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s�aasaoo�a City of Zephyrhills Permit Application Fax s�a-Tsaoa��
<br /> Bullding Departmenf '`�'
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<br /> Date Received < Phone�Contact forPermittin
<br /> Owner's Name c,!(� Owner Phone Nunnbar
<br /> 4wner's Address L� 1/! it/l1�. �- �I� ���7�� ��ner Phirne Number -�— � �
<br /> Fee Slmple�Titleholder Name ~�� Owner Phone Nunnber �—��^�
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<br /> _ -- �-, .
<br /> Fee Simple�Yltleholder Addres�
<br /> JOB 14DDRgSS � /•���tT° L.OT# ��
<br /> Stl�DiVIS10N � � �,�c���a# �' -�1-� t� �1 -- Q1��?� --O ..��'
<br /> � } , � (OBTAINED'F.RGM,PROPERTY,TAX NOTICE)
<br /> WORK PROPOSED. NEW CONSTR , ' = ` ADD/ALT [�� SlGN" "Q '�Q DEMOLISH
<br /> ! ��. INSTALL � ;-REPAIR •� -� .
<br /> Pf20P03EDrU$E � _ Q SFR Q 'COMM • ' Q -OTHER '
<br /> TYPE OF CONSTRUCTION Q ' BLOCK " Q FRAME �� STEEC Q
<br /> D�SCRIPTION OF WORK ' F-tt�w�Z Z�� 1�d t l�- �/"'fJ t�t�Q �dy�j�/�� �(� � �j�trL'�'��
<br /> � .
<br /> BUttDlNG SlZE � � 3Q`FQOTAQE�,�, ; HE1,GH'�jz,.
<br /> . .
<br /> QBUILDING $ VAIUATEON�t�F TOTAl;"CONSTRUGTtC?N ,� ' "
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<br /> QELECTRIC�L. $ � AMP SERVICE Q 'PROGRESS ENERGY ' [� W.R.E:C.
<br /> i . -
<br /> � �
<br /> QPLUMBING A($�� - , `
<br /> I �-- . .
<br /> QM�CHANICAI. $ ' " VALUATION OF MECHqNI.CAL INSTAU.ATiON r
<br /> i ,
<br /> QGA,S ROOFING .[� SPECiALIY C� OTHER _ �
<br /> FINISHED F,LOOR ELEVA710NS � � FLOOD ZONE AREA QYES :NO
<br /> y , ,
<br /> BU!l.DER ; COMPANY� � ` • ' '
<br /> SIGNATUR� REGISTERED Y f N F6E CIiRREh ';Y"I N`. .
<br /> Address � , Ucense# �! �--�
<br /> � . -- ._ , '
<br /> ELECTRICWN; : , 'C'OMPANY ` � ,
<br /> SIGN4►TURE � REGISTERED Y/ N FEE CURREK� `' %`Y/N
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<br /> Addrsss ' , ,_ License# , — .� ! I
<br /> _'_ , Z < - „� .. ,_ �
<br /> PLUMBER ; C;OINPANY <� � �r � . .
<br /> SIGNATURE' ' � a�'REC�IS.TERED� � Y./�.N.. ;,�, .s,FEE,CURRET �.' X/N.-�';'
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<br /> Addre�s � ' . . ' License�,# ��_ '--�..-
<br /> � _.�_�_.._._. . . , ,,r. �.
<br /> �F . . s . . . , . . _ _ . ,
<br /> MEGHAN1C14L' � ' �C,QMPANIf .
<br /> SIONATURE � ' " R�GISTEREo Y.,L N "` �'CUR€tEn.. � _Y../N . ,
<br /> - � � . . . _. . . ._ . .r . ..
<br /> J � .. _ k`..�1� ':rv�• , � - -�
<br /> aadress- ', � . � , � , . ` . , � � Lir.ense#`� ,.... . ... „..!
<br /> , _.._.. .. _ � . �t� / `
<br /> OTMER _C���it, , -.. ;SCOMPANY a��/L' �,�i�Y•��-
<br /> SIGPiATURE .:- °' � ' - T REGISTERER ` ' Y I N.;.�.i ` �EE CtlRt2Eh . Y/C+}•
<br /> �►ad���� � 4 ,�k�.,X:��. .3��� �irt0� .�i` , . u��e#_° �G��lj��:�cj/ -"�: , T
<br /> .�.., ��,�r.,_,.r ;_ .��;..1��.�_,:� � . .
<br /> ,... .,.;.,4.z.;. ,. . . , .
<br /> RESIDENTIAL P•s.�: �A�tacfi'(2),,PlotrPlans;::(2)sets:of;Building�Flans;•(1)set`of Eriergy Fortns;�R=O=W'Perrrilt ftir-new construction, ; ` '
<br /> � �...�. �,
<br /> , ���. Minlmumetep�(1,0)working;days�afte�;submiital`d"ate.��Requlred onsite,:Gbnsbuction�Rlans,Stamiwater Ptans w!Si1t Fence tnsta!led,
<br /> `. .�.'r'J �"f't.,e,..e ��....r �.w�... _' '.. „ .
<br /> Sanitary Fat�lities;&�1�dumpste,r,,Slte�,WorkyPerm�t for,;subdivisions!large p,,rojeats.:..,__ ::. ,, , . � ,
<br /> CONlMERGIAL Attach(3)�aorriptete`sets"of'Builcling Plans`�plus a l.lfe Safety Page;(1)set of Energy Fortn's.R-O UV Permit for new canstruction. �
<br /> Mintmum ten(10)woricing days'after submithai date. Required onsite,ConstrucHan Pians,Stormwater Plans w!Silt Fence instailed,
<br /> Saaitary Facilifles&1 dumpster,Slte Work Permit for ail new�projects..Rll commercfal cequlnements.must meet compllance - �
<br /> SI�N PERMI'� Attact�(2)`sets ofEnginee�adl'lans.,,.:-;:,.; , t. . � , - . - - -- - -- - , -
<br /> """PROPERTY SURVEY requtrecl„for ali IVE4V aonstruc.tian., . . -
<br /> RErectlon�: � �� �. _ - ' '
<br /> Ffll out applica8on completely. .
<br /> Owner 8 Contraator slgn back of applicallon,�otadzed
<br /> if aver�540.a Notta�af Cammencament t�required. {A!C apgrade�aver�7500)
<br /> -s<<,;�.,...:::•r•.;.� _. . _ . _.._. _ _r-
<br /> `* Agent(for ths contractar)`or"Power of Attomey(fci�tliie owner)would be someone with nota�ized letter from owner autharizing same
<br /> DYER THE COUNTER PERMIT'itNG- - -{Eront of Applicatton Only)�- � - -' '
<br /> Reroofs if shingles Sewers Servica Upgrades,A/G� Fences(PIoUSurveylFoo#age)
<br /> Drivawaya-Not aver Counter if on pubHa roadways:.fieed"s RG?W' '
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