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<br /> 813-780.0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> 8uilding Department . 'i`
<br /> Dat6 Received /_ ' -
<br /> �� Z'�.(� ` - �' Phone Confact for�RermlttEn �
<br /> Owner's Nama !� �Y'C� � �./`L d �M7'�l 1. Owner Phone er ����' ?O �—� L�
<br /> Owner's Address �o2a'� �` �,,�. '�'$ a, Owner Phane Number ��,�, � .�c��-�* ]O'��
<br /> Fee 8lmple iTitlehold�r Name ` � Owner Phane Number '�� ��
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<br /> Fee Simple j7ltleholder Addresa �
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<br /> �os AaaaEss �o +�� � �.- � - i'�ril�S �or# .�
<br /> SItBDIVISION S�"����"' .�.Arl« "��� PARCE�td# � � — �Ct O D� QI t') � �D3 jJ
<br /> ; . , , (OBTAINED F.ROM PROPERTYTAX NOTICE)
<br /> WORIC FROPOSED. .,�tEw CONSTR ADDlALT � SiGN ,Q- [� DEMOLISH
<br /> 4 '•.e. INSTAI..L B REPAIR
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<br /> PROPt?SED�USE � Q SFR � CQMM � ��THER '
<br /> TYPE OF CGNSTRUCTION Q BLOCK " Q FRAME � � STEEL [�]
<br /> � �o nc r�'e�
<br /> DE3CRIPTfdN OF WORK` [�C�- � /e . SGit /�T S R�B
<br /> BUI�DINGSlZE �� �� �q�FOOTAGEC`�, .HEIGHT_� � �
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<br /> �$������'' � �, � VAIUA'fiOt+t"t?F�T'OTAL CONSl'RUCTiOtd "
<br /> QEIi.EGTRIGAI $ � AMP SEiZViCE Q Pf20�i�SS ENERGY Q W:R.E.C.
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<br /> PLUMSING '
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<br /> QMEGHANICAL $ VALUATION OF;MECHANlCAt INS7ALLA7'ltOtV
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<br /> QG�►S Q ROOFlNG Q SPEGiA�TY � � QTHER -
<br /> FiNISHED FLOOR ELEVATIQNS FLOOD�ONE AREA QY�B. NO
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<br /> BUII.D�R ' � l-{� COMFi4i�lY: .. , � '
<br /> SIGNA'i't)RE ' REGISTERED Y/ P1 FEE CURRE� Y�/N ,
<br /> Addre�$ � Cicense# �— � �
<br /> ELECTRlC.IAN. , • -CQMPANY �
<br /> SIGNATURE � REGISTERED Y J N FEE CURRE�`' ''` %'Y/N �
<br /> Address � � ,� � - ltcense# i, ,� � - �
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<br /> PLUMBEtt $ , ,-CONI,P,.ANY ; „ � .�.
<br /> SIGNATURE ' ` . REGIST.ERED . . Y./..N� : ,-..FEE CURREK Y—/N.'�.:
<br /> Addre�S � - _ , � " zIC8t1S8r# �_. ' � ,` � ,�-
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<br /> MEC#f�tNlGAI:' C{}MPANY � _ � , - •
<br /> SiGNATURE � ' � ��� REGI$7EFtE0� , .Y./.N_ � ' FEE�CURRE�-..� XJ�N� ��
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<br /> Address T; • -. - < } , � > ..
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<br /> . , , _ ��cense�# .. - .
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<br /> , 03HER . ,,_ _ .. , �,, „ � - -
<br /> .COMPANY"
<br /> � StGNATURE . ` � � ' ' '° `RECIS7E�o' ` ' Y/ N,.:,.' " ' �E Cutu�n' Y/N
<br /> Address - .,,° � �� ,� _ � � , � License# �� ���� � �
<br /> RESlDENTWi.f'. tAttacti:(2)�Plot?_Flan's;.;(2}s"ets.ofiBii3kling?t?!an"s;('i)setoF<Energy4Fcnns;�f2=Q-1N�Perinitfar'-�ewconstruct�an, - • . ` . -
<br /> , *,.,�;;:.,Minimum>ten�(:10);wgrlcing�days,a(terr`subiniitsi'd"ate::Requlreil onsite,=CahstrticHon�Rians,`Stormwafer Plans�w%Si1t Fence installed,
<br /> � `Sanitary Faciliti,es-&�1;dumpster?Slte;Work,;Permlt forsutidiylsio�s/large:prnjegts.., .:".,. , . . ,:` . . " ..
<br /> � GOMMlEd3�1R1. Attach(3}-coriipfet�i sets of Bult�fetg Piaiis�plus a�I.ife�Safeiiy Page;(1}set af Energy Forcns.R-0-W Pem�tt#o�new constructlon. �
<br /> Minimum ten(10)woricing days after submittal date. Required onslte,Construcdan Plane,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides&1 dumpsterRSite Wark Permit for all new proJects:All commerctal requlrements.must meet compllanca �
<br /> SlGN PERMIT Attat�(2)sets ofEngineered-Piatis;.,,-- �:..�-. - _� � , � ,
<br /> "'•"i?ROPERTY SURVEY�eguired,for all IVEW_constructlan. � . ° ' T � „-
<br /> Otrectlons: • . � . . . . , � ' ' '
<br /> Fili out applicatlon completely. ,
<br /> Ctwner 8 Cantractor sign back of applfcatlon,notadzed
<br /> If aver�2500,a Nottce of Cammencement is reguired. (AtC apgrade�aver�750Qj
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<br /> Agent(for the contractor)or'Power of Attcmey(fo'r tFie owner)�would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNi'8R PERMlT[1t+lCi.. .-_�(Front of-Appllcation Only)- �
<br /> Reroofs If shingles Sewers Service Upgrades A/C Pences(i'IobSurvey/Footage)
<br /> Driveways-fVat aver Caunter if on pubiic roadwaps..rieeds ROW � �
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