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<br /> 613-780-0020 City of Zephyrhills Permit Applica#ion Fax 813-780-Op21
<br /> Buitding Department �''
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<br /> Date Reaeived � Phone Catitaat far�P�rmtttin `
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<br /> Owner's Name �`� � { Owner Pho»e Plum6er
<br /> Owner's Address - � y�. G� � Owner Phone.Number �� �
<br /> Fee Simple�TItleHolder Name f�^ ' - � Owner Phone Numbe� � �
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<br /> Fee Slmple 7ltleholder Address
<br /> JOB ApDRESS / � ! � ' � I� LOT# C�
<br /> SUBDIVIStON , � �� � P.ARCEL tD#
<br /> , , , (OBTAINED FROM PROPERTY,TAX NOTICE)
<br /> WOF2K PROPt'3SED <,NEW CONSTR �. ' ADDlALT � S1GN Q � �Q DEMQLISH
<br /> ; re: INSTALL � - REPAIR
<br /> PRQPQSE[3..1J$E . Q SFR. � 'COM{Vl "[�� OTHER c�. L� - �
<br /> TYPE OF CONSTRUC'I"ION Q` BL.00K " [� FRAME . �� STEEI: �Q
<br /> DESCRtPT10N OF WORK` f �LLG` I� �`�-'-��CS "I �i���L,
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<br /> BUtLD1AtG SIZE' �� � St�FOOTAGE 7 ��d ..,HEIGHT�C�_=-� ,
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<br /> QBUII.QING $ � VALUAzIOi�i:<OF'TOl'AL CONS'rRIJCTION r `
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<br />'' QELECTRICA� - $ AMP SERVICE Q - PROGRESS ENERGY Q W.R.E:G.
<br /> QPLUMBtNC3� ' � �� ���-
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<br /> QMEChiAiViCAL ' $ ' • VALUATtQN OF',MECHANICAL INSTALLRTlON
<br /> QC,AS �� ROQFlNG [� SRECtA�'!Y.�'] OTHER� • �
<br /> FINISHED FLOOR ELEVATIQNS r�� FI�OOD ZONE AREA �]YES ,NO
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<br /> BUI�RER CONlP�WY� ' ` '
<br /> SIGNA7UFtE REGISTERED Y/ N PEE CURRE� ' " Y/N
<br /> Addres$ ' Cicc�nse#'1 '��
<br /> EtfCTRICIAN: : . • � ,`GOMPANY _
<br /> SIGNA7URE � REGISTERED Y J N FEE CURRE� "'Y/N
<br /> Address ` � , _ . License�# � , �
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<br /> PLUMBER ' . , COMPANY �: � .
<br /> SIGNATURE' ` '' _ REGISTERED Y./;.N.; ,,FEE_CURRE� Y.•/PI,
<br /> Addre$s _' ` ,.�iaense,# r_ --.-,,.. . , ,.,�:
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<br /> MECHRNICAL: ' .' � COMP��I+tY. � " , ` .
<br /> SIGNATURE• ,, , , . • , � , ,�,:,,x -
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<br /> ' ` , , ,. REGISTERED., Y./ N . : ,.,� FEECURRE�.� Y;/�N.. •,
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<br /> Addess����`°= � ' , , ,. ., s . � .
<br /> ' ` ` License# � _—�
<br /> oz���t �� � - ��-° �:coiui�a�nr,. ='.1�'.-s n�a �. : Q .ct.�... �1? �L. �
<br /> � SIGNA7URE - � ' �` " REGisTEiiEn`� ' Y/ N_., FEe Cu�tEn Y/N
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<br /> Addreas � � % ,� �:` ���J�-"` ' Cicerise# C` �t.�� 'l ��.J���
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<br /> RESIDENTlAL}a< :Aitact"r,'(2)„Pla#�Platis;:.(2}sefs:.of»But[8irig�Plarits,'(1)ssfoE=Energy"Fa'rtras;R=t)=WPerrrittfor''newconstructEon, _
<br /> :� Mtnlmum:,ten°(:1.0):w+orlitng;days,afte�;subinittaf d`ate.=.Requlred onstte;Constiuctlon:Flans;'Stormwater`Plans w/Sllt°Fence tnstalled,
<br /> ._� :...� .,�.,,._ ,..�. ,
<br /> -Sanifary'Facilides:&;1,du,mpste_r,,Slte WorlckPermit_for'subdiyisions/large.proJects_,,::;..;�; .. �` ' ' � '- �
<br /> CQMMERCiAI. At#ach{3}�ccmptete sets of 8ulldlr'sg Plans plus a'.t:ife Safety Page;�(1)set af Energ}r Fotms.R-{a W Permit for nevir construcflon.
<br /> ._ � Minlmum ten(10)working days afker submlttal date. Requlred onslte,Construcdan Plans,Stormwater Plans w/Silt Fence installed,
<br /> �– = Sanitary Fac(Iltles&1 dumpster.Slte WoMc Pem►It for all newtprojects..All commercla!requlrements,must meat compltance
<br /> S16N PERMIT Attac,fii{2j sets of`EiigliieenedyPlans..: .-'-°',;;�._ -�. -:.� w
<br /> """PROPERTY SURVEY reguirecl for all NEW ganstruc8bn.,. �` �
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<br /> Dlreetions: ....a-�:, ... � � ,
<br /> Ffll out applicaUon completely.
<br /> Uwner&Contractor stgn back of appllcaUqn,notarized
<br /> If av�r?2500.a Notiae of Cammencement 1�re.quirad. {A!C upgrades avar�750dj
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<br /> '" Agent(for tFie'con'tractor)ar'Rower of Attoniey(fo�tlie ow�e�)would be someone with�notarized letter from owner authorizing same
<br /> OVERTNECOUNTER,PERMITTINfi....:,.�_. .(Front.ofApplicatiamOnly}__._ ., - . ,
<br /> Reroofs If shingles Sewers Service Upgrades A/G. Fences(PIat/Survey/Footage) .
<br /> i Driveways-Nat over Caunter if an public roadways:,�eeds ROW
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