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a`�saeaoaao City of Zephyrhills F'ermit Application Fax 813-78f1-0021
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<br /> � Bu3tding department - "�
<br /> nac�R.���,�a " $13 3 � S _ 1I 9 5
<br /> �� Phone.Canta�'for Permltf[n
<br /> Owner's Name •�bk1�"'� �N'"��'� � 4wner Phone Nurnber
<br /> Owner's Address �6 27 � � S� z'��"S�.�L Owner Phane Number � �
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<br /> Fee Slmple;Titlefiolder Name /�.A � �� Owner Rhone Number '�� �
<br /> Fee Stmple;Titlehalder Addresa N .Q�--
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<br /> JOBADDRESS �(02 ZaTN S�• Z'lfiuS, FL- 33 S'f� �oT# ��
<br /> SUBpIVtStON �� . � � P,ARCEt»ID#
<br /> 7 - , - . (OBTAINED FROM PROPERTY,TAX NOTICE)
<br /> WORK PROPOSELI :NEw CONSTR• . ADDlA�fi �` S1GNy Q � [� • DEMOLtSH ,
<br /> � e- INSTALL � . REPAIR •� -
<br /> PROPOSEDtUSE Q SFR Q COMNI' t ' � =OTHER ""
<br /> TYPE OF CONSTRUCTION � Q =°BLOCK ' Q FRAME L�' `STEEC C]
<br /> DESCRIPTION OF WORK ...,, I/�sT�,�'�' �r✓C• Q�V��1�Y S ��� S/'� P�'�1 �
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<br /> �[lN.DlNC,SIZE N•J� - � SQ FOfJTAGE��, . . HEIGHT���
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<br /> 8;���tNC'' I' � VALUATION;OF`TtOTAL CQWSTRI:ICTION
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<br /> QEI.ECTRICAL ` �� AMP SEF3VICE Q PROGRESS ENERGY [� W.R.E:C.
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<br /> QPl.UMBING� g 1 . - .
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<br /> QMECHANtGAL $ VAR.UATtON OF.MECHA�IlCAL INSTAlIA'f10N
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<br /> QGAS [� ROOFlNG ;Q SPECIAITY �� OTHER� �
<br /> FINISHED FL.00R EI.EVATIONS � � FLOOD ZONE AREA QYES. .NO
<br /> BUlkDER . ".i���� Gt�N1PANY� 1'�'9� '�'�S'�:�InJC. '
<br /> SIGPIATURE ��— REGISTERED Y/ N fEE CURREA Y'/N .
<br /> J4�ldrs�s - L":Irsnse#'� � �
<br /> E�ECTRIGt�t+l: - ,CdMPANY
<br /> SICiNATURE ' REGISTERED Y/ N FEE CURRE�`' �`Y/N �
<br /> Address , • , -. . . LlcenSe#.�` _ �
<br /> PLUM�ER' - CC?MPANY.� , • �
<br /> SIGNATURE` ` '' , �REf315T.ERED . < 'X./.N.. ;;h,FEECURRE� � " Y�/N
<br /> Address " ' ` Licepse.# �r . .. �. •.
<br /> MECHRNICAl: ''� - •, ,. CCiMPANY, - .
<br /> SIGNATURE •� " � REGIS,TERED • Y./ N. . ; , FEECURRED - Y./r.N
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<br /> l0.dd(8s8 , t c; . � . r . ' ` UGer,IS6# ���. �
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<br /> QTHER - � _ , ' � , . , t.: ,.COMPANY '- , . .., � , :
<br /> SIGNATURE -�. � " T • ` ` REGISTERED` Y/ N., FEE CURRE� Y/N .. s
<br /> Address � . . . ' _ L'icsnse# ��,. �
<br /> RES4DENTiAL';. Atkach(2}nPtot�Plans;.(2}§ets�af�Bullding�Plari`s�(1 j�set'oF=Eneigy�Foiins;.R=O=W'Peiirii#for new consttuction, - � ' � � ,
<br /> - .. =MlnimumUten,_(:1.0),puaricinA�days:afier,'submiftal date.�`:Requlred onslte;:Consfruictlon=Rlans;�Stotmwater Plans w/'Silt°Fence installed, '
<br /> � `� Santtary Facllfyes;8�1,,dumpster_Slte�;WprlczPerrnit forsubdivisions/larg"e;project`s;_,:., ..::�4:� -' �' ' "` ' �- ` �
<br /> COiVtM�RCiAt. Attach{3)=cbrriplete'se#s'of�Buliiiing Piaiis plus a'Life S�fefy Page;{1}set af Energy Forms.R•4MU Permit fcr nernt construc#an.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides&1 dumpster.Site Work Permit for all new:projectsi.All commerctal requf[ements,must meet comppanca
<br /> S1�N PERMFT Attach{2}sefs of Engl�eer_ed.Plans.� �: �-, , . " -
<br /> """"PROPERTY SURVEY reguired for_all.NEW,constructlon.. ,
<br /> D€rections: �t �,:_` r .
<br /> Fill out applicaUan wmpletely.
<br /> Ctwner 8�Contractor sign back af appi(caHon,ttotarized
<br /> If over�2500,a Nottce of Camme�ecement is required. {AtC apgrades over�7�00)
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<br /> Agent(fq�tFie co�tractor)or`Powe�'of-Attoriie`y(for tfie"ovmer)would be someone with�notarized letter from owner authorizing same
<br /> 4VER. 'ft{E COtlNTER.PERMITTING - �-- �(Frant-af-Appflcation Only}- ' `
<br /> Reroofs if shingles Sewers Servlce Upgrades A/C Fences(PlodSurvey/Footage)
<br /> D�ivewaya-Not aver Counter tf on publfc roaduvays..naeds F20W" � `
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