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813-�eo-oozo City af Zephyrhills Permit Application Fax 813-780-0021
<br /> v " Building Deparbnent _ �`"z
<br /> Date Eteaelve�d :: PhonetCantact•for�Pe'mt#tin ,
<br /> �: - —
<br /> Owne�'s Naine Owner Phone Number
<br /> Owner's Ad�ress � Owner Phone Number� � Y�
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<br /> Fee Simpl��Titleholder Name T� � Owner Phane Numbe� � �
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<br /> Fee Sfmple Tltleholder.Address
<br /> JOB NibDRESB �� LOT# �_^_�
<br /> SUBDIVISION , �� � PARCEL Ib# � ` � � '
<br /> i - s . , . COBTdINED F.RONO PROPEItT1f,TAX NOTICE)
<br /> WORK PROPOSED :�.NEW�CONSTR - ADD/ALi' � S1GN" Q [� DEMOI:ISH
<br /> _:e.< INSTAL,L � ;�•=REPAIR ��
<br /> = PRQPOSE[}llSE Q- SFR. [� �COMM � 'C� OTFIER ,
<br /> TYPE OF CONSTRUCTION - _��`, �`BLOCK " [� FRAME �- ;Q STEEL CJ
<br /> ,�--~-
<br /> DESCRIPTION OF WORK' � �. '"'�` � �
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<br /> BtlIL�ING8�2E` - " SQ'FOOTAGE � .HEtGHT�, , .. .
<br /> f .
<br /> <.� ;__-
<br /> QBtIt�DING $ -� ' ,�-. . .- , ; '
<br /> , VALUATION:�F`TOTAL CONSTRUGTION� •
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<br /> QELECTRIGAL $ AMP SERVICE [� 'PROGF2ESS E[titERGY Q W:R.E.C.
<br /> ; -�._.��
<br /> �PLUMB1NCa° `$ ` ' � `
<br /> i Y,�� �
<br /> �MECHAi�lIGAL ` � � VAlUAT14N t)F`MECHAiVtCAI.{NSTA�LATILON" .
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<br /> QGAS � ftOOFli�iG ;Q . SPECIAl.TY � OTHER� . .
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA [�YES. µ.NO . .
<br /> BUFLDER ����Y CC1MPi4NY' � ; �.''. ., :
<br /> SIGNATURE � REGI$tERED Y/ N `FEE CURRE� ` '' ' Y YN
<br /> Addre�� � Licerise#'� �
<br /> ELECTRiCl�iN r, COt�11PANY � ` ` ' °
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�•' ' �Y/N
<br /> Addres$ �' � �. � . . _ , , - . .= License-# � �
<br /> PLUMBER " _ - .� GQMPANY , , ��., -.= '� _
<br /> SIGPIATURE' ` ' REQISTERED Y/>.N: �;FEE CURREK Y-/N, '
<br /> Address " � _ - . ` ` ;License�# � _-�-,. � � � °� � t:
<br /> _ . � .�°
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<br /> -E�.� ° , �� -
<br /> MEGHANFCAl: � � ' � �CQi41PAFtY .r � '
<br /> 51GNATURE� ' " ' " ' ' ftEGI$TERED, � Y,/.N _ FEE'CURRE�:. Y,/��N_ , �
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<br /> Address� - '` , . .. . ..z. � ' ' ' Ltcanse#�� � � ,
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<br /> 07HER " - � ' ��- � � � � ,.C01UlP11t!lll,_ �
<br /> SIGNNTURE, ""� "" , ' �' ' � " = `'` ; ° ' �'REGI$TERED' ` Y/ N..... FEE CURRE� Y/N-
<br /> �►ddre�Y . � ._ . .. .. -. . " - -Licknse# �I ' � � r. 4� .
<br /> .�;�y t ny,�.:,_-.,,,a 6,Fe.,�.,..�s�:.. ,-`x,�,w � -
<br /> RESlDENi1A9;,�;.::Aitacti;(2)uPCot P,tans;,,{2}sets:o�'{Bultding'Plan`s;{1}`s"ef of=En'ergy`.Fa"rms;Ft=O=W�Perinit for'new aansbvc�on,� - `
<br /> , :?;;a^Minimum;tem(,1,0)�workin'grd"ays'.after,"s'�timlEtafd'ate:-_Requl�ed onsite,:Constiuction:Plans;Stoimwate'r`Plans w%SttEFence tnstalied,
<br /> � Sanitary Facilltles&�1�;dumpste,r,�Slte Wark;Permit#o,r,subdiVisions/large:ploJecis,s..�._�,.,,;-- - -�"`'` ��� ` � � ° � `
<br /> CQMMERCIAL Attat� 3`corif'lefe`seti5"ofBuildin"¢Plans��lus a.Ltfe-'.. Pa�e,> 1 set of Ene � Forms.R-fy-W'Pecmitfor new'cons�uc�tlon.
<br /> { ) P 9 P 9�afetY 9 '{ } c9Y -C-
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Construotlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FacilEdes 81 dumpster.Stte Work Permit for all nevrprcjects.All commercial requlrements.must meet compliance '° : ° '
<br /> Sl�N PERMIT Attacis(2)sets cif'Engiiieer's`d�i?iaris�::�;.�, . ,. .<s � . • � -
<br /> "`"`PROPERTY SURVEY required for all„IVEW_construation.,_. �
<br /> Directions: ...w.�� ., .. . , '
<br /> Fill out applicatlon completely.
<br /> Owner&CocKractar slgn back of appi(catEon,aotarized
<br /> If over!�2500,a Notice of Commencement i�eequlred. (A/C upgrades over�7500j
<br /> ,x5".,rf+yuffi cs"�d:P�:T."_ . � . � . ,w _ .. �� . . � _. �.,.� ,� �
<br /> " Agent(for ttie contractor)or"Pov+re�of Altomey(fo�4he owner)would be someane with notarized letter from owner authorizing same
<br /> °�VER THE CQUN7'ER,PERMiTfiNf3--. -.-:..(�ront•ofaApPlicatiomOnty} .. -� . ' " ` `
<br /> Reroofs if shfngles Sewers Service Upgrades AJC Fences(PIoUSurvey/Faotage)
<br /> Drivewaya-Not aver Counter if on pubitc roadw�'ys:.need"s ROW
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