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s��-�eo-ooao City of Zephyrhills Perrr�it Application Fax 813-780-0021
<br /> _ � Butlding Departrnent - "
<br /> Date Recetved _. Phane•Cor�tact+for Perntittin d � ) {� - �� �
<br /> Ow�er'$kame :�V C"C'�t Owner Phone Nnmber
<br /> Owner's Address ��� �/�GG`� � u � Owner Phoee Number .�� � �
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<br /> Fee Slmple.Titleholder Name � � �rrner Phone Number �^ �
<br /> Fee Stmplei Titleholder Address
<br /> JOB ADDR6SS � ,�� � G�✓ G � � � LOT# �_�
<br /> SUBDIViSIdN �� � ' PARCEL ID# j ` Z�'iai���"G�/�G D"�J O C�� C� ^C� 3�i�
<br /> � . , , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> W4RK PROPOSED NEW CONSTR .. RQDlAI.T � SIGN' Q [� DEMQLISH
<br /> ; �. INSTAI.L 8 REPAIR � •
<br /> PROPQSED•�tlSE ° Q �FR. Q �COMM `[r� •OTNER ,
<br /> TYP6 OF CONSTRUCTION Q�'� 'BLOCK ' Q FRAME � [� STEEC 'C]
<br /> DESCRIPTCON OF WORK ' ��. r^/ �. r �- fM"C. �✓��
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<br /> BUtLI31NG SlZE �� � � SQ"FOOTAGE��_��: . ,hE1,CiHT� �� „r �
<br /> ��=���Q�N�'" f�/�/ � VALUATION�"'OF`TOTAL CQNSTRl1CTiON ,
<br /> , L� � � O
<br /> QEl.ECTRIGA� ' � � AMP SERViCE [� PROGRESS ENERGY [� W.R.E.C.
<br /> QPi.UMBING� �� '
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<br /> Q . 1 � VALUATION OF,MEGHANICAL 1(USTAC�f1T10N J � � Q
<br /> MEGHANICAL $
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<br /> QGRS Q ROOFlNG Q SFEClA�.TY C� OTH�R�
<br /> FINISHED FLOOR EI.EVATIONS �� FLOOD ZONE AREA QYES. ;;NO
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<br /> BtJF�DER .f' ._..._ CdMPANY� ` � ' � cJ ' `G-n/Gf� CfCI '
<br /> SIGNATURE � REGISTERED Y/ N �Fee cu�trtE� Y!N .
<br /> Address - . C(cense#"� �
<br /> E�EC'tRlCiA1V; C'OMPANY ' -
<br /> SIGNATURE � RECaISTERED Y/ N FEE CURRE�" `�Y/N
<br /> Address � . - � � . L(cense# � � �
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<br /> PLUNIBER . CQMPAFIY -.. ' .
<br /> SIGNATURE' ' r. , REGISTERED � : .Y,/,N•- ,V,FEE CURRE�. ' Y�/N - �
<br /> Address . . , , . . Lic�nset#�� - � - �.
<br /> MECHANlCA1: ' .. , ' C{}MPANY � , - � _ .
<br /> SIGNATURE � � ` �` REGISTERED Y,/ N. . , �� FEECURRE�. � Y%N -
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<br /> Addregs� - �� � � � ` � ' � , ' , Ucense# � � .
<br /> OTHEEt � �- � ' - �. ii - . �
<br /> 5 CONlP1tF1Y ,
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<br /> SIGNATURE "- � `"= `� � ReGISTEr�b " � Y/ N.. FEE CUR�n Y/N-
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<br /> Addre�s ,:: . :.,:_; ; ;'.,, � ,,,,. . ' • ,,.. . , ..
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<br /> ... . ttaense#`�� -� `
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<br /> RESiQEN'i7A1:;�; Aitac�i'(2}.;Ptot;Plaris;v(2}set5�af}8ullding`t i?tairs;{'I)set af�Energy�Foii»s�R=O=W`Permit Eor new constnrctfon, ' "' '
<br /> �� ,1,Minlmum;ten;(.1,0)�,vw,rkingkdays;after;submittal-dak"e.:�.Requlred orisite;.G+onstruc8on:Plans;'Stormwater'Pians w%Sllt°Fence installed,
<br /> Sanitary Fac(IIUes:�&=.1�,dumpster-Site°WarlcrP.,errnitfor;subdivislons/large,pr�ti]ects,�._,�..': . " � "� `
<br /> COMM�RC1Ai. Attach{3}�ci�inpt'ete�sefs cf;Buitding Fiatis�(stus a E.ife Safefy Page;{'f}set af Energy Forms.R-f1-W Petmit for new construc�t(an. _
<br /> Minimum ten(10j working days after submittal dake. Required onsfte,Construction Plans,Stormwater Plans w/Silt Fence fnstalled,
<br /> Sanitary Fadlidas&1 dumpster.Site Work Permit for all new;proJects:All commercial requlrements,must meet compilance ' �
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<br /> StGN PERMIT AltacFi{2)set's'of Englrierer.ed�Plans.,. .-_�-, ,:. �.,, . -
<br /> •'"•PROPERTY SURVEY r , uired_for all NEW,construction.., •
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<br /> DlrectFOna: � _�� . `'
<br /> Fill out applicatlon compietely.
<br /> Owner&Contractor sign back of applicatlan,rtotarized
<br /> !f over�2500,a Notice of Commencement ls reguired. {A/C upgrades over 57500) , .
<br /> �. -.:�^,�,:��,�:,r.,,
<br /> Agent(for the contractor)ar PoweY'of Attbriiey(for tFie ovmer)`would beJsomeone with'notarized letter 1'rom owner authorizing same
<br /> OVERTHE�COtlN'�ER:PERMITilNG�- --- (Frontof�ApplicettonOniy}- ' ' `
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> privewaya-hiot aver Counter if an public roadways..need`s R8W �
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