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a�3-�so-oo2a City of Zephyrhills Permit Application Fax-813-780-0021
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<br /> Buflding Deparhment '�
<br /> Date Recetved
<br /> �: Phane:Canlact�forFermittin �S%�— �C?�� _ ��
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<br /> Owner's Name Ownar Phane Number
<br /> Owner's Address 1��� �: � Ow�er Phone�Number � �
<br /> Fee Simple E7ltleholder Name � � � � Owner Phone Number � �
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<br /> Fee Simple}Titleholder Address
<br /> J08 ADDRESS t.iL��� � txL �� �(` ` 8`-�'1� �S S T� LOT# C�
<br /> suso�vis�oa ��� � p;�c��..�u# t��. —`�.t�—.�-��,t�`�Q= c�c�c� —c�c�9�
<br /> , . (OBTAINED F.ROPA PROPERTY—TAX.NOTICE)
<br /> WORK PR4Pt?SE� NEW CONSTR ADDlA�3' �,] SIGN'� Q -� Q DEMOClSH
<br /> \. e. INSTALL 8+ , REPAIR ° .
<br /> RROP05ED:11$E • Q SFR Q Ct�MM ' � �THER ,
<br /> TYPE OF CONSTRUGTION Q ` BLOCK " '[,� FRAME � STEEL Q
<br /> DE�GRIFTION OF WORK` µ �'��'< C�`��" �'12�,,.. C��,,,�
<br /> BU1LDtNG SIZE` �� � 3Q�FOOTAGE `�� .. HElGtIT tC�,� ,
<br /> �SUIt.QING r� � �O _� VALUATtONsqF�i'Ol'A�:;CONSI'Rl7CT1�N t . ' ,
<br /> • L_�T_ ,
<br /> Q E[.ECTRiCAI $ ' AMP SERIJICE: "` .'Q Pi2{OGRESS ENEI2GY Q -.'W:R.E:C.
<br /> [�]PL'UMBING �f_ � , ,
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<br /> , QMECHAPl1CAL � � VALUATION OF;iyECNANiGAI INSTALIATiQN
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<br /> Q _GI�S �� F2QOFIMG ,Q Sf?EGIAI:TY:.�]_- ,�•OTHER- .
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA , ;[�YES. ,NO . ,
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<br /> BUl�DER . CflMFi4NY�° >. : � -. . �
<br /> SIGNATURE REGIS7ERED Y/ N FEE CURREA Y/N ,
<br /> Address . ' License#,� �
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<br /> ELECTE21C11'!tN- ` �COMfa'ANY � ' � -
<br /> SiGNATURE � REGISTERED Y/ N FEE CORRE�'` '' '�Y/N
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<br /> AtldPe�s . , lfcensB# � - �
<br /> PLUMBER'y � GOMt��fitY •;:: ` . ..r =�,;. �.. ��f� ` , ..
<br /> SIGNATURE' � , REGIS.TERED.; ',Y_/�:N.�a, =..eEEE;CURRE� Y•/N;" �
<br /> AddtaBS y:v ' �. , :�LiCBttSe,# ' - . ��:
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<br /> MEGMANiC�tI: - CONtp�+lY � � � . �.: � �_� . ' ,
<br /> SIGWA7'URE � 'g` REGI87ERED Y/_N. . �,FEE�CURRER=� Y/.N � �
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<br /> Address° - . _. - , . �liceiise# �_..�,
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<br /> 03H�it `¢� � _ j(j :COM,PANY" � .�n, a:C�'\��C�'�.d� �
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<br /> SIGN�1TURE �" " . ~ " 'REGISTERED" "�Y/ N.;.�: — �`'F CURRE� Y/N
<br /> Addrass . - � . , , , , ` lic�nse# C�.0� �� `-�" t� �` '
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<br /> RE3iDENTi�4l;;�:� :Attz�cFi'{2).,PIofi,P,laiis;,,(2)`setis of�Biiilding!'Plan`s;%(1}sef aF'Energy�Farins;�R=O=W:Peririff for new cor�struct�on, ,. _ `
<br /> _;:Mi.nlmum,tena(:10j;working:;d@ys',a#ter subritittal'date..;;R`equtred onsite,:Cnnstiuc�on°Plans,�Stormwa'te'r•'Plans:w%Silt°Fence-installed, �
<br /> `: ��'�:'Sanitary FacfliUes,�&1,.dumps.ter;-h$ite'Wo,r,k�.Permiffqr:subdivision�Aarge;pro]ecfs, _,.:';>: _. `�- � �' �`� - '� "
<br /> COMMERCIAI. Attach{3)cbmptete sefs`'ofBultilliig Plans`plus a�1.tfe SaEety Page;{1}set af Energy Fatms.R-0 W Petmit far new`constnsctian.
<br /> - Minimum ten(10)working days af#er submittal date. Required_onsite,Constructian Plans,Stormwater Pians wi Silt Fence Installed,
<br /> Sanitary Fadiities&1 dumpster.Site Wark Pertnit for all new projects:.All commercial requirements.must meet compllence
<br /> &iGN P�RM1T AttacFi(2}sets of�nglneeXed;Plan's:, _ ° � . � , - - ,
<br /> '•"'PROPERTY SURVEY requlred,for aII;NEW constructtan. -
<br /> DIPBG#1QAs: ,_ ' ,
<br /> Fill out applicatlon completely.
<br /> Owner&Contrackor sign back of appllcatlon.notr�eized
<br /> If over�500.a Notice of CommencemeM is tequtred. {AtC t�pgradas avar$T540) ,
<br /> '" Agent(far lkie con'tractor)'or PoVirsr of Attbn'mey'(far tFie owner)would be someone with notarized letter 1'rom owner authorizing same
<br /> DVER TH�COUN'fER.PERlVIlTTfNG.. {Front of,Appllcation flnty}T _ _ , ..
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Foatage) ' ' _
<br /> Drlveways-htat aver Caunter if on pubtic roadways..needs ROW' ., - ��,.,.°'�n .""`"""",{'•_`.". .. :~,,.. . '-. . . • .
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