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� a�s-�eaooao City af Zephyrhills Permit Application Fax-813-780-0021
<br /> _ . Building Degarkment - �
<br /> t?ate Racelved `. Phone.Contact for Fermlttin :' � d.� r�u �
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<br /> Owner's Name 1 r��A r� �L oti Ow»er Phone Number
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<br /> Owner's Address ���� S� Owner Phane Number-
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<br /> Fee Simple�Titleholder Name ��Ar� L...D�� � Owner Phone Numbe� �W �
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<br /> Fee Simple iTltlehoider.Address -
<br /> JOB ADDRESS �� LOT# ���
<br /> SUBbiVISiON � . � PARCE4ID#
<br /> � , , _ (OBTAINED F.R4M PROPERTY.T/1X NOTICE)
<br /> W4RK PROPOSED �,;NE�nt CONSTR ADDIALT -� SiGN `Q �Q DEMOi.iSH
<br /> �e: INSTALL � ; REPAIR
<br /> RROPOSED:USE Q S�R- � 'CQIUIM `� Q •OTHER
<br /> TYPE OF CONSTRUGTION' Q"� BLOCK ' Q FRAME �'� ,'STEEC Q
<br /> DESCRIPTIQN OF WORK ` ¢ %� ��' x,,[.
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<br /> BtlELDING 81ZE' � � 8Q FOOTAGE ' - . NEI,GHT ;
<br /> QSUIGDING � �,I/(r��r 1��� -<.. ._,s.�. ,: =, . . . '
<br /> � VALUATION:bF TO'fAl CONSTRUC710N -
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<br />, QEt;ECTRICAI $ AMP SERilICE Q �PFtO�FtESS Ei�IERGY Q Vtt:R.E:C.
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<br /> QPLUM81Nt3 �. " . �'
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<br /> [�MECNANIGAL ' $ � � VALUATlOF+1 OF MECHANICAL INSTAi.1:AT10N
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<br /> ' QGAS Q RC}QFING :Q $PEGIAi.TY � OTHER� -
<br /> FINISHED FLOOR ELEVATIQNS r�� FLOOD ZQNE AREA QYES. .:NO , ,
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<br /> � BUI�OER . CBMPANY� � ` '_' ' '
<br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/"N'
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<br /> Address Lic�nse#'� �
<br /> ( E�EC7RICIAN. , 'COMPANY � . .
<br /> � SIGNATURE � REGISTERED Y/ N �e cU�teK � �"Y/N
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<br /> ' Address `' " - ' , _. - License# � . 1
<br /> PLU(YIBER ' . - .COMPANY . ' ...
<br /> SIGNATURE` � . ,REGISTERED . Y/�.N : ,FEE CURRE� Y/N. �
<br /> , Address ' • � , `_fi'License,,# �. � ��:
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<br /> MECNAHtlCAt: ` , . ., COMPANY. � ' , � • - ,
<br /> SfGNATURE• ' �` REGISTERED ,` ,.Y,/.N FEE.CUWtEn;= Y:/�N� �" �
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<br /> Address' - ° , „� .�- -' ' „ . ' m . License#��`� �
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<br /> OTNEfi . . . " , . � � ,COMPEtNY
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<br /> SIGNATURE `-• �'7 �� � � ' � '� �'REGISTERED� Y/ N.....; FEE CURRE� Y/N
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<br /> Address •,`:-, , �_=.;• .�� � , > Msa'" . ' Liceiiise#�1 � �
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<br /> RESIDEN'fFAi:', �Attach;{2):PlofP.lans;,;(2}sets-:ofsBuitdingrPlans;{.1)sefof=Energ}r>Fosms;R=t}=W"Perinitfiar new coi�s#rucUcn, .
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<br /> � -Minlmum�ten�(:10);working;d'a_ys'.after,",subriiitfal dake.x:R�qulred onslte;:ConstiucUon.-Flans,•Stormwafer"Plans w%SIIf Fence installed,
<br /> � Sanitary FacillUes�&z;1t:dumpster=�Site•Woric€Permit#or subdivislons/lerge?proJects-_. .� � ` � �
<br /> GOMMERCiA1,. Attach{3}corn'plste`sets of Buildiiig�Plaiis`plus a'l:ife Safety Page;{1}set of Energy Forms.R C?-W Permit for neuv constructlon, '
<br /> • Minimum ten(10)working days�after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes&7 dumpster.Site Wark Permit for all naw.projecfs:..AlI commercta!requlcements.must meet compliance
<br /> S1�N PERMIT Attacti'{2}`sets cf EngtRee�d-Plans.,:�.:-=^-:�� . ,.� � - . .
<br /> •`""PROPERTY SURVEY reguired,for_all�NEW canstrucUan.= - j
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<br /> Dlreettons: •� ._:. ., - _ ,, .
<br /> FIII out applicatlon completely. i
<br /> pwner&Contractor sign back of appllcaSon,notatized
<br /> (f aver a2500,a Nctice of Commencement is required. (A/C upgrades over�7500j , �
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<br /> ' '" Agent(for the con6ractor)or`Powe"r ofAttoiney(for tFie owne�)would be someone with notarized letter from owner autho�izing same
<br /> OVER 7HE COUNTER,PERM1'iTfNG.. _..-..(Front of-APPl�cation•Oniy}-- • � - .. _ .
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> drivewaya-Not aver Counter if an pubiia roadw'sys..needs ROW � �
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