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8��-�saooaa City af Zephyrhills Permit Application Fax-813-780-Q021
<br /> BuAding Departmsnt . `'�
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<br /> bate Received �i� . �C� . ) p}�one�Contact for Fermittln �
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<br /> Owner"s Plame �'�t'`-"�- ('1�C ��P"�-'1 Owner Pho�e Number � �''�"���
<br /> Owner's Address ,a (P c�,1� 6 Owner Phone Number �Ol;T �I 7''I� J � I��"'"�
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<br /> Fee Simple TI#letioider.Name �� - ' � Owner Phone Number �� �
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<br /> Fee Simple Titleholder Address
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<br /> JOS ADDRESS �Sr J�� �3'�t�iC� �tf/�--' LOT# �_�
<br /> SUSDIVISI4N �� � RARCEL IQ# �
<br /> f � , . (OBTAINHO FROM PROPERTI:TAX NOTICE)
<br /> WORlC PROPOSED �.NEW CON5TR ADDIA�T �� S1G3+1 Q - Q pEMOLISH
<br /> � :e. INSTALL � - REPi41R
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<br /> PROPQSED:U9E Q S�R Q COMM � OTHEF2 � �
<br /> TYPE OF CONSTRUCTtON = 'BL.00K " ' � fff �
<br /> Q Q FRAME � STEEL 'Q r , �
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<br /> DESCEt1PT10N OF WORK � �'�
<br /> BUILDFNG$IZE � �'SQ'FOOTAGE.�"�_ . .NE1GFlT���r--_�� .,
<br /> QBUILE}ING �_� . .n..,.. . �.- .,�,� } � ' �WIG��`���Zdt�✓
<br /> VALk3A710NsOF"t'O'EA�'COiVSfif2l1CTION �� S`�
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<br /> �ELECTRtCAI $ ' ` AMP SERVICE •'Q PROGRESS ENEF2GY Q W:R.E:C.
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<br /> [�PLUMBlNG� $ �
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<br /> �MECHANICAL ' $ VALUATION OF�MECHANtCAI INSTALLATlOi�! � . .
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<br /> QGAS �' E200FING ,-Q SPEClAI.TY � _ OTHER� . -
<br /> FINISHED FLOOR ELEVATiQNS �� FLOOD ZONE AREA QYES ,NO
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<br /> StGNATURE °// REGISTERED Y/ FEE CURREA Y/N�
<br /> I Address � - ' - Cicense#�� �
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<br /> ELECSRtClAN.. , - , , , GOMPANY � • �
<br /> StGNATURE � REGISTERED Y/ N FEE GURRE�a' ` <Y/N
<br /> ' Addre�'s ' , ,� , Clcense_# �. `�
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<br /> PLUMBER :_ :.GOMPAtQY � �;". ,
<br /> SIGNATilRE' ` ' ` , �REGISTERED Y:,/,.N , ,F,'EE.CURREK � ''.Y:�/.N' � ,-�
<br /> Addres"s - . . �, ` , _ . Ucense,#_�1<. "r�: .
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<br /> MECHANlGAL: ' GOMPANY .�,� � . . _, .
<br /> StGNATURE '�' ' " � '' REGISTERED, � ,.YJ N. _ FEECURRE�:� Y%N, •
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<br /> Addre�s, , - , , ,; . ` . , . License#
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<br /> OTHEEt - - � - , � �:GOMPAAIY,. ; � ` . _
<br /> SIGNATURE �-. � • = - '' � REGISTERED'.� -. � Y/ N,.- FEE CURRER Y/1�) ,.
<br /> Ad8�888 ,. . .. .. Y . �s' ,.` { _ClcetiSe# �� � , � -�� .
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<br /> RESIpEMTlAL'„? :Attacfi"(2),;Rtot�Ptaas;,(2)sets-'of'Buitding�`Fiarts;'('f)setofxEnergy�Foiins;.�R=O=WPecmlt#ornew'constsuction,,_ ' ° . �
<br /> � Minimum ten 10 w ` - .. - • - .. , - -�- �'. . � - .
<br /> - orkin tla . , " � ;
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<br /> ; ,,.-�,__ ,,,_ . }.: •:{�y );.�, r gs ..ys°afte.r;;submiftat date:�.Required onsite;�Gonstiu'c8on Rlans;Stormwater Plans wi Silt°fence instalied,
<br /> Santtary Faciiitles;&=1,,dumpster�Site°Wortc;,.P,,ermlt�for sukidivisions/large:q,.rojects;: -:: .�� .,` ��.`� ' :,�.=� ;�� , -
<br /> GOMMERGIRi. Attach{3)•comptete sets of Suftdirig Piaits ptus a��l:tfe Safr�ty Page;{'1}set of Energy Farms:R-O-W Permit#or rsew constnscUon.
<br /> ___ Minimum ten{10)working days afier submitta{date. Requlred onsRe,CanstrucUan Ptans,Stormwater Plans w/Slit Fence tnstalled,
<br /> Sanftary FaciliHes S 1 dumpster.Site Work Permik for all new�projects..All commerGal.requi[ements.must meet comptlance � �
<br /> 51GN PERMIT Attacti'(2)seis ofErigt�;ieer,ed;Plaiis:�.= :��� �� . � . ' ` . .
<br /> '•""PROPERTY SURVEY�equired for ail NEW constructlon._
<br /> 0lrectlons: � _ ` , �
<br /> F01 out appiicadon completely.
<br /> Owner 8 Contractor sign back of applicaUon,notarized
<br /> � [f over�2500,a NoEtce of Commencert�en#Is t�equlred. {A!C upgrades aver ST500)
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<br /> `" Agent(for the�conti'aotor)or`Power of Attbiney'(fa��tFie owner)would be�someone with�otarized letter from owner authorizing same
<br /> �VER THE GOUNTER PERMtTTiNfis - ,(Front of-Appllcatio�Only}� . . ' �
<br /> Reroofs If shingles Sewers Service Upgrades A/G Fences(Plot/Survey/Faotage) -,
<br /> Driveways-Not over Counter tf on public roadvirays..iieeds ROW' �
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