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813-780-0020 City af Zephyrhills Permit Application FeX-813-7$0-0021 �
<br /> Building Deparkment -
<br /> Date Received Phons-Gontact for Permtttln • �
<br /> Owner's Name t�8 �j Owner Phone Number �'� .` ��,,,2��
<br /> ; Dr13��01�-� . ,�
<br /> Owner's Address • C3�arner Phone Number. ,� �
<br /> Fee Simpl�Tlklelialder Name ^ " Owner Phorie Number ��r �
<br /> Fee Simple Titlehalder Addresa
<br /> JOB AbDRES$ �� � I � I"t E �r._ �'"�.J � ' �� � LOT# �,,� ,
<br /> SUBDIVISI,ON , � � PARCEL II� � � , " �' L���" ���Q � d �
<br /> , � (OBTAINED F.ROM PROPERTY,ZAX NdTICEy
<br /> WORK PROP4SER ,NEW'CflNS71t . ADD/ALT �� SIGN `Q � Q DEMOLISH
<br /> ; � e: INSTALL 8 : � REPAIR �• �
<br /> PRQPOSED�USE Q SFR. Q 'COMM� C,� •OTHER
<br /> TYPE OF CONSTRUCTION� Q BL.00K " `Q FRAME ,. [� 'S7EEC '[�
<br /> DESCRIPTiON OF Wt'3RK � � Jl.ti;�1 � �-'�" � : J�- � �cz. �. L�.�.�L��'C
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<br /> BUtLDlNt`s':SiZE - ' SQ FQOTAGE ' � . HE16tiT .,,.._
<br /> , . .
<br /> QBUILDING $ �� - - • �
<br /> ; VAt�UATtO1�t:OF'i'OTAL CONS'FRC1CTiON -
<br /> , •
<br /> QELEGTRICAL $ AMP SERVIGE [� �Pt30GRESS ENERGY [� W.R.E:C.
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<br /> QPLUMBING • � � " ' �
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<br /> QMEChANiCAL $ ��'� �� VAI.:UATIOPIOF�MECHANICAI.INSTALWTiON � �l�e�"'�'
<br /> ` � J� '' �
<br /> QGAS Q RQOFING .�SPECIALTY.Q OTHER �`
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZQNE AREA [�YES NO
<br /> BUILDER � COMpl4NY` ' • - ' `
<br /> SIGNATURE REGISTER�D Y/ N �'eE Cua�n Y!N'
<br /> Address � Lt�ense#'� � ` �
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<br /> ELECTRIC!/1N; ' 'CfJMPANY � �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURREN� � �`'Y/N
<br /> Addres�e - . . - ' � � ; � . . .,x �iceriSe#.1 . � �
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<br /> PWMBER� ., , � ': COMpANY �` ' .,
<br /> SIGNATURE' � ' " ;. ,_REGI37ERED� Y,/;-N , =•, • .FEECURRE� '" Y•/N �
<br /> AClC�f8�8 , ' � � ' - � ' _,{.ICenSe# +r ..'. � _ . � .
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<br /> , . , _ ., , .
<br /> MECHAPIICAL � . . . . CQMPANY . _ ,
<br /> SIGNATURE ` � � � ° ` ' � '� x REGI57ERED _ Y/ N -�FEE�CURRE�.- �. Y:/�N • '
<br /> Astdra�s'� -- �,, ` � � L. _ � ._ , . , _ . Ucense# ( . ... , .. — � .
<br /> � �`� ;,`:. � "� j g G �- ;�.
<br /> OTHER ' � ' � ,COMPANY �� (JC�}' {. �!, Gti' ,{-
<br /> SiGNATURE �• �r'" ; ' - , " ' ` '§ "REGISTERED` � ' Y/ N,.: FEE Cu n ' .. Y/N. _
<br /> Addres��. - _ ��,,d�1. ,�-. �?-�5" � [:icerise# �M-��-�'.,��j'1j��J'��
<br /> ,. ., . ;�, ,,.;:..<_;_.,._ . .: . ; . - •,� , ` , . �
<br /> RESIDENTIALF�:. �Attach'(2):Plot�P,lans;�(2)set"s:of:Building�Rlans;�(1)'set"of Ene'ngy�Forrn's;�,R=O�W'Perrri`lt far new ccnstructton,.,, �"�� '
<br /> - �: Minimum�ten�(,10}�working;days,after:submlftai"d`afe:r;Required orisite;�Construcdori�Fikans;Stortnwater'Pla�s w/Silt'Fence installed,
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<br /> ..._... ,�: .., ..
<br /> Sanita'ry�actl{U,es;&�.�1d:�dumpster,Site Wor1c,�}Perm�t�or sutidlvisEons/targe:proje,cls_••�,..,.;- r • ,_ �.; ,, , .
<br /> COMMEItCIAL Attach(3)�complete set�`of Building Plans plus a Life 5afefy Page;(1)set of Energy Famts.Et O-W Permit for new constru�tion,-
<br /> Minimum ten(10)wark�ng days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, ,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permtt for a8 newrprojects:.All commatciat requirements_must.meet comptlance
<br /> SIGN PERMIT Attacti(2)sefs of�Engineered�,Plaris:t:r�.�� ,--. 'i� �,-- . ` .'
<br /> •"••PROPERTY SURVEY required,for all NEW construcUon..
<br /> Direction�: , - ...;•� .. �- , ,
<br /> Fill aut applicatlon completely.
<br /> Owner&Contractor sfgn beck of applicaation,notarized
<br /> If over�2500�a Motice of Commencement ts�eqafred. (A/C upgrades over 37500) ,
<br /> .« -;..:,:,a�>�.�-�s .:;. � . .._. � ..., .,, . _ ._ _. � ' �' _ ,
<br /> t�qent(tor the c�ntractor)`or Powet of Attcriiey(fot tlie awnerj wauld be sameone with natarized letter fram awner authori73ng same
<br /> dVER THE COUHTER PERM!'t"ilNG- _---(Front of=ApP1EcaSamGlniy)-� ., ' �
<br /> , ,..Y -a.
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences{PIoUSurvey/Footage)
<br /> Driveways-Not over Gounter 1f on pubifc roadwayrs..need's ROW �
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