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s�s-7sa-oazo City af Zephyrhills Permit App(ication Fax-893-780-0021
<br /> ' • Building Department :;��
<br /> Date Received � phone Contact for Permlttin — �
<br /> 9'"
<br /> Owner's Nam�s�'
<br /> ��"'� Owner Phane Number �CJ� " /� �✓
<br /> Owner's Address c�� � tl 1 Owner Phone Number �� �
<br /> Fee SimplejTitlehoider Name � Owner Phone Number � �
<br /> Fee Simple�Titleholder Address
<br /> JOB AODRESS � ���� {.� t LOT# [�
<br /> SUBDIVtSEGIN ��i�'��l�i� � PARCEt�ID# — '�� tl"" ""d .
<br /> i (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WQRK PROPOSEd e . NEW CONS7R 8 ADDIAL'f � SIGN "Q Q DEMQt�ISH
<br /> INSTALL REPAIR �
<br /> - RROP.Q,SED USE Q ' SFR Q COMM [� QTHER '
<br /> , 'fYPE"OF CONSTRUGTION Q BLOCK - Q FRAME [� STEEL �Q�
<br /> '' dESCRtPTi'ON OF WORK � �'�/lJ '��U�`
<br /> '�;. BUI�[?iN�'SIZE ��i � SQ FOOTAGE��� HEIGHT ����
<br /> ;.,.
<br /> ��: '
<br /> �>- QBl1ti,DING � � yp��AT10iV'OF TOTAI CONSTRt1CTlOh!
<br /> ; �
<br /> ,���LECTRICA� $ AMP SERVICE Q PRO�RESS ENEI2GY Q W.R.E.G. i
<br /> �:' � �
<br /> QPLUMBiNG � .�
<br /> •� QMECHANlCAL $ VALUATION QF MECHANICAL INSTALLAT{ON �
<br /> i ��
<br /> ,C],GAS Q ROQFEi�tG Q SPECiA�TY � QTHEf2
<br /> FINISHED F;LOOR ELEVATIQNS FLOOD ZONE AREA QYES NO �
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<br /> ,.. -StJILDER ; COMPA�+4Y
<br /> � SIGNATURE REGISTERED Y/ N FEE CURRE� Y%N
<br /> �; Address 'License# � �
<br /> �_
<br /> ;''..ELEGTE2I,GI,AN . CdMPANY
<br /> '>..SIGNATURE REGISTEREp Y/ N FEECURRE� Y/N.
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<br /> .;� Address - License# � � �
<br /> • FaF��- -
<br /> � R�UNIBEEt.,`s , , GQMPANIt
<br /> ;,- SIGN%�TUR� � :REGISTERED Y-/ N FEE CURRE� � Y/N
<br /> Addres's License#`�— �
<br /> . - . .. .�c.
<br /> =,°:n��c�at�tc�: ' cot�pa�r h�G�l"�1� D
<br /> ," . � ; • ���"""""�— �, Y/ N " , FeE CURREn Y/N
<br /> ; ;SIGNATURE` REGISTERED
<br /> , � ;; 'i�. � -
<br /> Add`r"e�s�-' ' � � � License.# �i �
<br /> �C;;t,';. '� - ..... ,
<br /> °.,.:oTMER; .._.� � co��aMr
<br /> I��:81GNATURE:7�°�� .r , � REGISTERED Y/.N . FEE CURREK , Y/N
<br /> � :rx. ;s},.�k, , � . . r: � �
<br /> Address: � ~ ' License#
<br /> , � .
<br /> - ,�,RESf0ENT1AL;�_`�Attacfi;(2);Ptof:P.laas;(2•):sets�of�8ultd[ng�Plans;{1)°setof~Ene�gy;Forins;R=O=W Per`initfornaw.constivction, .
<br /> � - �-:�;•�-�:-; ,�:_<.Minimum�ten,(10).;working'r,days aftersu6mittal:ifate:�Requ�recJ�prisite;'Con`striiction Plans;�Stor'mwater Plans w/Silt Fence installed,
<br /> �, �,.:.,:�k...�,_ , :.. ,. , >� ,:: , .
<br /> Sanitary-,Facilities,�&:alaxdumpster;,S,ite�Wor,icRermitfor.;subdivisionsllarge;p'rojects - -
<br /> ��:GOMMERCIAI. At#acFi'{2)"coinptete sets ofBu�lcting Ptans ptus a�ife Safety Page;{1}set of Energy Forms.R-Q-W Permit for new construcfion.
<br /> r�rry��
<br /> � ,,•� . Minimum ten(10)working days after submittal date. Required ansite,Constructian Plans,Stormwater Plans w/Silt Fence installed,_
<br /> ��"�'� Sanitary PaciliUes&-1 dumpster.Site Wark Permit fo%ai4-new proJea�.Ail commerciai requirements must meet compiiance
<br /> ���SIGN:PERMiT ""AftacFi'{2}sefs_of;Engi�eered P.-lans:�=•��, � •
<br /> ""`"PROPERTY SURVEY required for aII,NEW constrvctlon.. ,
<br /> #r -_ , -
<br /> ;,�Directloiis: _ � ._f , .. ., - .
<br /> ;;;'"� -�Ftll out application completely.
<br /> #'�t �Owner'&Gantractor sfgn back af appifcatian,notarized
<br /> ' If over:$2300;a Notice af:Gommencement is required. (A!C upgrades over$7500j ,
<br /> ;.:�rr— � 'r�,;:..,., q.
<br /> AgenY(for'tlie cont'ractor)arPouver'ofAttomey(for'ttie pwner)would be someone with nokarized letterftom owner authorizing same
<br /> : :- .a
<br /> ;,OVER:THE�Ct3UNTER PERM17TiNG:. .. {copy_of.cantract�required)-
<br /> r`;Reroofs if shingles �Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> , .._._._........_---_..�..__._... n _�,. .
<br /> � Driveways-Not over Counter if on public roadways:.n'eeds R01N `"
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