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<br /> s�s-�so-oaao City af Zephyrhills Permit Application Fa�c 813-780-0024
<br /> � Building Department
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<br /> DaLe Received /�"" � r �t��-�?`�
<br /> /..e / � PhQne Contact fo'r Permttting � `J �Q -
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<br /> Owne�'s Name � Owner Phone Number
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<br /> Owner's Address �i�' � Owner Phane Number �— �
<br />` Fee Simple?Titleholder Name � ` �l V` �Q,�'t3�c>T- Tl�t Owner Phone Number �� �
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<br /> Fee Simple�Titieholder Address �`E�"��.S � -�IV L � C�E-• � �
<br /> � �J08 ADDRESS LOT# �
<br /> S�s��V�s��� ���.��.� ������� �����1�# P � P g�-- � �C�
<br /> � (OBTAINED FRQM PROPERTY TAX NOTICE)
<br /> � WORK PROPOSED e � NEW CONSTR 8 ADDIAl..T \[� SIGN 'Q � Q DEMC1E.t8H
<br /> ; WSTALL REPAIR •
<br /> ` PROP.,QSED USE Q SFR COMM � OTHEft _
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<br /> TYPE"OF CQNSTRUGi'tON �J BLOCK • FRAME 0 STEEI. [�
<br /> :. DESCRIPTtON OF WORK x � `Y � 1L��} /
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<br /> BU1�[}IAt,G SIZE SQ FOOTAGE HEIGHT : -
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<br /> �ts���'�t�� �� VALUATION'OF TOTAL CONSTRUCT[Otsi.� '� ���r
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<br /> ,, QELECTRIGRL �—� A{t+lP 5ERVIGE � PRpGRESS ENERGY Q V1t.i2.E.C.
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<br /> �PLUMBiNG �, �
<br /> ` QMECHANlCAL $ VALUA710N OF MECHANICAL iNSTALLR"ftON �/��'"°
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<br /> �� QGAS Q ROQFING Q. SPECIAl.TY C� t�THER �
<br /> � FINISFiED FLOOR ELEVATIQNS FLOOD ZONE AREA DYES NO
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<br /> . -SUII.DER � — " CO�ANY
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<br /> 'SIGNATURE REGI3TEREp Y/ N FEE CURRE� Y 7 N
<br /> .. Address -Liaense# � �
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<br /> , �ELEC.,3.,RICIAN � � COiU1PANY
<br /> :.-SIGNATURE REGISTERED Y/ N FEE`CURREA Y/N
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<br /> Address - "License# � �
<br /> , p ia'bF���."� � }�}��abA�({� '
<br /> �`.� i"��ii,p��..i 1i\JIl7('Aiii'
<br /> r SIGNATURE REGISTERED Y•/ N FEE CURRE� Y/N
<br /> Address License#` �T �
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<br /> :'`MECMANIGAl: COMPAl�IY
<br /> �"SI.�'aNATURE' REGISTERED , Y/,N. FEE cUR►3en- , . Y/N .
<br /> Ailii�e'ss�: ` " -' " . License# � � M
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<br /> :-OTHER� �"-�,'_, " ' � CQNtPANY
<br /> ;' SIGNA7URE::��� .� � •- - RecisrEReo Y/.N . r�e cUR�n' Y/N
<br /> `-, Address,:- . _ _ _ .- ' . , Licerise# � �
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<br /> +�,,RESIDENTfAk{^�;. �Aftacii�:{2)�P[tit'P.laris;°{2}:s`ets<o��Builiiltig=C'lans;(1�)°set'ofEne'rgjr�,Fortiis;R=t?=W.Permit'fcjrnew.c.onstruction,
<br /> , •:���tl,;•:^,;,.��,,�;,��Minimum;;,ten,(s10);working'�days;afte�sutihiiittal�dafe.-'Requi�ed�'onsite;Can`sUuction Plans,`Stormwater Plans w/Sflt Fence installed,
<br /> " � " Sanitary Facilities�&1 dumpster•;:SifetWork Permitfor.subdivisions/large:projects�- " �
<br /> ; ::GOMMERCIAL At#ach�(2)c;ompEete seets of'Build�rig Plans plus a�ife Safety Page;{1}se#af Energy Forms.R-O-W Perm�t fof new construction.
<br /> � ��,�"'� . Minimum ten(10)working days after submittal date. Required onsite,CanstrucNon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> !<.,' Sanita FaciliUes&1 durn ster,_Stte Work Permit foi��al!-new
<br /> ry , p, proJects.All commerclai requirements must rrtest comptiance
<br /> �``St�N<PERMIT "Attaoti(2j"s"ets of;Engineered Flans:��: .<� � � -
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<br /> i .,;: PROPERTY SURVEY required.for all NEW cpnstrvctian.-. - �
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<br /> �Directions: .. .. .__, . � - ,
<br /> ' �FIIC:out'appllcation completely.
<br /> �:`t 'Owner&Contraetor sign baek of application,notarized
<br /> �:' If over$2500,a Notice af Gommencement is required. (A!C upgrades over$7500) ,
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<br /> "'�'"" Agent`(for th'e�contraotor)�or Power�of Attomey(for'ttie owner�would be someone with notarized letter from owner authorizing same.
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<br /> '.,`OVER;THE COUNTER':.FERMITT:ING. .. .{copy..of•contract�required) �� ` " �' , _ -
<br /> �� ,"Re�oofs lf shingles Sewers Service Upgrades A/C Fences(Plat/Survey/Footage)
<br /> . Drlveways-Not over Counter,if.on.pub(ic;roadways..n,'eeiis ROW ` � � ��� .- �T� � �
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