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8�3-7aaooaa City af Zephyrhills Permit Application Fax 813-780-0021
<br /> � • Buiiding Department '�
<br /> Date Recelvsd � � r'c�'� `'-'� `t Phone=Contaa#•for Permt#in ' -
<br /> Owner's Name l �� � Owner Phone Number � �� 1 ��'"` t '�
<br /> Owner's Address �-c `r'�J.> �'���1�"�-� c1J� C.4. * �ner Phone Number� ��� 3`�'� � ( ' I
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<br /> Fee Slmple�Tltlehold�r Name �� " Owner Phone Number
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<br /> Fee Simple lTltleholder Address �
<br /> JOB ADDRESS LOT# C_,�
<br /> SUBD1ViStON �1,����t.���! 1�"�j PARCEL Id# •�
<br /> : ' _ , (OB.TAINED F.ROM.PROPERTY TAX NOTICE)
<br /> WORK PROPCtSED _NEW CONSTR - � ADD/ALT ��� $IGiV 'Q ' Q DEMOLISH
<br /> ' �•e. INSTALL 8 REPAIR ^
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<br /> RROPQSED=USE • � SFR. Q COMNi ' �] QTHER ' '
<br /> TYPE OF CONSTRUC'M'ION Q' � BLOGK " Q FRAME ' � STEEL Q
<br /> pESCFtIPT10N OF WORK . ��`�"Q��� � `��'"� C Y�� ' � �'-�`� t� '
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<br /> BUILDING$!ZE � �`'SQ fOOTAGE -'`��� _ , HEIGHT ��_� „
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<br /> OB[lll.t}I�,� � oD1� e'�'. .�_.
<br /> : . VALUATION�`tOF TOTAI'CONSTRt1CT10N
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<br /> i QELECTRICAC $ � AMP SERVICE Q PROGRESS ENERGY ' [� W.R.E.C.
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<br /> QPLUMSlNG $ �..�
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<br /> [�MEChtANlCAL $ � � VALUATIQN C}F MECHlWICEiI ENSTR�LATfON �V��
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<br /> C]Gl0.S Q RQOFlNG Q SPECIAI.TY � OTHER 4
<br /> FINISHED FL40R ELEVATIQNS FLOOD ZONE AREA QYES. ,NO
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<br /> BUt�DER � �-���� C�MPANY�. �-��'���`���-
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �c���-{ � �t Ctcense# �Z'�i Z�? Z-���
<br /> j EIECTRtC1AN- �. - . ,,.COMPANY • .
<br /> �� SIGNATURE � REGISTERED Y/ N FEE CURRE��' ' "'Y/N '
<br /> ' Addre'�ss ' . .. . �� - , � � _ � License#��������������
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<br /> PLUMBER { . �(�,Q ��,/"� COMP.ANY • , � �: :
<br /> SIGNATURE � � ��J ""��"""". ; , ,REGISTERED; ;. , YL.N�• ;�, ,s�FEECUFtRE�� ': ' Y-/N. ✓ '
<br /> Address L.� t� r! kS�1-�l�1�= �� - � ,uceriset.# ,�.,�``�-�S`Z_r2 a -��1�
<br /> MECNANIGAL � _ COMP�WY � , }_, ` '-�?1,.�-X1.��-.. ,1
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<br /> SIGNATURE � � ��1�� `�"�. REGIS7ERED , . „..Y L N . : ..;,FEE CURREP �. Y„/�N
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<br /> Addre�s'~ � �' 'T {� �' � ���' � ` ` , � Li ~ ��-{��--'' �� ,
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<br /> 03HER ; 1 ?�v�.�;.�-�-- �� „ �CQ�111PANY � ,
<br /> SIGN�,TURE •- " " �Y" �t REGISTERED �; 'Y/ N,,�:' ':FEE cu�n Y/N .
<br /> Address � ����'i � . ,' �license# ! ' � �
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<br /> ,-�.x , a -. ,. � . ,. i.. p.s;�.t•;,-�_:�, � _ , .
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<br /> E2ESlDENi1At,;�� Atta'cii 2 Plot��Plaiis;:'2 sets�ofBul!`tlin zPtans;{'I)_sef cf Energy;For'ms;:R=O=W`Pemiit tor-�ew cQnstructicn, _. - � "
<br /> -, ;� Minimum:kenc(:1.0);working;days;after,:"submiEtai d"ate.:.;Required onsite;�Cbnstructlon=Plans;Storinwater'Plans w!Slit Fence instalisd,
<br /> '�,��� Sanitary Faclllyes;&t,1.,,dumpste,r,,Site��Work,:Permit for su6divisions/Iarge�proJects ,_�_�..�;_ _. � �" ��
<br /> C4MMEftCiA1. Attar,h{3)�abiiiplete sefs`of�Buildiiig"Plaiis plus a`I.ife Sef�ty Page;{1)set o#Energy Fatms.R-Q-W Petmit far nerni canstroction. �
<br /> Minimum ten(10)working days�afker submlthal dete. Required onsfte,Canstructlan Plans,Stortnwater Plans w/Slit Fence installed,
<br /> Sanitary Facilitlas&1 dumpster.Site Work Permit for all naw�projects.All commercial requlrements.must meat campliance �
<br /> SICN PERMFT Attach{2)"sets of'Ei►glneered�Plans:,.,., ,.,' . =� .. �
<br /> ••""PROPERTY SURVEY required for.all NEW constructlon. .,
<br /> � Dlrectioas: �:-.:�.; . , �
<br /> Ffll out applicadon compietely.
<br /> Owner 8 Contractor sign back of appltcatlon,notadzed
<br /> [f ovar ffi2.rit30,a Notice oE Cammencement[�reqaired. {AtC upgradea aver�7500)
<br /> .. .:� f�;,f.,,,
<br /> Agent(for the cantractor)or Power of Attomey(fra�tFie owner)would be�someone with notarized letter from owner autha�izing same -
<br /> DVER THE CCIUNTER,pERMITFING.._ __ .{Front of-APPIIcatiart�Only)_ . � . _ .
<br /> Reroofs if shingles Sewers Service Upgrades �A/C Fences(Plot/Survey/Footage) ' , -
<br /> Drivaways-M1tot over Counter tf on public roadways..iieects ROW -
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