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a��-�eaao2o Ci#y of Zephyrhills Permit Application Fax-s�$asaoo2�
<br /> 8uiiding Departrnent .`'.
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<br /> Date Recelved . - � P..honexContact�for Parmittln
<br /> Owner's Name� ��P�^'`2 (TE'�( �'�T-�i�''�'e r0 (�C��� Owner Phane Number
<br /> Owner's Addre�g � � ��(�CGcs� � l�C Owner Phone Number
<br /> Fee Simple�Titfeholder Name � • � C►wner Phone Number I �
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<br /> Fee Stmple Tltlehalder Addresa
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<br /> �OB ADDRESS LOT# ��
<br /> StIBDIViS10N � � PARCEL tD# . .
<br /> , (08T/llNED F.ROM.PROPERTY.?A?F NOTICE�
<br /> WC1RK PROPOSED „NEw COt357R " - ADDIAI_1" [� SIGN` Q 0 DEMOLlSH
<br /> � e. INSTAI.L � REPAIR
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<br /> PROPQSED;USE • Q SFR (� GOMM �� O'iFiER
<br /> TYPE OF GONSTRUCTION = Q' `� BLOCK " Q FRAME " STEEL Q
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<br /> DEBCRiPT10F!OF WOR1C'� ��� Sr /U'" �— `�.
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<br /> 8tlII.D1NG 81ZE �� St.�FOOTA{'sE�-� � H�IGHT�,�� .,
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<br /> [�BUILDlNG $ VA�UATtON`'OF'TO'Tfit CONSTRt1CTiON �
<br /> 5
<br /> QE�EGTRICAL $ - AMP SEFtVtCE Q PROGRESS ENERGY [� `"W:R.E:C.
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<br /> QPLUMBING ��� � .
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<br /> QMECHANlCAL $ ` VALUATION OF:MECHANiGA�1(�EBTALLAfilOPI. ��� � ��
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<br /> QC,�,A.S Q ROQFING ..C] SPECIALTY � OTHER� - , �
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<br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES ;,NO
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<br /> BUE�DER ; .� _,�...�--� Ct�MPAEIY'` � . '
<br /> SIGNATURE REGISTEREp Y/ N �E CURttEn Y/N'
<br /> Alddre�'s � � [.icense# ( ` �
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<br /> ELECTRfC1AN, ._ COMPAFIY � .
<br /> SIGNATURE � REGISTERED Y/ N FEE CURREN''' " ` 'kY/N
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<br /> A�dclress , � , - Ltcense# [ . p �
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<br /> PLUMBEIt � : CCtlYIFANY :: .: , .
<br /> SiGNA'fURE ,fREOIST.EREp r Y,/,.N•� .F�cuREt� Y</N: - � �
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<br /> Addrass - , ,; � " � � ,}License,#.��- �. .
<br /> MECHANlCAt:" . . COflIlP/WY _ �. ~ = y _ . :r � �
<br /> SIGNATURE " - . - , 3 . .. �_ . , , � _..:,• .�:: ,.,f
<br /> REGIS7EREp Y„/.N� ,FEE CURREA=. Y:/eN. - .
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<br /> Address , , . ' , . " . �� , ' License#�� �
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<br /> OTNER ;� . . `;GUMPANY -
<br /> SIGN14TURE' -, • � - � � � '� "REGI3TERED� Y/ N:. FEe CUR►��" Y L N ,
<br /> Address' , - ' license# �!` '• �� t �,f
<br /> RESiDENTiAi:,... :Aits�ct►'{2};Plof=P.,laris;,.(2}sets_of=Biiililingii?lans;'('!}'seE'af�Energy">Fa'rins;R-O�Vti=Peri»itfornaw;constructlori, - , ° ' ° .
<br /> �A,,-��Minimum�ten-(10)�worlcing;days�.aiter`subinlEtal date.:�Requlred ansife;<ConstiucUon PI'ans;=Stormwater P1ans w/SfIE'Fence installed,
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<br /> � 'Sanitery FacillNes;8��7,,dumpster�Site�VVork,P..ermitfor sGbdivisiansAange,prujeat's,; _`;;�w _ "' °' � `" ' =°�
<br /> COMMERCIAt. Attech 3`cbm let�`sets ofBultd'Iri Pianst'tus a'Cife'Saf+� Pa e; 1 set of Ene Farsns.R-U-W Petmtt#or nerni canstructl6n.
<br /> { ? P 9. P tY' $ { } r9Y
<br /> Minimum ten(10)working days�after submlthal date. Required onsite,Canstrucdon Plans,Stornrwater Plans w/Silt Fence inst�lled,
<br /> Sanitary FacillUes 8 1 dumpster.Site Wark Pernnit for all new:proJeots.All commerGal,requi[ements,must meet compUance � • �
<br /> Sl�N PERMIT Attacti{2)"sets cif�ngineered;Ptaris.t.�..,,^ . ��.. , • .
<br /> ""`PROPERTY SURVEY reGuired for all„NEW construction._. . -
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<br /> Dlrectlons: . • „ . ..
<br /> Fill out applicaUon completely.
<br /> Owner 8 Contractor sign back of appllcaiHon,natarized
<br /> 1f over�i2500,a Natice af Commencement is required. {AtC upgrades aver ET500)
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<br /> Agent(for the contr'actor)or Power ofAttomey(for tFie owner)woulil be�someone wltFi�notaKzed letter from owrrer authorizing same
<br /> OVER THE COUNTER.PEttMITT1NG -.-{Frant of-APPllcat3an Onty}- , , �
<br /> Reroafs if shingles Sewers Service Upgrades A/C Fences(Piot/Survey/Foatage)
<br /> Drivewaya-Not over Counter if an pubtic roadways..r`ieeds ROW t 4 � .
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