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813-780-0020 City af Zephyrhills Permit Application Fax-F113-780-0021
<br /> / Buitding Depattment . '�'�
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<br /> �Recelved • • � ° Phone�Goritac#�far�Pe�rilttin —
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<br /> wner's Name ���','� ���'2��� . Owner Phone Number �l 3 ' .�/' �� l �'
<br /> Owner's Address � �` � �
<br /> "� � �J �f�` � (, r /�V� � � OwnerPhane Number ��
<br /> Fee Simple Tltle6older Name � • � ' Owner Phane Number �i I
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<br /> Fee Simple Tltl�holder Address
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<br /> JOB ADDRESS � `�d � �' ` � �� �V� �/�` LOT# C�
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<br /> SUBDIViStON � � PARCEI.ID# f I ��D � t o �s'1 d „11 Z� 4 U �Z t v
<br /> . � (OBTAINED F.ROM PROPERTYTAX NOTICE)
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<br /> WORK PRO.POSED ...NEw CONSTR ADDIALT [� S1GN [� [� DEMOt�ISH
<br /> � INSTALL REPAIR
<br /> PROPQSED USE Q SFR- [� COMM [� OTHEF2 ` ' '
<br /> TYPE OF CONSTRUGTION � Q BLOCK " C] FRF►ME �] STEEC Q
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<br /> DESCRIP710N OF WORK �+, ��G`�'p C� � l�C . S�� �m 1�S O-�� j� Z�i(f/� ,
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<br /> BUIi.D1NG SIZE ��" �"SQ FOOTAGE�� HEIGHT"C___—_� .
<br /> QBUII.DING $ �. . . �
<br /> i , VAIUA't10N`tOF TOTAI CONSTRUCTION
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<br /> El:EGTRICAL �$ � � AMP SERViCE � PROGRESS ENEI2GY Q W:R.�.C.
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<br /> [„�MEGHAi+lICAL $ ' �.. ��'" VALt7ATlON OF;MECMANICAL•lNSTALLATfG?N- �'���I
<br /> QGAS [� RQOFING .Q SPECIALTY ..���� OTHER� , �
<br /> FINISHED FLQOR ELEVATIONS r�� FLOOD Z4NE AREA [�]YES NO
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<br /> eu��o�� ; cai��i�r � -. _ , - �
<br /> SIGNATURE REGISTERED Y/ N FEE cURttE� Y PN`�
<br /> Addre�s �� � ' License# � " �
<br /> '� "xjavc�'�r �ZoGd2s .. � aG �� fsc,��
<br /> ELECTft1C1AN, , � 'COMPANY ' �
<br /> StGNATURE '' �.rt�G�7'�R�^, ..1P/ N FEE EUitRE�`.` : _�Y 6 N
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<br /> Aderess '31� �'^�C r�7'If pf��9E C'/J`� . , ticense# .:����_o t 2Z'L `� ° �
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<br /> PLCJMBER �� , C�MPANI( • �
<br /> SIGNATURE' r' � ,REGIS7ERED . , Y„/�.N�� � r�„FEE:CURRE� � ` Y-/N. : r,-.- '
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<br /> AddrBSs `' , . , . . . . � LiC@TtSe,#.��. . �: .
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<br /> MECl�IAAIIC�tt:" ' � � �- . GQNIPANtY _ . , .; - , . . � ' ;
<br /> SIGNATURE `' ' � REGISTERED ,� , Y/,N, ; .FEE,CURREP,=� Y/5N �
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<br /> Address i'` � ' ,� . , ` ,. . , , ,_ _ License.# -
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<br /> Q7FlER �' � - � _s�CO1VIPJ�t+tY.: - . _ -
<br /> SIGN�4TURE -. � ° ` �' REGISTettED ' Y/ Na. FEE CURREA Y/N_
<br /> Add�ss , � u __ _ .. � ' �icense# ��� ' � ` �� .
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<br /> REStDENTtAIi,.;t :Athacli'{2},,Plof�F,latis;:(2}sets=of:Buil�3ng�Plans;�{1)sef'ofEriergyi>�aims,,�R=O=WP_eriri,ltfornew;cbnstnic#Ion,,, '
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<br /> Minlmumr.tem(•1.0)�u,yorlcingjdays;afker�submfEtai date:;.Required onsife;�GonstiucUon-Rlans;Stormwater Plans wTSOE'Fence installed,
<br /> "✓,�`Sanifery Fadlldes;&t1r,dumpste,r,-Sfta;Work,..P,,ermlt#or,sutidivisions/large_proJeofs. ,_:':��� ° � � ° - . - �
<br /> COMMERCIAL Attach{3)completessets of Bulltli�g Plans�plus a�ife Safety Page;(1}se#af Energy Foims.R-t!W Permt##or naw wnstrvc�tlon.
<br /> Minimum ten(10)working days after submlttal date. Required onsite,Construc�an Plans,Stomrwater Plans w/Silt Fenc:e installed,
<br /> Sanitary Facilitles&1 dumpster.Site Wark Pertnit for all new:projects..All commercial requl[emen�must meet aompllance •
<br /> SIGN PERMIT Attac�{2}`sets of�Eiig{,'iiee�ed=Plaris.�,.�_:-;.-- _ . � - . . ,
<br /> ""'PROPERTY SURVEY required for_al,l,NEW_aanstructton..
<br /> Dlrectlans: � . . _ .
<br /> Ffll out applicatlon completely.
<br /> Owner&Contractor sign back of applicatlon,notarized
<br /> tf over�z500,a NaNce af Commencament 1�reqnired. {AtC upgrades over S75o0) .
<br /> ��:��.r'�`s���;��,-.
<br /> " Agent(for the contractor)qr'Power of Attbmey(far the owner)wiould be someone with notarized letter fmm ownar authorizing same
<br /> ' OVER THE COUNTER,PERMlTTlNG- - (Front of•ApPHcation Only)- , w'f � ' . �
<br /> Reroafs if shingles Sewers Service Upgrades A/G Fences(PIoUSurvey/Footage)
<br /> Driveways-Not aver Counter if on public roadways'..�eed`s ROW
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