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813-780-0020 City of Zephyrhills Permit Application Fax-813-7$Q-0021
<br /> Buitding Qepartment .
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<br /> Date Etecelved . ;. phone>Contact fcr Permtttln � �
<br /> Ovrner's Name 1.�,) QE'�` Owner Phoee Number
<br /> Owner's Address � "G dwner Phone Number �� � �
<br /> Fee Simple TlNehblder Name �� � f7rwner Phone Number � �
<br /> Fee Stmplei Titleholder Addresa
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<br /> JOB ADDRESS � L/ LOT# �`�
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<br /> su�aiv�siaN � � � p�c��.i�� l�� ����1 b—' 6���DD-�
<br /> � , , (OB7AINED F;ROM.PR4PERTY.TAX NOTICE)
<br /> WORK PRQPOSED . ;NEW CONSTR ADDlAI:T � S(GN` Q Q DEMC?LISH
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<br /> e INSTALL 8 REPAIR
<br /> PRQPOSED�USE Q SFR Q CON1M � ` �� •OTFIER • �
<br /> TYPE OF CON37RUCTION Q' ''~BLOCK " C] FRAME �] STEEC '[� �
<br /> DESCRIP7I,OH OF WORK� .. �� �-C C� jO�I ��"�. � i"f' � � �v P VjC'C
<br /> BUt�DING SIZE - = SQ FCtOTAGE C�, . .,,HEt,GHT-��
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<br /> D�����N�`' � VAI.UATiOfil:OF`TCi'i'ALCtONSI'RUCTION F• ��
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<br /> �ECTRICAL $ ?��b" � AMP SERVICE 1�� �pROGRESS ENERGY [� W.R.E:C,
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<br /> OPi.UM81NG�. '� � _ ,
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<br /> QMEChiANlGAL $ - VAI:UATION OF:MECHRNiCAI INS7ALlAT10N ��
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<br /> [�GAS [,� ROOPiNG .Q SPECIALTY � QTNER� �'/Q 2 �
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<br /> FINISHED FL.00R ELEVA710NS � � FLOOD ZONE AREA QYES. NO
<br /> BUII.DER COMPANY� ° -. -
<br /> SIGN�►TURE REGISTERED Y/ N ' FEE CURttE� Y/N
<br /> Address Llcense.#'I ` �
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<br /> E��cr�cr;a�+i, �coM�n�tir � J� .�C t� � �-' � � ��1`� ��
<br /> SIGNATURE � REGISTEREp Y/ N FEE CURRE�`��' •Y N
<br /> Address .L �' � , � t _ License# ��G� I���L��
<br /> PLUMBER` , .-CQMPANY � ,� .
<br /> SIGNATURE REGIS7EREp ,Y./..N,= �FEE�CURRE� ' Y�/N. k
<br /> Addre�s , - � ' `;License# t: � -= �� �. ,
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<br /> MECFlAl+IICRL' ' � , _ .C.OMP�4t�E1f - -. . : .. • '
<br /> SIQNATURE � " REGISTERED .' , Y./ N {FEE-CURREA� Y./:N
<br /> AddrBss - ' ' - ` � z ' l.iCenS9# � ' �
<br /> O'iFtEt2 ° - - ,• . . . ,;Gt1MPANY � �
<br /> Sl(3h1ATURE -. i• ��"�"a- ' ` ' ' � ` " REGISTEF2ED Y/ N�_ FEE CURRE� Y/N-
<br /> Addeess = ' .,. :<_ �.. . I.icsrise# � -� rv�' ° , .
<br /> .. . " .. •.,r. ,..•yk,.�..,�...�.. ..,�, � :. •t�. _..4-._^�; ',: .. .,�:.�.." .,, .. , j. �. . ,. ... .
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<br /> RESIDENTIAL.��: Aitacti�{2};P[aticPlan's;�(2}se#s.of:Bultdiitg=Plar�s,(1),seEofyEisergy��airns;:12=�W�.Perm,lEfcrnewconsbuctEon, '��' ' .
<br /> � - Mtnimum;ten�(:1,0)�wortiing�days,�after,;subm(ftal dat"e.'�.Requlreil onsite;:Constiuchon Plans;-Starmwa�ter Plans w%Silt Fence instaileif,
<br /> :___..c��n(tary Faclll8es;.&;1r,dumpster;Slte�,Work�:P,,etmitfor;subtlivisians/Iatge-proJects,-==Rn.�.;,; . . ' -� .` _= ,
<br /> COMMERC114L Attach(3paomptete sets af 8ulldliig Pians plas a Life S�afety Page;{1}set cf Enengy Farms.R-O-W Permtt far new constructi0n.
<br /> Minimum ten(10)working days'after submithal date. Required onsite,ConsWatlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facifltles 8�1 dumpster.Site Wark Permit for all new,projects:�.All cammerdal requirements.must meet compllance
<br /> S1GN PERMFT Attaci`i{2)s"s#s�iif'Engin�eer.ed;F?ians:,,��.;._;_ ,. :.-� � - ,. . .
<br /> `"'•PROPERTY SURV�Y required for all.NEW,construction.
<br /> Dlrectlon�: ... - �. ' ' _
<br /> Fill out applicaUon completely.
<br /> Owner 8�Contrackor slgn back aE applicaHon,notarized
<br /> tf over$2500,a Natice of Commencement 1s reqaired. {AtC upgrades aver�"TS00)
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<br /> " Agent(for the cantractor)�or'Power of�Attortmey(for tFie�owner)would ba someone with�nota�ized letter from owner authorizing same
<br /> dVER THE COtlN'T�R:PERMIT'TlNG�.• --- .(Front of-Applicatton Or�iy}- . ,
<br /> Reraafs if shingles Sewers Service Upgrades AJC Fences(Plot/Survey/Foohage)
<br /> Ortvewaya-Not over Counter if on putatic roaduvays..aeed`s ROW �
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