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,� s�saso-oozo City ofi Zephyrhills Perrni�Applicafion Fax 813-780-0021
<br /> ' • Building Department
<br /> DaQe Received 'r� �� Phone�Con4ac4 for PermiQting..-� I � ! v v` -- l.C���
<br /> Owner's 4Naene �,r Il C 1 � 5 Owner Phone iVum6er ���-' �U� � ���i
<br /> OwneP's Rddress. � `� v ��� 1 �- � � ��I�SOwlh�e�Phone Nure�b�r
<br /> F�e Simpl�7itleholder'Name OwneP PF�oaae�9aaeai��P
<br /> F�e Simple YitleholdeP Addeess
<br /> JOB ADDI2ESS �I !V � �� v'e- 1 � �f I�� ��1 LOT� �- �d
<br /> i
<br /> su��ivosio� Ci�- � o� Zl��l�s ���c��,i�� � (�a�a'c�?.� - b10 � 0 ba0 a ���
<br /> (OBTAIfVED FROM PROPERTY TAX PlOTICE)
<br /> WOR�L PROPOSED i e NEW CONSTR e ADD%ALT � SIGN Q � Q DEfVIOLISH
<br /> IiVSTALL •REPAIR
<br /> PROPOSED USE j Q SFR Q COMM 0 OTHER
<br /> YYPE''OF CO�dS7'RUC7'IONf j Q BLOCK • Q FRAME 0 STEEL Q "
<br /> DESCl21PTI0�OF WOB2dC ' �.f b� (P—/0()+� (� �S UC�,f�S �UC�-i� +�"un'1C�.�'1
<br /> �UILDIP�G SIZE � SQ FOOY.Ats� I 1 dO p���(��p'�
<br /> �UILDING � $ ���/,�Q/� VA IOPV'OF T�TAL CONSTRUCl`IOIV
<br /> � lJ V ��� �
<br /> QELECTRICAL $ AMP SERVICE' � PROGRESS ENERGY Q _ W.R.E.C.
<br /> i
<br /> � QPLUMBING � $
<br /> OMECHANICAL ' $� VALUATION OF MECHAiVICAL INSTALLATION
<br /> OGHS � Q ROOFI Q SPECIALTY � OTHER
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> �
<br /> �UILDER COMPP,�9Y
<br /> S�G�d�+��1RE REGISTERED Y/ N . FEE CURREA Y/N '
<br /> ��dP�ss -Lieense#
<br /> ELECi'RI.GI�iV COfViPAPfY
<br /> SIGR��TURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> �4cGdress Cicense# a
<br /> PLUE111,�IE�. , COIVO P�4P�Y.
<br /> 51G�R�1�U�E REGISTERED Y�/ IV- � FEE CURRE� Y/N
<br /> �,ddress License#
<br /> M�CHi41�11CP+1: � CO�fl��4P2Y
<br /> SBGiVA'I'URE � REGISTERED Y/ I�1 FEE CURRE� Y/N
<br /> Atlo1¢e"ss � License.#
<br /> �, ..
<br /> or�a��- .. co�n��,�v �'YICi,(1 (� � `t-�'1 C
<br /> SIGP1ATlIFaE:� :i REGISTERED IV FEE CURRE�' N
<br /> �+ddPess � 5 IFh�I� S FI 3 S�� License# l,Cl.l�� ��bS
<br /> PiESIDEWTIAL:��` Attach�'.(2)':PIot�Plans;�(2)=sets�ofFBuildirig-Plans;:;(1)'set of'Energy Forms;'R-Q-VU;Permit.for new.construction,.
<br /> - ,,, � , �.Minim;Um�.ten;(1'Q.)..w.qrking:,�8ays`after.';subtnittal.date. 'Requiretl'onsite�'Constr0ction Plans,S'tor.mwater Plans w/Silt Fence installed,
<br /> � � Sanitary�,Facilitie,s�:&�1,:,_dumpste�;Site: .W.ork�P.ermitfori'sutitli'visionsllarge.projects
<br /> COMME6tClAB. Attach'(2)�complete`sets`of Building�Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit fqr new construction. I
<br /> Minimum ten(10)working days after submittal date. Requi�ed onsite,Construction Plans,Stormwater Plans w/Silt Fence�installed,
<br /> Sanitary Facilities&1 dum,pster.Site Work Permitfd��all•new p'rojects.All commercial requirements mustmeet compliance -
<br /> :SIGb�PERf1�11' Attaofi(2)sets of:Engineered Flans.��
<br /> *'"*PRORERI'Y Sl1RUEY required for.all.iVE11.V.constcuctlon. • .
<br /> DirecQiores: - . , •
<br /> Fill out application completely.
<br /> Owner&Contractorsign.back of.application,notarized
<br /> Ifi:oveP$2500,a R9o4Bc�of(Cornm�nc�m�n4 os r�qaeiP��. (�4IC ug��ra�es ov�r$7500j
<br /> '" A ent for`th�e`''contractor•or`Power of Attorne for'tfie owner would 6e someone with notarized letter from owner authorizin same
<br /> 9 � � ) i Y� ) g
<br /> •OVEP3T8iE'COl3,NTER=B�ERiViI'Y''PIV�G. (copy.of-contract�reGuired)
<br /> Reroofs if shingles Sewersi Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Deivevuays=Not�overCounterifon=putilic;�bai�ways..needsROW ,�:.._-- ----._'= .= - -"= --= -''�-- --"_-'��
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