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813-780-002Q City af Zephyrhills Permit Applica#ion Fax 813-780-q021
<br /> ' Buitding Depattment ''^�
<br /> Date Re�sived _ . PhoaeFContactfar�Perniittin � ��1 y G� -
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<br /> Owner'�Na�,�e �'r
<br /> 1� Owner Phone Num6er
<br /> Owner's Address � � fT�► �� OwnerPhone Number
<br /> Fee Slmpie 71tte6older Name ` �� • � Ownar Phone Number `� �
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<br /> Fee Sinnple 7'Itleholder.Address •
<br />, J08 ADDRESS �i I ! Y� �T �1 l�l � LOT# C��
<br /> SUBtlIVlSEt)N � � " PARCEL t13# /!���� � "` C�U � '" � `
<br /> a � , , (OBTAINED F.ROM.PROPERTYTAX NOTICE)
<br /> WORK PROPOSED M NEW CONSTR ADDIAE.T C�` S1GN` �Q � - Q DEMOt;ISH -
<br /> z e. INSTAI.L � ±._ REPAIR �
<br /> PRQP05ED:USE Q SFR Q COMM �,] �OTHER ' '
<br /> TYPE OF CONSTRUC7'ION = Q ' BLOCK ' [;� FRAME � STEEL Q
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<br /> DfSCRiPT{ON OF WORK y �- L_- j'l1 �,� �`�' �'7"
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<br /> Bt1t�DlidG 517.� � � �`SCt FOOTAGE"I��V .H�tGiiT
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<br /> QBUII.DiNG � � VA�CIATION':'OF`Tt71'Ak."CONS'fRt1Ci'iON ` � -
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<br />, QE�ECTRIGAL '-� � � AMP SERVICE Q PRt?GRESS ENEi2GY Q , W:R.E:C. ^
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<br /> QPLUMBINCi $ �� ,
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<br /> I [�tECHAIU{CAL $ �� VALUATION QF MECHANICHI INSTALLATlOi�t , �
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<br /> QGAS CJ FtOOFIl+�G ,CJ SPECfA�.7Y-� OTHER� . . , - �
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<br /> FINISHED FLOOR ELEVATIQNS FI.00D ZONE AREA [�Y�5 ,NO ,
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<br /> BUILDER ; CONlRANY" "' � , ' . � - > -
<br /> I SIGNATURE REGISTERED Y/ N . FEE CURRE�` ' Y/'N' �
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<br /> �, �ddres� . � � - � ttcense#�� �
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<br /> ElEC7RiC1AN:. . C`OMPANY � _
<br /> SIGNATURE � REGISTEREO Y/ N FEEbORRE��` '�Y/N
<br /> i Atldr��s �- ' ` .. . �ICSnSB# � . ��
<br /> PL{1MBER ` , C�MPANI( � �
<br /> SIGNATURE' ' 6_,REGIST,ERED Y�/:.N�: ;FEE CURRE�. Y�/iV: - _ •
<br /> Addre�'s � ' � . - � �.- License;# �� '� . . _�:
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<br /> MECHANlGAl: ' �/r � GONtPAN_Y, �Vy� ��, �J�'t._C.:',t__�-p��°� . '
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<br /> �i1GNATURE; ' , � REGISTERED .� ,N, =- ',FEECUFtREA�._ /�N'.--
<br /> Address t� �(,�cr �� �t ll r (� s , license# � t,l�L.- 1 B�.� � I I .
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<br /> QTFiEFt � ` �GQNIPA�IY - � � , -
<br /> SiGNATi7RE' -� � ' ' ' " ' REGISTERED�' , Y/ N�.: FEE CURRE� � Y/N, ,
<br /> AddreBS� , . �� -. .. . . � tTceFlSe# � . ' t ' �_
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<br /> RESIDENTlAL;,rr;; .Attacf►"{2):Rtof.P.lans;,{2}sets;of<Butiding�Pian"`s;(1}set af�EnergylForins;,.R=O=W'Peiiriit for new c4nstnictton,.., � ' �
<br /> �Minimum.ten(;10};worliing,days�a�ter,;subm�ftai"date:���Required onsite;:GonstnicBon=Pians;'Stormwafer'Plans-w1=Siit'Ferica insfalled,-�"""
<br /> _—-----� � 4' `'�'V Sanitery�Facilttles&1,dumpster,Site Work PenmdfartisulidiVisionsAarge•qroJects,� �- ;-.�: _ '�� ` .�:- �� � '' ', ,
<br /> CQtVlMERCIAI. Attach(3}compiete setis'of Buitdlrig Plaifs'pius a[.ife Safety}Rage;{1}set of Energy Forms.R-Ct-W Permit tor new cons#ru�Eion. '
<br /> Minimum ten(10)woridng days aHer submittal da#e. Required onsite,ConstrucUon Plans,Stormwater Plans wl Sjlt Fence installed,
<br /> Sanitary FadliUes&1 dumpster.Site Work Pertnit for all new projects..All commercial requitements.must meet aompliance ` �
<br /> s�6N PERM�r Attac�{z�set�o#Eng�ne��ed�Pl�ns:. = >�:w , .�_ f� � - - - - � � ,
<br /> •`•"PROPERTY SURVEY reguired,for all,_IVEW,aanstructian.. -
<br /> Dlrestions: , t : . �
<br /> Ffll out applicaBan completely.
<br /> Uwner&Contractor sign back of appltcatian,notarized
<br /> If aver 52500,a Notice of Commencemen#i�requ�red. {A!C apgrad�s avee$7500)
<br /> ent far the""� '":r',;f,, ; .
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<br /> Ag ( cantractor)or Powe�ofAttomey'(fo��Uie owner)would beµsomeone with�notarized letter from owner authorizing same
<br /> dyEEt THE CttUNTER PERMI'f'i1H{�- .-(Front-of-Appllca�on flnly)� �
<br /> Reroofs If shingles ;�Sewers�- �--. Service,Upgradas_A/C Fences(Plof/Survey/Footage) _
<br /> Drivawaya-f�iio#over Counter.iffln,public,madyi+ays.:neetls FtOVit � � ' � .. R�5
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