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813-780-0020 City of Zephyrhills Permit Applic�fiion Fax 813-780-0021 <br /> - 8uifding Depaetment <br /> pat�t��ceevoa ��� _ ' �'"� � <br /> �t�oc�e Confiac2 fo�tPerm[�ting <br /> Owrner's F9ame V�V 1�C�LY t s ►"�-.- �+r�n�e Pi��n�Plumb�e <br /> Owner"s Address �liV W l..-�- � � �" Ornrn�rPhone Piumb�r �� M1•� <br /> Fee 5impo0'Piei�hold�r R➢ame �nrn�r Phen�Plumber � � <br />� <br /> F�e Simpl�T(gl�holder Ad�re�s <br /> Sa�ACf����S c.�ll.)l�� �.�T�'�1c�. �"� ���i � V � LOTa� �__,� <br /> �i1BD14iiS1�R! �� ���,1� �'�(,.- ��� ��E2CEL OD� �"t� ��� �1 — ���� —��� r���(� <br /> (OBYdINED FROIN PROPER7'YTAX N0710E) <br /> U1l09�&t�F3�PC}SE� � e t�EW CONSTR 8 ADDIA�T � SIG�I Q Q DEMOLISH <br /> INSTALL Fi�PAIR <br /> PROPCI�E[9lBSE Q SFf2 Q COMM � UTtiEit <br /> YYPE O�C09d��UC'6'tOP� Q �L.00K " � FFU4fVIE � STEEL � <br />: �ESCRii�Y6�td��ttYt9FtiC ��1� i�t. t V ? t� 1��� �t <br /> �t�t�c���a��i�� ���om�,����� �o�t���' ��� <br /> 0 au��.ai�c ��� VALtlfiTlON OF TOTAl.CO�STF2UGTIOR! <br /> �ELEC7RICAi. ($ � � A141P SERVICE Q Pi�4GRESS EtVERC'aY � W.R.E.C. <br /> � <br /> OPLUMBlNG $(�"��� ' <br /> � <br /> OMECMANICAL ($i � V,4�UATIC}h OF l,�ECHANlCAi.lNSTALL4T30�! <br /> � <br /> QGAS Q RQQFING � SFECIALT( � O'Tl-IER <br /> FiNISHED FLOOR ELEVATtQNS ��� FLOOD ZQNE AREA QYES NO <br /> �UILE?�R C��+tP�3Y <br /> �i������� REGISTERED Y/ N FEE CURREi� Y/N <br /> �dt�r�ss Ltcense# � � <br /> ELf�CT�I!GdF�4lf CO�IPAPIY <br /> �3G������ �' REGISTERED Y/ F) .- FEE CURREP Y/M <br /> �4t�t4f�s8 LlGetiSB# <br /> �-'LUlb7��R CQ�tiFat�tdY �� l.tt r � �t � i✓(.��{JY I � <br /> ����+����� REGI57ERED Y I N FEE CURREt� Y <br /> Ad�r��s �� �t � �� Ltcense# ��.��"t`���� � <br /> YYI,�GH/4ai9' lC�,L Ci2t�fE�'�RIY � <br /> �g���+�U�� REGIS7ERED Y./ IV FEE CURREP- Y/M � <br /> �f�t�Y�S LCCeiiSB# � � , <br /> ����� L'Q���� <br /> SIG1�9�aTldF3� REGISTERED Y/ {�1... FEE CURREh Y I N _ <br /> �da9p�s� License# �� � <br /> R�SOD�C�4TI�E: Attach(2j Plc�t Plans;{2)sefs of Buttding•Plans;{4)set of Energy�Forms;R-t?-W Permit for nsw consbvct'son, <br /> � Mintmum ten(10}working days affer subrriitta)date. Requtred onsite,Constnration Plans,Stormwafar Ptans wf S1E Fence Enstatied, <br /> Sanitary Facllities&,1 dumpster,-Site Worlc Permit for subdfvisions/large projects <br /> COA90fl��Cl� Attaah{3)comptete sefs of Buildirig Pians pius a 4.ife Safety Page;{1}set af Energy Fosrns.R-Q-W Pe,•rs�it�crr nev:c�nstruc�on. <br /> Pdllnlmum ten(10}warking days�af#er submtttat dafe. Required ansite,Ccnstrvc6on Ptans,Stormvrater P?�ns v�7 Silt Fence instalied, <br /> Sanitary FaclliBes&1 dumpster.Site Work Permit for all new pr+ojects.All commercial requlremertts mvst meer t�mp{iance <br /> SttaR4 P�@3t1�tT Attacti{2}sets of Engineered Plans. � <br /> ""PROPERTY SURVEY required for ai(NEW construction. <br /> �{P�c4losos: - - . _ . <br /> Fiti auf appiication completely. <br /> Owner 8 Cantractor sign back of appl(catlon,notarixed � <br /> ti avsr���BQ,a 6�04��a�Gee»en��e��asen4 i�r�quiredl. {�StG t�pgr��e�ov�r;�7600} <br /> � �"' ,=.;a�i!for khe contractor)or Pbwer of Attamey(for the owrrer)would be someane with notarized letter from owner authorizing same <br /> � :��'=='.":e=^'-,'.;;s cR PERP�ITil�dG {Front af RppllcaUan On1y} <br /> j �=:�-``z�"•^:-�� ��°�^r^ Sarvice Upgrades AlC Fences(PIaUSurv�y/Footage) <br /> � .',��,•..�_.s�--�~�-. �. ��—..��==a--na�ds ROtfV <br /> �"'�"'' _�'°�;,.� ' " <br /> i _ :ts-+.m , <br /> `---- - ---._.__.--- _ __._�____.. __� _._-- - <br />