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813-7eo-ooao City af Zephyrhills Permit Application Fax-813-780-0021
<br /> 8ailding Depatfinent - '�}-
<br /> Date Reeeived
<br /> ; _ � Phone�Contact for�PercnEtEin � ��� �f� -�3� ��.� �
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<br /> I qwner's Name /-'/ f3 �"�-[ 7 �t.e-�+-!'�? .�rz-�C� Ownsr Phone Humber � `�%v� ^ � g..r� -�.� .
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<br /> Owner'sAddrass �7 2� 4 K�- [� � � Owner.Phon�:Number
<br /> ; t�/%l� ?l 4-"O�'`�rr3/.`*7/ �',�'t� � �
<br /> Fee Simple TltYefiolder Name , Owner Phone NumbeF
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<br /> Fee Simple Titleholder Addr�ss
<br /> JOB ADfJRESS �✓'"��� � cS�`7�� �/� LOT# ��
<br /> SUBDIVISiON ; �' � PARCEL ID# '
<br /> WORK PF2OPOSfO , NEW CONSTR ,. '�� ' ADDlA�T ��� S1GN NED`F�PROPERTY.T�TICE)���OI:ISH
<br /> �e. INSTAI:L � .� �-REPAIR ~, �
<br /> PROROSED,U$E Q SFR. Q �COMM ` [,,,,� =OTHER `
<br /> TYPE OF CON$TRUGTION' Q' ° BLdCK ' CJ FRAME �[� STEEL', Q �
<br /> DE3CRIPTION OF WORK' ��G/ ��f GI�I.,.._ � � '
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<br /> Btl1LDtNG S12E' �� � �'SQ FOOTAGE���, . _ ,HEI,GHT . _
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<br /> ��u���»�' � , VALUATiON;OF`TOl'ALCONSI'RUC't'ION`LLr ` " '
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<br /> �ELECTRICAE.. .;��� � AMP SERVICE ��'+=> Q ` PR�GftESB"ENERGY Q W:R.�.C.
<br /> � S-v r� _ .
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<br /> �PLUMBING $ < � � .
<br /> � . ,,,����������„�%,,,,�:����� � .
<br /> QMECNANIGA� $ 1/ALUATI�N OF,NIECHANICAt.11�15fALlATlON
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<br /> OGAS Q C�OOFlNG Q SPECEAL'1'Y � OTtiER< . �
<br /> FINISHED FLOOR ELEVATIONS ��� FI.00D ZQNE AREA [�YES. „NO r , _
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<br /> BUl�D i� f - y t _ _
<br /> E COMPANY'
<br /> SIGNATURE REGISTERED Y/ N �=�E cuR�� � Y/'N �
<br /> J0.ddress � Clc�snse# � �
<br /> ECfCTRICIAN; ,; � r '�COMPANY` r�f�� � .��' , �
<br /> SIGNATURE " M REGI$TERED Y/ N FEE CURRE��� �'`'Y/N" '
<br /> Addre�s ' ' -� ` - • , . - ` .. ,. ... Licanse# � .� .� �
<br /> 1 � �
<br /> PLl1MBER - G�MP.ANY T� $ �t�� ���C.��lP -�
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<br /> SIGNATURE' " ,REGIS,T,ERED . Y/,. --FEE CUftREP Y•/N. -
<br /> Address �'� ��iVt � t � _ � .- >S .,�tic,ense,#� �_F��-.�'°"�,�__�_.`I�;,..�,
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<br /> MECHJ0.i+111CAl: � ` ° . ' G�tVtP/WY ..z-: . '
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<br /> SIGNATURE" � �' � � �" � ' REGISTERED ,' ..Y,/ N � Fee cuFtRe�:• Y.3/aIV. � -
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<br /> Addres"s, - `" , .. '' " _ � � ; � ,, , � � - .License# � f � .
<br /> OTl�iER . _ " _ h J .` _ 'FCOM,PAt+tY ' � ,
<br /> SIGNATIDRE - � �"T ` L " ' � ` �`REGISTERED' � ` � 'Y/ N....= FEE CURRE� Y/N .
<br /> Address: s �,.� •. ,. - _ .. .. � ` License#��1 ��` ` - ��—�_ , ;
<br /> SZs. ._..:i: . y-.. .f ' o.: -.. �.'.�.•4.}'..ru�:� '.. - � �
<br /> RESlDENTIAL�,;'.. ;Attact�`(2),P1ot=P.,laris;,.(2}sets::o#=Buitding�'P'lans;(t)ssf of�Eitiergy`�Foims;,R=O=W�Periiiit for new coi�stctiatiori, " .
<br /> M;��>_Mlnimum;ten�,(10);,aworking,d'ay,s.affer;subm�fFal`date.�.Required onsite;;Ca'nstiucBan�Rians;Stormwater'Pla"`n"'s�w/SIICFence tnstalled, I
<br /> p, SaniteryFaciltdes&�1dumpster,n8lteWorlctPermit#or.su6divisionsnarge,p,roJec��,._,.:-.ti� -� �`�� �� � �•� ,_ I
<br /> , C4MMERCIAl. Attach(3)compfete sefs of`Butldirig Pians plus a I.ife Sai'�e#y Page;{i)set af Energy Fotms.R-O-W Petmit hsr new cons�uctlon.� - " _ �
<br /> Minimum ten(10)working days'after submlttal date. Required onsite,Canstructlon Plans,Stormwater Plans w/Silt Fence installed, '
<br /> Sanitary FacUitles&1 dumpster.Site Work Permit for all new;projects..AU commarcial tequl[ements_must meet campliance ;° � '
<br /> SIG�!PERMIT Attacti{2}:sets of�Eng[neered:Flaiis:, : - . �°r;`, �, _ , �- - �._ � . ,
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<br /> •'*"PROPERTY SURVEY required for a11,IVEW gonstruction.y... ,. -
<br /> . Dlcec#lons: , . ,. � . - - - � ,, .
<br /> Fill out applicadon complekely.
<br /> Qwner 8�Contrackor slgn b�ck of appficatton,notarized
<br /> if ovar�2500,a NotFce of Camrnencement t�cequired. (AtC upgrades over�T500j ,
<br /> .�:c uty prYsy^'Z;1J!f ^J '
<br /> '" Agent(for the�contraotor)'orPovi►e�'of"Atfomey(fo�tFie owner)would be someone with�notarized letter from owner authorizing same
<br /> OVER 7HE COUNT,ER.P.ERMITTl�!{'a. __ ..(Front of�APPilcatlon-Only)- ._ �`- . ,_ . . .
<br /> Reroafs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drivewaya-Not over Counter if on pubtic roadways..needs ROV1( `
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