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s�saso-ao2o City of Zephyrhills Permit Appiication�~�~ ax-813-780-0021
<br /> • Building Department _
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<br /> Date Received . �Phone Cantact for Psrmi J l� r
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<br /> Owner's Name ��r7 � � � Qwner Phone Number � � � � 7J
<br /> Owner's Address � () Owner Phone Number � �
<br /> Fee S1mple Titlehalder Name �� ' � Qwner Rhone Number �� �
<br /> Fee Simple Titlehalder Address
<br /> JOBADDRESS T/� � LOT# C�
<br /> SUBDNIStON � 1 PARCEl.ID#
<br /> (OBTAINED FROM PR4PERTY TAX NOTICE)
<br /> WOi2K PROPOSED e .. NEW CQNSTR 8 AQQIAI.T �"� SIGN Q Q DEMOLIBH
<br /> INSTALL REPAIR
<br /> PROPQSEp U8E Q � SFR � CQMM � QTHER �" t�
<br /> TYPE'OF CONSTRUCTION Q BLOCK • Q FRAME. [�, STEEL Q.
<br /> DESCRIPTION�OF WORK �1�t>T C�P /l`�D�v� � c�C��.- � ' '
<br /> BU}�E)1NG SIZE � � SQ FOOTAGE C� HEtGHT �C���
<br /> QBUtLDING 5 ��, � VA�UATlC1N=0F TOTAL CONSTRUCTtON
<br /> r✓ J
<br /> .:QEi:ECTl2lCAL ��� AMP SERVICE Q PROGRESS ENERGY Q W.F2.E.C.
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<br /> QPLUlUi81NG ($ �� �. �
<br /> L_ �
<br /> QMECNANICAL $ VA�UATlON OF M�GHANICAL IRISTALLATION C(('j � ��
<br /> v
<br /> QGAS Q ROQFING Q SPECiALTY � OTHER 1� �G�
<br /> FINISHED FLOOR ELEVA710NS FL O O D Z O N E A R E A Q Y E S N O � t�
<br /> . _ � �,/ CQ,?
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<br /> �u��oe�z �� co�Pa��r �.-��,t17�L�._
<br /> SIG�I�4TUl�E "" f��� _ REGfSTEREd Y-/ N FEE CURRE� Y/N
<br /> Address "License# �— �
<br /> ELEGTRIGIAN COMPANY �
<br /> SIGNi4TURE REGISTERED Y/ N FEE CURRE� . Y/N.
<br /> ' Addrass - License# � v �
<br /> PLUMBEft, , CCtIVtPANY �
<br /> 'SIGNATURE REGISTERED , Y-/ N. FEE CURRE� Y/N
<br /> Address License#��— �
<br /> `MECHANICA{:� � CC}MPANY
<br /> SIGNATURE' � REGISTERED , Y/ N_ ; FeE cUrttten . Y/N
<br /> Aildress4�=� � � - License.# ��' �
<br /> fi;;i�. � � . .
<br /> .: oT��R�=...,._ ._ .. � ` c.or�Par+n�
<br /> ,�`SIGNATUREci�;:;+ .,� � - REGISTERED Y/.N � FEE CURREK Y/N
<br /> Address�- - ��. _.j - . � Ucense# �� �
<br /> �:RESiDENT(AR.��;, "Att°ch;(2)'.Piot:P.lans;�{2)>se�af'Buildiiig Ptans;'(1�}°set'of EnecgynFo�r`ms;R;0=1�V.Peritiit,far new.constivcGon, �
<br /> ^� . -,�,�-3�a�;:.r,• ;,.Minimum:ten(;1Q).working�days,aft'e�su6mittal.date:�Requi�eil`onsite;-Can`str`uctlon Plansr"Stormwater Plans w/Silt Fence installed,
<br /> ::. � �;,__.._......
<br /> � ����- Sanita,ryd,Faacilities�.&;�1,;dumpster,�Site.Wprk Remiit for•,subdivisionsllarge`projects� " '
<br /> ,�,:..:•.. , ; _. . .
<br /> ;;GOMMERGti0.t, Attactr��2•}`�coriiplete'sets of�Builiiir'ig Plans'ptus a Gfe Safety Page;(1}set of Energy Forms.R-O-W Permit for new construcHan.
<br /> _ 5 Minimum ten(10)working days after submittal date. Required onsite,Co�struction Plans,Stormwater Plans w/Silt,Fence installed,
<br /> ,.;;-; Sanftary Faeilitfes&:1 dumpster,.Site,Wotk Permit"fa�a!!new projects.Afl commerclal requ�remenis must meet corr�pliance -
<br /> ,.;StGN;:PERMIT AtNach(2)sets:of�Engineerer!Plans:�+: r=•�;... - � �
<br /> '�`�'�'_ `**"PROPERTY SURVEY required,.for aII,NEW.canstruction. , "
<br /> II �;i}ire;c4loiis: ...._..w,�_ Q�'.i'._ . . � .
<br /> �°`4' � "EilC:out application completely.�
<br /> Owner&GoriVacitar sign.tiack of appl3cation,natarized
<br /> �� !f oVer.$2508,a Notice:af Gommencement is required. (AIC upgrades over$750Q)
<br /> �*�; �..:-:.. . ,,a w.. .
<br /> _ ,AgenY(for tlie•contraotor)?or�Power-of.Attomey(for'ttie�owne�)wauld be someone with notarized letter ftorr►.owner autharizing same � .
<br /> ; :<QVER.TME'COUNTEF2:P,ERMIiTiNG:r,'., ;(cc?Py'�of contract�required) �'` ' - -� , � � ; ,
<br /> �.�,: . `._�
<br /> ;:'�Reioofs.if'sfiingles ^ Sewers ; Service Upgrades NC Fences(Plot/Survey/Footage) �� � . .
<br /> - ; , . . _ . . ., , ..
<br /> Driveways-Not aver.Counter if on public'roadways::n`eeds:ROW � ' '" "' tt. . . ,
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