTALG4TEON ,
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<br /> � QGAS Q RQOFING Q SPECIA�TY [� 4THER �
<br /> � FINISHED FLQOR ELEVATIONS �^� FLOOD ZONE AREA DYES NO i
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<br /> � BUlLDEF2 COMAAAtY !
<br /> g SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N �
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<br /> � Address License# � �'
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<br /> � ELEC7FtIC1AN �.] a � j�s �G�l� COMPANY � � �CTfZ J l`
<br /> , SIGNATURE Z REGISTERED / N FEE CURRE� Y/N'
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<br /> � Address � � j��Ll �U"-{'� 5'C ��-T�1 �� �+�y License# .�-'- fL l�� � Z Z 2 `� �
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<br /> j PLUMBER ' COMPANY � � '
<br /> ; SIGNATURE REGIS7ERED Y_/° N FEE�CURREn Y/N `• �
<br /> ,Address License# � ��
<br /> � MECHANICAL COMPANY - �
<br /> SIGNATURE REGISTERED Y/-N. .FEE CURRE� - ; Y/�N -', �
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<br /> ! Address ,License# � i��
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<br /> qTHER,. COMPANY �
<br /> �- SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N, �
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<br /> Address License# �— ��3
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<br /> `? RESIDENTiAL" =Aftacti 2 Plqt Plan;s; 2 sefs af Sui(diri Plans;_1 set of Ener ��orms;`R;O W.Permit for new construction, , .
<br /> �w { ) t .) 9 t ) 9Y �.
<br /> " Minimum#en.(.1.0)":working days�affer sutimittal•date._ Required onsite,�Construction Plans,Stormwater Plans vir/Silt Fence installed,
<br /> �_ San�tary Facilities&1 dumpster,S1te Work Perrnit far subdivisians/large projects
<br /> COMMERCiAL Attach(2)complete sets of 8uilding P�ans plus a,Life Safefy Page;(1}set of Energy Forms.R-O-W Perrrrit for.new construcGon. �
<br /> _ �Min(mum ten,(10)working,days after submittal date. Required`onsite,Construction.Plans,Stormwater Plans w/Silt.Fence installed, , -•
<br /> Sanitary Facltities&1'dumpster.Site Waric Permit for atl"new projects.A[I commercial requiremen#s must meet campliance �
<br /> .; - SIGId PERMIT Attach(2}:sets:of Eng,ineerad Plans.
<br /> • •"`PROFER'IY SURVEY required for all NEVV construckion.
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<br /> Di�ect'ions: I
<br /> Fill aut application campletely. (
<br /> Ouuner..8�-Contrastor sign back of appEication,natarized
<br /> If over$2500,a Notice�of Commencement is required. (A/C upgrades over$7500)
<br /> '* Agent{far the contractor-),or Pawer-of Attomey(for the owner}wotild be someone with notarized letter fram awner authorizing same
<br /> OVER`THE COUNTER PERMITTING (copy of contract required)
<br /> Fteroofs If shingles 5ewer's"`'"'°�'~��Service.Upgrades��A/C _ Fences(Plot/Survey/Footage}
<br /> 1.d_,�. ;,;.,:,.:t.x=' , .-.-. '
<br /> Driveways-Not over Counter ifon�public�roadways..needs R01N �
<br /> - i�C(�- . ?ci�., , .` _
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