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813-�ao-ooao City af Zephyrhills P�rmit Application Fax-813-780•ao2�
<br /> Buitding Qepattment :x°
<br /> Date Recelved : .. pl�pne=Contacfifor Rerntittia - - — '
<br /> Owner's Name � `f""� r�1�1G Owner Phane Number
<br /> ` S�2 �.�
<br /> Owner's Address �� .� 6L�O/U �!� � h /' .` Owner•Phune.Number� � �
<br /> Fee Simpie Tlkieholder Name �� • -� Owmer Phone Number '� �
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<br /> Fee Simpla Tltleholde�Address •
<br /> JOB ADDi�ESS � 'r '�,,.�'.. !/LS �C .�S�(2 LOT# ��
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<br /> SUBDMSION � . � PARCEL ID#
<br /> � - ° , _, (OBTAINED FROM PROPERTI!TAX NOTICE)
<br /> WORK PROPOSEQ , ,.NEW CONSTR� ADDIAi.T -[� StGN' Q Q DEMQ�ISH
<br /> � INSTAI:L , REPAIR - .
<br /> PROPOSED:USE • SFR- Q COMM � OTHER `
<br /> TYPE OF CONSTRUCTION" BLOCK ' 'Q FRAME , � STEEL Q
<br /> oEscrt��no�o�waR�c� - `lf U✓-�-� � a�ir- �� s'' r�,v � �+?.�-�t-t� ��/�'
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<br /> Btt1�D1iVG SlZE � �`SQ FOOTAGE�� . ,HEIGHT��-��� .,
<br /> QBl!lLDtNG ��] VAl.UATION�tOF'('O'1'ALCONS7F2lICi'10t�t .
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<br /> QELEGTR1GAl �$ �� " � AMP SERVIGE �Q PROGRESS ENEFtGI' Q W;R.E.C.
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<br /> OPLUMSlNC�� ;���� '
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<br /> ECHANICAL �$ "�'A � VAl:UATION OF�MECNANICAL 1[+iSTALlA7tQN.
<br /> � t_�l �' �.. . , .
<br /> �$ Q ROOFING ,Q SPECIAL7Y �� QTFlER� . -
<br /> FiNtSHED FLQOR EI.EVATIQNS (��� FI.00D ZONE AREA QYES ,NO , . .
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<br /> 8Ul�.DE�2 ; COMPAt+tYi, .. " "
<br /> StGNATURE REGISTERED Y/ N �EE cua�n ` Y•/N "
<br /> Addre�s - � - Ctcense# �` �
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<br /> ELECTRICI,AN;. , co���r .
<br /> SiGNATURE � REGISTERED Y/ N ��cuRr�n=• • ` Y/N `
<br /> Addre�s . - � � y . _ License# [. . .;�: � � �
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<br /> PLUMBER ? , . . �COMPANY �, ,
<br /> 5(GNATURE' ' „ .REGIS.TERED.- , *,Y./,-N+. ' y,�E,cuFtt;En- ,` Y-/N: �• -
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<br /> MECHANlGAl:' " � GOMRIWY � - :1'�1• :f- • �= „�� " . ,
<br /> StGNATURE r'�,.�--= ' =°< ,..x:::;: `
<br /> �/� REGISTERED.r .,Y,/.N: � FEECURRE�; . Y�/�N'. ,
<br /> Addre��` - :ZB �z`/2-`�f`�-O, �� .. �T�l�� .��� °,�'��,: -: i� > � , �
<br /> �3.bt. Licanse#
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<br /> t?3HEEt ;' ' , `�COlUf PANY��.� - � _
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<br /> SIGNATURE •- • '� � ' " " ' ` ` �' REGISTERED'' ' � Y/ N . �FeE CURRE�' � . Y/N
<br /> Addt�e�s ,� _ � � � . . � Llaense#•� _, � . _ :<�' . �
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<br /> ttESIDENTlAl:.y:. :Attacti{2)�i?tot P,laris;:.(2j§ets;of:Buff�lfngtFians;'(9)'sef af�Energy.Faiii�s;:R-O-W-'Petirilt far new coi�structlori,= ' ' '
<br /> -; ;;�� Minimum,ten;{;1Q};working�days„afte.r,:submiftai�date.��:Requi�ed onsite,.Con§tiu¢Hon`Plans;Stortnwater Pians w/Stit'Fence instailsd,
<br /> , ,{. �Sanitary Fa,cflltles;&�1,;dumpster Site°WorlrPermPt,#orsutididislons/Ierge:proJecfs' :; .;: ' "..° ;; , •
<br /> _ GQMMERCiAL Attach{3)�comgiste sets'of 8'uitdirig'Pians pSus a�(fe SaSefy Page;{1}set of Energy Fonns.R t?•W Pemtit far new constructian.
<br /> �,;,` Minimum ten(10)working days a�ter submittal date. Requtred onsite,CanstrucUan Pians,Stortnwater Pl�ns w/Sllt Fence installsd, ,
<br /> � .._,__ Sanitary Facilitles&1 dumpster.51te Wark Permlt for all new projacts.All commercial requiremen�mu�t meet compliance �
<br /> SlGN PERMIT Attach�(2}sets oi�ng�neered=F��nS:.:�-; :�--'—_. - -.. - �- ----,- ` __ - ' _ ... -
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<br /> -�-, ,R'iY SUR1/EY reyulrea for ail_NEW constructlon. � . .. _ ;
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<br /> �?11@Ct�QRB: , r,, ,
<br /> Fill out applicadon completely.
<br /> Owner&Gantractar sign back of appl(catlan,notarized
<br /> If aver�2500,a Notice i►f Cammencement ls required. {AtG upgrades over yT50Qj
<br /> 4R `•" •tt�r�_� � ..-
<br /> Agent(for the con'tractor)or"Power of Atkomey(for�tFie awner)would be someone with�natarized lett�r from owner authorizing same
<br /> � t}VER THE CC}UNTER.PERMI'fTiNG- --{Front af-Appllca�on-Oniy}�- � '
<br /> Reroofs If shingles Sewers Service Upgrades A!C Fe�ces(Plot/Survey/Footage)
<br /> �O Iveways-Not over Counter if on public raadwaps..rieeds ROW �
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