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8�s-�eo-oazo City of Zephyrhills Permit Application Fax 813-78p-0021
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<br /> , . Building department
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<br /> Owner's Alatne �� Owner Phone Namber
<br /> Owner's Address Own�r phone Number s.� �-
<br /> F�e Slmple;Tltleholder Name �� • �� Owner Phone Number �� �
<br /> Fee Simpl�1'Itl�hold�r Addresa
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<br /> JOB ADDR�SS 42��� UZ,� . � LOT# �_��
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<br /> sua�ivisia� � � p�c�t,i� '!�v��V��==G�6�L)-a��'-� o`Z�a
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<br /> � (OBTfUNED FRCIPA,PROPERTI!TAX.NOTICE)
<br /> WORK PR�;POSED ;.NEW CONSTR . ADDlRI.T �` St{3N` 'Q ,�� DEMOLtSH
<br /> , , _� �. INSTALL. � � ; .,REPiAIFt
<br /> �R4PQSED-US� Q SFR � 'COMM ,. ��_, dT.FfEFt .
<br /> TYPE OF CONST�2UCTION - Q 'BLOCK " `Q FRAME ��� STEEL [] �
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<br /> DE3CRIPTI�N OF WORK - �� �L��5' Ct.Jr'�L.. Gc.�.Q ���tx.-i'�.
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<br /> � � �,.� �...� 3/ALUATiON>OF�TO`fAL'"COA1S'I`Rl`ICTION
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<br /> QE�,ECTRIGIAE. �r� AMP SERV{GE. .- �� PRt)GRESS ENER�� [� � �W:R.�:C.
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<br /> IUIECNPiNIGAt $ ,1tAk:.UAT10N OFtMEC
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<br /> FINISMED FI.00R ELEVA710NS FLOOD ZONE AREA _QY�S. NO
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<br /> BUlI.DER {; CCMPi4NY-� �-' �� " ` ,
<br /> SIGNATURL REGISTERED Y/ N FEE CURREK" Y/N�. ,
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<br /> Addre".ss ' _ License#�'� `. � �' i
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<br /> .ELEC'1'�ICIR@t' � -�COIVIP/1NY �
<br /> SIGNATURE '� REGISTERED Y/ N FEE CURREk�` ` ��;Y/�N'
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<br /> Addre�',s_. � ' . - .. , ,;;` . :. License#.I.� . . . ��
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<br /> SIGNATUR�' � r�,`REGI9TERECI�: . ..Y,/,;N=i �,�,�Ee�CUFi�� Y/N. �
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<br /> SIGNATURE^. ' � ` REGISTERED�� .Y/,N`::s ' FEE CURREA,: • -
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<br /> SIGNATURE '�=;'� � �`REt3187EriEii�`: . ..:Y/ lV.,.:.' ="�FEE URREP` Y/N.
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<br /> Addre�`�' e,t� - ,=. . _ -, . `License#� c��� t �����,.�.�` . - .
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<br /> lZES1DEN31At:.,-< ;:Attact�'"(2)�FIot�Rtari,s;;{2)sefs:=of:Bul�d�`iigj{Plaris;'{'t:�seraf;E�iergyr�Fortits;�F2=�W,PeRii,iE�fiar rieuir�ns4ruc�oe, � ° ' =
<br /> �,'�;�j�r Mlnlmumaten'(:10)workldg�days afterwsubmlftal=date�;,Requtred onslte CanstnicBdn'Plans;Stormwater'Plan's�w/SIIE'Fence tnst�lled;
<br /> '.. = -Santtary Facllltlss�&F'�rydurrppster,91te W.,cjrk.Permlt.for subdEvislans/large:pru]ects ..-_::;�; _�. ':.�_+��-� : �"�� .�� :;. ' � - . --
<br /> COMMERCIAt. Aftach{3):caii�ple#e'sets�af�Biilldtng-Plans plus a Cifa�Safely Page:°(1j set of'Energjr Forms.R-0 W Permi##or neyrr constructton.
<br /> , MI�Imum ten(10)working days after submlttal date. Rsquired onslte,GanstrucUon Plans,Stormwater Plans w/Sllt Fence ins#alled,
<br /> Sanitary Factlitles 8�1 dumpster.Stte Wark Permit for all new.proJeais..All comme�cla!recjulrements_must meet compllance
<br /> �=SlGN P�l2M17' A#tadi{2j:sets Sf'Engi��r`,edwP�ia�is.;;-�;,;_�-;�' -. , _ ,
<br /> ", ""'PROPERTY SURVEY � uirecl,for aII�NEW Mcoiis.tructton. _ � ,
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<br /> Dlret:ttons: :{., ; ` ' .�. .
<br /> Ffll outapplicaUon completely. ��
<br /> Owner&Cantractor stgn track of appltcatton.aotarized
<br /> if aver�,2500,_a Not{ce af Commencemsrrt is reqaired. (AJC upgradss ov�r 57500)
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<br /> Agent(for tFie oonU'actor)'or=PoWer of Altamey(fa��the owner)would�be someane�with notarized letter from owner autharizing same
<br /> DVER-THEC{�UNTER.P..ERMt7TiNG.-_ ..(Frnn#of�APPBcatlon�Only},.• , .. :`= � � ,
<br /> Reroofs tf shinglas Sewers �Servlce Upgrades A/C Fe�ces(Plot/Survey/Footage)
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<br /> Driveways-Not avsr Caunter if on publi�s roadw�yse:nei�ds'R�tfit" ` �
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