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��a-7eaoa2a Gity of Zephyrhills Permit Appl�catian Fax-E113-780-Q021 ��
<br /> _ _ ; Building Depertment -
<br /> Date Received .-��i� � ; phaneiContactfonPermtttin ' — `
<br /> Owner's Name Owner Phone Number /�.S 1{ 2 •'/ ���/
<br /> ' v ' � . ..<�.
<br /> owner's Address �fs�`� ��.� tlwner Phone Number
<br /> Fes 51mpIs,Tltleholder:Name Qwner Phone Number '� ' �
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<br /> Fee Slmple�TltRehalder l�d J � . � '
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<br /> JOB ADDRESS � �� •.'�'Y LQT# �
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<br /> SUBDNISION , PIIRCEL ID# �
<br /> i , „ (OBTAINEp F.ROM:PROpERTYTAX NOTICE)
<br /> WORK PROPOSED ._NEW-CONSTR ; ADD/A�T � S1GN` Q �` [� DEMOLISH
<br /> � ',e- INSTALL 8 <- REPAIR . `-
<br /> PROPOSED�USE Q SFR [,� 'COMM � OTFtER " ' ° . � "
<br /> TYPE OF CON3TRUCTION Q " BLOGK " Q , FRAME �] 'STEEL 'Q
<br /> DESCRIPTION OF WORK � /" �
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<br /> BUt�DtNG StZE' t 1..��D St�FOOTAGE ' �DdO , : ,HEtGHT�' f� � ,
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<br /> UILDiNG $ �� �� { VALUA710N OF=TOTAL CONSTRUCTION s '
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<br /> QEt,ECTRIGAL �� AMP SERVICE Q PROGFtESS Et�ERGY [� W.R:E:C.
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<br /> [�PLUMBING ��� ' � '
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<br /> QMECHANICAL $ '� VALUATIQN OF;MEGHANICRl.INSTAILATlON
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<br /> �]Gi4S �� ROOFING Q _ SPECIALlY [�� OTHER �
<br /> FINISHED Ft�.00R El.EYATlONS ! `� FLOQD ZONE AREA , QYES. ,, NQ
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<br /> SUIl.QER , /��.��7 ',� ,�- f 7 rCp ANy� �
<br /> SIGNATURE V)G��'�''r �GtST�o Y! N �Cu�n ` Y i N .
<br /> Addres,s � Glcense#'I' ` � ' �
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<br /> ELECTRiC}N,►N COR!lPANY�'
<br /> SIGNATURE � REC,ISTERED Y! N FEE GURREts= -' Y/N' '
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<br /> Addre� . , � . . . Ucense# I ,. .. . �
<br /> PLUMBER �� - . GOMP.,ANY ~ �,
<br /> SIGNATURE ' REG�STEi�D .Y,.[g�N.� ;_ .;F'EE CURREP� Y/3�I.
<br /> Addre�s �_ :L'icense.#��� - .,�..
<br /> � ^.-- — - , - ,,,
<br /> , � ,..;_;, , > >. � _ �
<br /> MECHAt+lIGAL' ' � � � CQ�hftP.A1+lY • � " �
<br /> SIGNATURE� � ' ' ` 'REG.ISTERED : �...Y.! N . -PEE CURRER-; . .Y!N
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<br /> Address{' w ' � - , � . , � , � • � . . . , License# �—..�--.,—..—�
<br /> ;f. . _ - - � • -
<br /> OTHER • � � , . `iCOMP�AI+1Y , �
<br /> SIGNATURE .� � '"�,. 'j'" �' ' , ' � • 'REGISTERED� ' � Y/ N:. ' FEE CURREt� Y/N.
<br /> i4dilre8S ' ' GceiiSe#.1 ����
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<br /> RESIDENTlAL,, :A►tacfi;(2),.Plot�_P,lans;.(2)set`s`-.oftBuili!ingil?lar`is,'{1}.'sefaf,.�`��•,` � " '•-��.',. � '
<br /> °EnergY Forms;�R=O=W=Peririit for new cansttuctiori, '
<br /> � •Minimumrten°.�1,.0:warkin da , ". . '; , � � • ..
<br /> a ,, a (� ) ,. . � g,_ .ys�;afte,r.:subrriittal tlate.,:R'equlred ansite,=Con'stiucBon�Plans;'Storiawate'r'Plans w!Stlt'Fence InstaAeil,
<br /> ��� 'Sanitary Fac�titles&�.1,=.dumpsterSSi#e Worlc,Permit for subdivislqnsJiargeaprujects.- •,., .:° ' � � `� � °-
<br /> CQMMEEtClAL Athach(3j�carnpiete sefs`of 8iiltili'tig�Fiaiis pius a�Ufe Safety Page;(i)set of Energyr Farms.R O-W Parmtk for new ccnsWction.
<br /> Minimum ten(10)working days after submitNal date. Required onsike,Construc8on Plans,Stormwater Ptans w!Silt Fence instaUed,
<br /> Sanitary Facilttles 81 dumpster._Site Work Permit fo�ail new,projects..All commerclal requlrements.must meet compllance
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<br /> SlGN PEFtM}T Attacfi"{2}"sets�af'Engliieered�Pians:,,. ..~;- . :� .. _, . . :
<br /> "'•PROPERTY SURVEY required for all_NEW cor�stcuction.. �
<br /> --_. . ._�. - .,K.
<br /> Dlrections: - _ . - � , '. ,
<br /> Fill out applicadon completely.
<br /> Owner&Contractor sign back af applicatlon,natarized
<br /> If ovar�Z500,a Natice of Commencement is required. (NC upgrades over ST500) . '
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<br /> � " Agant(for the contraator)or'Power df Attbr`tiey(far ttie owner)waulcl be aomeone wifh�notarized tetter from owner authortzing same
<br /> OVER THE COUNTER.RERMI7YING- - •(Front of Applicatlon Onty) - -
<br /> Reraofs If shingles Sewers Service Upgrades R!G Fences{PIoUSurveylFootage} _
<br /> Drivewaya-iVot over Counter if on pubiic roadways`..needs ROW
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