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�� e`��-�eo-oo�o City of Zephyrhills Permit Application Fax-813-780-0021
<br />, BuBding Department . �
<br /> Date Recelyed . PhonerCantact for Permlttin �
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<br /> Owner's Name Owner Phone Number
<br /> I Owner's Address Owner Phone Number � �
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<br /> Fe�Slmple.Tltleholder Name �i Owrner Phone Number �
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<br /> Fee Slmple�Tltleholde�Address -
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<br /> J08 ADdRESS � � c7 ^�' ��OT� ��`(�
<br /> SUBDIVfSEON ^ �. � ' P,A1tCE1.YD# '
<br /> i , � (OBTAINEO FROM.PROPERTY.TAX NOTICE)
<br /> WOEtK PROPOSED .NEw CONSTR ADQ1Ai:T [�` S1GN` [� C] DEMOLRSH
<br /> , �. INSTAI.I. 8 � REPAIR
<br /> PROPOSED'-USE , � Q SFR. Q `CQMM - � �OTHER �'
<br /> TYPE OF CONSTRUCTION Q� "'BLOCK ' FRAME C� STEEI: Q
<br /> DESCRiPTIQN OF WORK " ,
<br /> i BtlIk.DI1viG 8IZE �` �� �Q FOOTAGE�–� HEt,GHT��______�
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<br /> I 0�'���i��'' � , VALUATION�OF�fiO'i'Al CQWSTFti7C'i'ION
<br /> QEI.ECTRICAL $��� ' �. AMP SERVICE Q PftOGF2ESS E[+1Ei2Gl' Q W.R.E:C.
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<br /> QP��MB�I�G � . ,
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<br /> I [�]MEGNANlCAL $ � VAL(1ATtOiVOF,MECHANl.CAt:INSTALLATit?iV
<br /> QGAS [� RCIOFING ,Q SPECIRI.TY �� QTHER
<br /> FINISHED FLQOR ELEVATIONS �� FLOOD ZONE AREA QYEB. ;NO
<br /> 8Ui1.DER COMPANY= . � � -
<br /> SiGNATURE REGISTERED Y/ N �E cuR�K ' �Y'/"N .
<br /> Address license#'�� �
<br /> E TRICIAfil. _ -'COMPAl�IY ' t '`�..�� ��l SS ,-i-�{:�t��t�'
<br /> ATURE ' REGISTERED Y/ N F�cuR�n�' �Y/N
<br /> Address . . • - .. license# ,�`r-%�t�.���`�
<br /> PLUMBER; ' ,. CQMP„AHY �
<br /> SIGNATURE` ' ' , 4 , REGIST.ERED � � . , Y/.N,� {;FEE CURRER ' Y•/N
<br /> J4ddr883 ' . , , LIC@nSe�l �— - . ,�. .
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<br /> MECNANlGAf:` �` � " ` , �, , COMPANY °� � _
<br /> SIGNATURE � REGISTERED ,.,.Y,/ N . FEE CUftRE�� , Y./-N �
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<br /> Addra�s�'` `; ' _ .V ' � ltcense# � -� ,
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<br /> �'fHEft - - , . • . . � ` �COMPAHY .
<br /> SIGNATURE "' °�"` '� ` � ` ` ' REGISTERED ` Y/ N...� FEE CURRE� Y/N
<br /> ACIdr9� . .. .. - t . , -i= = ' lECBRSe# � � . �",, �, . _
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<br /> RESlDEN'i'lAl,,� =Attactti-(2},Flct�P,lans;�(2)se2s.ofBulldiag�Pians�{1)setof'Eneigy�Fa`rins;:RA�WPerinitfarnew,ixins#ruatiori, �-
<br /> = Minimum;ten:,�(1,Q).working;days:after,sub►niftal-data:�.Requlred onsite;_ConstiucNon Rians;�Stormwater Plans w/Sfiit�Fence instailed,
<br /> �� ��`Sanita'ry�acilifles:&,1;,dumpster�Sita�Worlc:PemnitforsubdiWsloiis/largeprojects ___- .'c `'� ' ' � �' � `' " -
<br /> I COMMERCtAL Attach�3)'compfete sets'of Bufldfng''Plans ptus a l.Ife Safety Page;{1)set of Energy Fotms.R-O-W Permit for nev+i canstruc�tian. �
<br /> ( Mlnimum ten(10)working days after submittai da#e. Required onsite,Canstrucdan Plans,Stormwater Plans wi Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new;proj'e'cts:.All commercial requlrements.must meet campliance
<br /> SIGN PERMIT Attach{2}sets of'Englr�eer.ed:,Plans:. •� ^� . - • �
<br /> ••"•PROPERTY SURVEY required,for aII,IVE.W,construction.
<br /> Dlreatlon�: ... .. . > .
<br /> Fill out appiicadan completely.
<br /> Owner 8 ContracMr sign back of applfcadan,nohadzed
<br /> If over�2500.a Notice of Cammencement 1�reqaired. {A►C u�rgrades over�7500) .
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<br /> Agent(fpr the con'tractor)br`Povire�of-Attamey(fa�ttie owner)�wduld be someone with notarized letter from owner autho�izing same
<br /> OVER THE CtiUNT�R.PERMl7-T1FIG.. .___ .(Front of�APPlication Only}•- � �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage) .
<br /> Driveways-Not over Counter if on publ3c roaduvays..riaeds ROW � _ �
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