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813-780-0020 City af Zephyrhills Permit Application Fax 813-780-OQ21
<br />'� Building DepBttmeftt ''a�
<br /> Date Received �Phone:Gaetact far�Parntiittln —
<br /> Owner's Name N9�, . � 'lJ � Owner Phane Number
<br /> Owner's Addres� —7 �i2- � ,J..] 3'� � ��Owner Phone Number � �
<br /> , Fee Simple Tltleholder Name � • � Owner Phane Number �— �
<br /> Fee Slmple�itlehotder Addres�
<br /> JOB AdDRESS � '�� `� � J��`Y LOT# ��
<br /> SUBDiV1StON � 1 ` PAFtCEI.tD#
<br /> j � , , , � , (OBTAINED FRdM.PROPERTYTAX NOTICE�
<br /> WORK PROPt}SED � NEW CONscR ADDIAi.T -C,� SIG1V" [� ° Q QEM0I:ISH
<br /> S B- INSTAL.L. 8•.' -REPAIR -
<br /> PROPQSED llSE � Q SFB- Q 'COMM Q OTHER ', , � .
<br /> TYPE OF CONSTRU6TION = Q BLOCK " [� FRAME � STEEL � '
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<br /> DESGRiP710N OF WORK� ' � Y1J I�� ``U'��1 . G �
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<br /> BUII.DtPiG SlZE SQ FOdTAGE�_��_ ; .H GFIT��
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<br /> QBUli.DING � �'1. �J")� VAItlATIOtd�'tO`F`TO'i'ALCOIVSTRUCTION h ;r _ . ( '
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<br /> QELECTRiCAI $ " ` AMP SERVlCE �Q �PROGRESS ENERGY � Q "W:R.E:C.
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<br /> [�P�UMSING •'{�'�. � -
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<br /> C] f _ ' YALURTlQNtOF;N1ECHANtCALlfVSTALLATltON-
<br /> MECHAIVICAL $ '
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<br /> QGAS Q ROOFING ;Q SPECIALTY �. >_ OTHER� • -
<br /> FINISHED F'.LQOR ELEVATIONS FI.00D ZONE AREA [�Y�S ,NO �
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<br /> SiGNATIJRE G/ REGISTERED Y/ PI FEE CURRE ' " Y/'N�
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<br /> Addrass � -Cicense# � �
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<br /> ELECTRlCIAN� , ' . CG1MPAt�Y '
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE��� ` �"Y/N
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<br /> PLUNIBER '4 ` � . �COMPANY: _
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<br /> SIGNATURE' � _REGISTERED. . , X./,,N,� . £FEE CURREN_ Y;�/N: - `
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<br /> MECHAAItC"l�t: � . . � ' GOMPANY, ;�.<, . . - . . . , .
<br /> SIGNATiiR� `•` , � , � "r REC�,ISTERED,. .Y:/.N.. FEE`CURREA:,� Yt/�N. �
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<br /> SIGf�ATURE -� Ye •� ' • "' "� REGI�$TERED` Y/ N:..3 FEE CURRE� Y/,N
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<br /> RESlRENTIJ41: ; Atta:ch 2 Ptot�P,tans��.2 si3fsof=Buit�fn''�F'larts�'t1 'sefafErie'� Fafnts��'Ft=O-W+P'siir%itfc�rnewycooshvctio ,p - �. � �
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<br /> ,..�,' ' �{..)=- _- ,�( )"..,., , 9�, � .t ) �93r,'.,,, .- . �� .:n�,.: �, , .
<br /> �.>_�'Mlnimum�,ten�(;1.0)kworicingydays,�,_after;"sutimlEEal d'aCe.�Requlred onsiEe;�4onstRictlon=Rtans'rStormwater Plans'w/SI�t Fence lnstalled, '
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<br /> �Santtary Facllfyes,;&:1,;dumpster;SItB�:WorkxP;,ermit�#or,sutidivislans/lafge4projects,�_='�:<r ' - . � -
<br /> COflIIIMEt�ClAL Attach{3j=cainplete sets'of Bulliling Plans p1u§"a�tfe"Safety'Page;�(1}set of Energy Farms.R O-W Permit+#or new cans#ruiKion. �
<br /> _ _MPnimum ten(10)working days after submltMal date. Re'quired onslte,CanstrucUan Plans,Stormwater Ptans w/Sllt Fence installed,
<br /> � Sanitary FaclliHes 8�1,dumpster.Slte Wark Permlt for all new:proJects..All commercial,requl[ements_must meet compllance
<br /> .StGN 1�ERM1T Attac�{2)sefs of�iig�rieered=',Platis:t� ;��. . ��_ .., , „ ° - .
<br /> .«««PROPERTY SURVEY
<br /> ._-_ -- -_.__.._�._.re9ulredforall,NEWconstructlon._ .,...
<br /> Dlrec#lon�: . _ . � � .,
<br /> Ftll out applicadon completely.
<br /> Owner&Contrackor slgn hack of appllcadlon,notarized
<br /> If over�t500,a Notice af Cammencemea#ts required. {AtC upgrades over 57500j
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<br /> '* Agent(far the-contractor)or'Pow�r of Attomey(fur�the�owner)would be'someone with notarized letter frum owner authorizing same
<br /> �VER THE COUNTER,PERMII'11NG __..(Front of-Application Onty)- .�- _``� : ,.
<br /> Reroofs If shingles Sewers Service Upgrades A✓G Fences(PlodSurvey/Footage)
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<br /> privewaya-Nat over Caunter if on pubiia roadways..iieed"s F2aW
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