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913-780.0020 City of Zephyrhills Permit Applica#ion Fax 813-780-QQ21
<br /> t , , Building Department �
<br /> Dats Recetved (i �- !� Phone�Gontact for�Parmlttin �y�.� '�� - gs
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<br /> O�+rner'a Name �t�� �� �� `��� L� Owner Phane Number "/�� �` ��� - �a"��
<br />� Owner'sAd:dress ��� N�. �� A�G '� 3�� 1"��'�'`1,, � OwnarPliane'Numbar � - �
<br /> Fee Slmple iTltleholder Name � � Owner Phone Numbe� �- �
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<br /> Fee Simpla Titleholdar Addresa
<br /> JOB ADDRESS JrJ�� ��'" �'� ��'}' � � �ti��"� �J �' LOT# C�
<br />� SUBDIVfSEON � � PARCEt,ID#
<br /> (OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> j WORK PROPOSED. �.NEwCONSTR ADDJALT � SIGlV' '� [� � DEMOLiSH
<br /> ,:e. INSTALL 8 R�Pi41R �
<br /> PRQP05ED�lJ$E Q SFR Q G{�MM � �OTHER `
<br /> TYPE OF CONSTRUCTION Q BI.OGK " 'Q FRAME � ["� STEEC 'Q I
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<br /> dE3GRIPTION OF WORK �, ��fl� ���°� �✓� q-� �`} �',
<br /> Btl1LDlNG SIZE �� - � � 3Q fOOTAGE ' HEtGHT ���
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<br /> QBUEt�DINt?� � ,,,��„_,_,,,,������.,
<br /> • VALUATtO(V-"OF'f01'AL"CONSI'RUG1'iON � �
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<br /> QE�ECTRIGAL $ ' AMP BERVICE Q PROGRESS ENERGY Q 'W.R.E.C.
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<br /> QP�.UMBING :;�, � , .
<br /> ' �/'� � �`�
<br /> I �MECNANtGRL $ r.,,t��� ` YALUATION OF MECHANtCAL INSTALLATION y���Jy{��/ �
<br /> � 4� V ti
<br /> �c�s � ROOFlNG [� SPEGIAtTY �� ozK�R
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD 20NE AREA QYES NO
<br /> BUIE.DER COMPi4Hl'= ,
<br /> SIGNATURE REGISTERED Y/ hl FEE CURRE� Y 1 N�
<br /> Addrsas , Ltcense# �' �
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<br /> E�ECTRICIAN: , . � COMPIWY
<br /> SIGNA7URE � REGISTERED Y/ N FEE CURRE�''r �-Y/N
<br /> :'1 (''
<br /> Addres's � license# i, �
<br /> PLtl�flSE12 �; COMPAt�Y � .
<br /> SIGNATURE ` , REGIBTERED. Y/,N: 1 FEE CURREA Y�/N.
<br /> Address � _LIt�nSe,# �- _ •�.�
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<br /> MECHANIGAI: � � �, COMp�WY Y��#�L�N!-S �'��.��i� 11. � {��dntNco
<br /> SIGNA7URE � � ' REGIS7ERED Y/ N, . , � FEE CURRE�. Y,/-N
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<br /> Addre�s��` �`��o�- ,�? .�,'�� _g �`��:, �� ' �} 3��1 License# $L.A�,- (`�il.�`�t.�
<br /> � . . _ �, , • ..
<br /> QTH�it' , � � , _ ';COMPAIVY � . ,
<br /> SIGNATURE •• � � ' "� REGI9TERED Y/ N s. FEE CURRE� Y/N
<br /> Address .~ ` ticen'se# � . � t
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<br /> RE3IDEN�'IAL;°��Attacti'(2),Ptot�.P,latts;..(2}sets=of;Biilldirig;Ftans;'(1}sef ofi'Eriergy��oii»'s;`F2-0=W;Perrriif far new coissWctiori, � '
<br /> , N_;�Minimumsten}(;1.0)iworking;day,s':a�ter„subr"riittal`date::�:Requlred onslfe;:CohsUucHon'Rlans;�Stortnwate�'Plans�w/'Stlt Fence installed,
<br /> � ��Santtary•Faciltyess&=1_dumpster�Slte;Work�Permit#orsubdivision§/iarge:projects�; .�; � ' ' ���� =•
<br /> COMMERCIAL Aft�ch{3)-completa se#s of`8uliilliig Piaiis'pius a�ife Safei#yr Page;{1}set af Energy Fotms.R-t?W Petmit far new�nstructton. -
<br /> Minlmum ten(10)working days after submlttal date. Requlred onsite,Canstruc8on Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaailiUas&1 dumpster.51te Werk Permit for all newtprojects.All commercial requlrements must meet compllance
<br /> SIGN PERMFfi Attacti'{2)sets of�ngiriear,ed:Plaiis.� :.•.����_ ' - _. ..
<br /> '••'PROPERIY SURVEY re_quired,for all�NEW constructian.,�
<br /> Dtrectlons: _,.:_ , . _
<br /> Fill out applicatlon completely.
<br /> Owner 8 Contractor slgn back of appllcaUpn,notarizad
<br /> tf avar�2540,a Natls�af Commencement Is reqalred. {AtG upgrade�ovar$T500}
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<br /> Agent(for the�contractor)or Pov+ieP of�Attotney(fa'r ttie owner)would be�someone with notarized letter 1'rom owner authorizing same
<br /> dVEt2'THE COUFITER�PERMlTTlNG •- •(Front�of�Appllca�amOnly) - �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drlveways-No#aver Counter if an publ3c raadwayrs'..neeris ROW
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