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e�a-7eaoozo City of Zephyrhills Permit Application Fax-813-780-QQ21
<br /> ' Building Qepartment - ���
<br /> Date Ri�celv�d� �� ��' phone Contiact far°PermttRin ` G� — ��
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<br /> Qwner's Name h.� Owner Phone Number
<br /> � {���„�-� � i� Di IZ� Owner Phone.Number � � �
<br /> Owner's Address
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<br /> Fee Slmple Tltlehalder.Name • Owaer PEians Numbe�
<br /> Fee Simpfe Titleholder Addre�s
<br /> JOB AbDRESS �L�G/`'�"' e � /��[� � � � / G � LOT# �w,�
<br /> ; � �� �1 �,������ C- �P-�1��- �l�o a-
<br /> suan�vtsior�
<br /> � , , (08TAiNED FR4M PROPERTY,TAX NOTtCEj -
<br /> WORit PROPOSED �.NEW CONSTR . ADD/ALT �� SIGN' [� � �' �Q DEMOLtSH
<br /> ' .e. INSTAl:L 8� - REPAIR �.
<br /> PROPOSELI,USE ' . ' - Q SFR Q 'COMM' ' � -C}THER ' r rt9-r�
<br /> 'TYPE OP CONSTRUGTIOW Q� •. 'BLQGlC " �[� FRAME .C�_ � `S'iEEC _ '
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<br /> DE3CRIPTION OF WORK � �''- D�"� G'`FDcti� �2- �'�'�'' �`i., . '�d`0 a ���t"/' � �
<br /> BtlILDlNG StZE' ��.,.� 'SQ FOCiTAGE`+ , � ,.,HEIGHT ;�� �:
<br /> �.�
<br /> Q$UlLDlNG � ��� ,s„�'P VALUA7fON:OF TOTAL CONS'i'RGCI'ION '•, ' " � -
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<br /> [�E�ECTRICA� � $ �' : AMP SERVICE Q PROGFtESS ENERGY � W:R.E:C.
<br /> [�PLUMBING, . $ . , . , . ,
<br /> ( ,�� ��
<br /> QMECHANIGAL $ ' = VAI:UAtlON OF,MECHANlCAI.INSTAL.LA7lON C��
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<br /> QGAS Q ROOFING Q SPECIALTY; [�� OTHER� '
<br /> FINISHED FLOOR ELEVATIONS � � ELOQD ZOiVE AREA QYES. �NQ
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<br /> BUlLDER j���` COMPAAtY` �G��,C`�sttd I�.` '. j,,l�' d �ct.
<br /> 51GNATURE f REGISTERER Y/ N � EE GURREA ' ' Y/N'
<br /> Addreas (�l T ,�� f 4 � �G �3�l Q � License# �;��1,3.1�-b�2g�-� �
<br /> ElEC7RICIAi+l: _ � :COMPANIf ` ` � '
<br /> 51GNATURE " �G�sTE�p Y! N F�GURtt�R'' '��Y 1 N
<br /> „ - � � , , � � , (�'`�'
<br /> Addres's � � ;� , Llcense#,I. � �
<br /> PLUMBER `� � - ;_�CQMPANY �f : , , ,
<br /> SIGNATURE " _ , � ;,REi�lSTEiiED . Y,I,.N., ,, <,FEECURRER " Y/N. �- '
<br /> Address . . _, License:#��E . _ ., � •N _ • � �� I.
<br /> MECMANICAL` ' ., � . � _` . , , +� -. - ,
<br /> GQtY1F..ANY .
<br /> SIGNATURE� ; • , , " _ � . '` 'REG�sTERe�,:' .Y7 N '_F��Cu�EE:. Yl-N -
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<br /> Addres"s. . � - . . � ., � � , . . . ' '- ` M � Licsnse#�r�:, �
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<br /> OTNER ` � .` . , . , . ''C{?MPANY� _ � '
<br /> SIGNATURE ,. `,;-''• = •' ;-` ,' " :,REGfS7ERED • . ,Y! N__. FEE CUR�►: Y/N
<br /> Address - -,. . , . � , . ' L`lcense# 1 . , � �
<br /> .�.... . „_ ,.. . • ,•;. �,:,.:.,. ,r.. _ . ,
<br /> RESIDENTIAL'_�:�_Athacfi;(2),.Plot%Plans;:.(2)§ets�:of4Building;Flans;(•1)s'stiof-.`Energy=Forms�R-O-W�Perrriltf�rnewcbnstruction, '
<br /> --: ;;�,��,Mlnimum�tenr(1.0)_workingidays,efter;submftital'dat"e.��R'equir'eil ansite,:Con'stiucdon�Plans;'Stormwater"Pians�w!SIIt Fence�inst�lled,
<br /> � . � Sanitary Facilitles;8�1,.dumpster;Site°Wark?Permit forsubdiVisioris/iar9e:P.rojecfs: .,��`,=.c?- ° : � , .�,F x ' ,� �
<br /> GOMMERCl�iL Attach 3 corn lete sets;of�Biillilio 'Plans"`liis`a�C1fe Safe Pa e• 1 set of Ene Forms.R-O-W Permit for new canstruc�flon.•
<br /> � ) P 9 A tY 9 ,� } tSY
<br /> Minimum ten(10)working days after submittal date. Required onsike,Censtructlon Plans,Stormwater Plans w/Sllt Fence lnstalled,
<br /> Sanitary Facili8es 8�1 dumpster.Site Wark Permit far ali new�proJects..Ail commerclal requlrements,must meet comp0ance
<br /> StGN PERMlT AttaCti"(2j'sets of�Engfi�eier.eil:i?laiis:;,.__�'.��° _, .y - _ , . .
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<br /> '•"•PROPER7Y SURVEY reguirecl for all,NEW.constructton., �' �
<br /> 'Y�EVCIIO�H� ::Y..�..1�.._; _ i
<br /> FUI out appllcaHon campletely.
<br /> Qwnar&Contraotor slgn baak of appltcaUon,notarixed
<br /> ff over�2500.a No#ice of Commencement is requi�rd. (A►C uqgrade�over�7500)
<br /> �;.>, a�,��-,:.�
<br /> " Agent(for ttie contraeEtir)or'Povirer of Attomey(for ttie awner}woutd be someohe with notarized letter from owner avthorizing same
<br /> OVER'THECOUNTER.RERMlTE1NG .•�•�-•(Frontaf•Applica�omOnty}-� - ' '
<br /> Remafs if shtngles Sewers Servlce Upgrades A!G Fences{Plot(SurveylFootage}
<br /> Drivawaya-Not avar Counter if on public roaduvays..need`s RdW � �
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