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813-7$0-0020 City of Zephyrhills Permit Application Fax 813aao-oa2�
<br /> > „ Buitding Depar#ment L��
<br /> Date Fteceiv,ed . Phone=Cantact far=Paemitttn - _
<br /> Owner's Name � U � Owner Phane Number � � $�� -�� �5
<br /> Owner's Address �Y� Owner=Phone.Nurober -�— �
<br /> Fee Simple Tltleholder Name Y • Owner Phane NumbeF �� �
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<br /> Fee Simple i.Titleholder Address
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<br /> JOB Ab�RESS ��� � � � " LOT# �
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<br /> SUBDIVISION � � PARCEI.iD# '
<br /> . � , , _ (OBTAINEDFRQM.PROPERTY.TAX.NOTIC6)
<br /> WORK PROpOSED �.NEW CONSTR ADDIALT �� S1GN" �Q ' Q DEMOLISH �
<br /> p �: INSTALL , � �: REPAIR '- '
<br /> PROPOSED•USE = [� SFR [� COMM [� OTtiEFt " '
<br /> TYPE OF CdN3TRUCTIOId C] BLOCK " [� FRAME [^] STEEL [�
<br /> � �c , -�.�-. . ,
<br /> DE3CRIPTIQN OF WORK � � � 4 �C
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<br /> BUILDING SIZE ��, ,�`S4j�00TAGE C��, . .,tiE1,GHT�C ,,,� „
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<br /> BUttDING $ Cs a - . .: -
<br /> � �� .�E" ��� VAIIiATIO1V`?JF Tt�`TA!CONSTRt1CTiOtV ` '
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<br /> QE�ECTRICA� $ AMP SERVICE Q PFtO�FtESS EI�[ERGY 'Q . -W:R.E.C. ^
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<br /> OPLt1MBIN� '$ n,
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<br /> QMEGHAI�lICAL $ ` ' � 1tAk;UATtON tOF;MECHANICAL tidSTALLAT{ON. �t` �_ , ,
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<br /> QGAS y Q ROOF{I�lG ;Q SPECiA1.TY;C� � ,.OTN�R� ' .
<br /> FINISHED F,LOOR ELEVATIONS �� FLOOD ZONE•AREA QY�S. �NO
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<br /> BUII.DER ' ' �� COMPAHY�`• �� t � � .
<br /> SIGNATUR� REGISTERED Y/ N �e Curt�n ` ` Y/N`
<br /> A,ddress �'� ��S � �� ��S 1� 1- ° , � ` Gicense#�� �
<br /> ELECTRIGi,AN:. - � � `GOMPANY - •
<br /> SIC;NATURE REGISTERBD Y/ N FEE CURRE��'' ° "Y/N ''
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<br /> Addr��s � : � • .. _ License# [ I
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<br /> PLUMB�R ; ` � - -. �COMPANY , " - : . :. ' .
<br /> SIGNATlJRE' ' r�' REGIS7ERED:. .4 ,,.. , Y/r,N. <FEE CURREK Y/iV: ._ ,
<br /> Addras� ' , , , � .. . � - I,.icense,#� : . , .
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<br /> MSGHANICAL , ` � • _ ,CQMP/lNY < � : - Y - .:,,<,�.;.',�V;, . .
<br /> SI(3NATURE �' ` '� RE(31STERED; , `Y./..N, - ,F �ECuwtEn,�� Yi/-N - • .
<br /> Addres's�� , . . 1 r - ;� ,.� .. y , • � $,y- Y , _4 4 , license#�( _ .. . ..,. � •
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<br /> Oi'FtER " " . , ° ' F GQlVIPANY = � • • •- - =4
<br /> SIt3NATURE -, : � • . ° - " . ?� ` N
<br /> � �REGISTERED`' � Y/ N,. ` FEE CURRE� Y L
<br /> Address ,. T � , - ;} - , ` ' � " {:icerise# � . � �+
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<br /> RESIDEN'flJ�t:,F�� tAttaeh`{2);Ptot�Flaris;'{2}sets�ofBulEil3ng�Plans;`-'{1}sef of�Energy�Farins;'R�1N=:Peii»1#far new caiistniction,,
<br /> ,„_<{Minimum�ten�(�1�,Oj�uvo.rking;days�,after:submittal date:�Required onstte,::Cohsttu�cVon�Ptans;Starinwater"Pian's w!Siit'Fence ins#ailed,
<br /> ,�< � ��Santtary F-'actllGes=&�1 dumps,ter,Sfte Wortc Perrnit#or subdivislonsllarge�Pro7ects�:r...;�:" .. ':�--'U ��_"-,,�� �„ � -`
<br /> COitPiM�RGl�L --Attach.(3)compte2a`ssts of Buitding Flans ptus a Li€e�Safetyr Page;(1}set af Energy Forms.R-Q-W permtt tar naev canstru4tton.� �
<br /> Minimum ten(1p)wortcing days'after submittal date. Required onsita,ConstrucUon Plans,Stortnwater Plans w!Slit Fence instailed,
<br /> Sanita,ry FacfliUes&1 dumpster.Site Work Permit for all new:prcjecCs.All commerGal requlfements.inust meet compliance�--_ __. _.__
<br /> 516N RERM4T Attacti(2)`sets of Eng�neer`.eii;Ptans::, •,;�µ > � ;_,, .,_ " �
<br /> ""PROPERI'Y SURVEY requlred,for all_NEW constructlon..
<br /> [3I1'8CfI0A14'i. ^ . ,_, .
<br /> Ffll ouk applica8on completely.
<br /> Ownec 8 CantracEor stgn back of applEcatlon,notarized `
<br /> if over;250q,a Nottce of Cammencement is r�qulred. tac u�raa�s over srsaaj „ �
<br /> " Agent(for the�contractorj or'Power ofAttomey'(fo��Uie�ownerj would be someone with�notarixed letter from owner authorizing same
<br /> DVER THE COUNTER.PERMIT7'iNG- --=�(Front of-ApplicaUon On{y}��� - � _
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) _
<br /> _ _ .� • - , � , , , � , , ._..
<br /> Drtv�waya-Nat over Counter if on public ioadways..tieed`s ROW'.
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