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813aeaoozo City af Zephyrhills Permit Application Fax-813-780-0021
<br /> Bu{iding Depattment - "�
<br /> Date Recet�red -= Phane�Contactfar�Rermtttin '
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<br /> Owner's Name r1�'"lGf. �C.2 O r+G� Owner Phone Nurnber ���� �o �! � �/eG /
<br /> Owner's Address /� ` � a Owner Phone Number � �
<br /> Fee SlmpleiTltleholder.Name Y �� Owner Phone Number � �
<br /> Fee Simple iTltleholder Address
<br /> JOB ADDRESS �!�Q /l� (� LOT# C��
<br /> sue�ivis�ar� � � �aRCE�..i� r� Q�C1 O O/Od � d yf� �
<br /> � , , - (OBTAINED F.ROM,PROPERTY,TAX NOTICE)
<br /> W�RK PROPOSED NEW COPISTR ADQIALT Q SIGN` �• �_[� OENtQI.ISH
<br /> i ��e, INSTALL � REPAIR � �/
<br /> PROPQSEQ�t1SE - Q SFR, [� 'GQMM = ' � �t)TIiER .� �j
<br /> TYPE OF CONSTRUGTION Q� - BLOCK ' [� FRAIIAE " �� STEEL Q _ ������
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<br /> DESCRIPTION OF WORK� � , i" ' �
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<br /> Btlll.plNG SIZE - SQ FOQ'i'AGE '� , xHE1GHT ��� q,
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<br /> i , VALUATION�tOF`TO'i'N►L CONSTRt1CTION •
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<br /> QELECTRICAI �' � ANIP SERVICE Q PROGRESS ENERGY Q W.R.E:C.
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<br /> QPI.UMBING '� � � r„�� i
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<br /> �MECHANIGAL $�j� .�� . VALIJATlQI�!OF'MECHANlGAG INSTALlA71QN. , =
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<br /> Oc,�s o Rao�,N� _o s�ecia�rir�0 o�H�r�� .
<br /> FINISHED FLOOR ELEVATIQNS r�� FLOOD ZONE AREA QYES NO
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<br /> -----�t!![.���t , __ — _ _- - - —-___COMP�WY'; .: � : ---- . ; - . , -- - - -__ _
<br /> SIGNATUItE REC�ISTEREO Y/ N �'FEE CURREA ' Y/N�
<br /> �lddreas � License# � �
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<br /> ELECTRtCI,'Av i+l; , - � 'C'ONIPANY ' • '
<br /> SIGNATURE REGISTERED Y/ N FEE CURREt��� �'` �Y/N
<br /> �,ddre$s - ` - . . . ', � . License#,� �
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<br /> PLUMBER # . . � , COMPANY.. . " ..� �
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<br /> SIGNATURE �' REGIS.T,ERER�� Y.L,N>� �,;FEECURREn YY N. - '
<br /> Address - � � • ` " Ucertse#�� ` - °� 1-.
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<br /> MECHAP111CA1: ' - C4NIPANY ! , ,/„:t.--, : _
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<br /> SIGNATURE � REGISTERED � N _ ; FEE CUFtRED�; /�N .
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<br /> Addre�s � � ' _ � ,License# �� .(.��.���,..�- .
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<br /> SiGNpTURE ;;:` , ' ``- . '� , ` �' . ` ' REGISTERED Y/ Ns.. , FEE CURF2E� Y/.N.
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<br /> Addres� - � , � - � Liceiise# � � �1"
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<br /> RESlDEN'f1At:.;;, Attadi{2}.;Pto#<Plans;,_(2)sets.of;Suililfng}Rlan§;(1)sef of Eriesgy;�oims;'R-0=W�Per'miE for-new construc#Ean, .
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<br /> - Minlmumtten°(:1.p);�workingsdays'.after;subimiftal date.>�Requlied onsite;:CflnstivaUon:Plans;`Stoimwate�'Pians w/Si�t'Fence instatled,
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<br /> " � Sanfta �FaplpUesc&:;1„dum,ster^Slte.,�Work:P:.,ermit fqrsu6d(vis(qns/la'�e�,ro ectsy_.�:`::;::� �::�- ' � : . `
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<br /> COlillMEltCiAl. Attach{3)�compleCe'sets`'of Builslliig PlaiisYplus a'I.ife�Safeiy 3'age;(1)set of Energy Forms.R-Q-W Permtt for.nevrt corustcuctton. -- -
<br /> - - Miniriium�en(1b)working days'after submtttal date. Required anslte,ConstrucUon Plans,Stormwater Plans w!Silt Fence instalied,
<br /> Sanitary Facilidas&1 dumpster.Site Work Pertnit for all new•proJects.,AU commerdal requlrements,must meet complience �
<br /> SIGN PERMIT A4tacii{2}se#�of"Eisglneeir,ed�Plans:,...:����°- - ..�: �" , .-
<br /> """"PROPERIY SURVEY reguired,for all,NEW,construc8on. ,., -
<br /> Diiectlons: _y: , . `
<br /> Ffll out applica8on completely. ,
<br /> Qwner&Contrackor sign 6ack of appl(catlon,notarized
<br /> tf over�2500.a Notice af Cammencement is required. {�ttC apgrades aver�7soo)
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<br /> '• Agent(for the contractor)`or`Powe�ofAttomey(ta�tFie awnerj would be someane with�notarized letter from owner authorizing same
<br /> DVER TNE COUFITER-PERMIi71NCa�. .__ (Front cf-Appllcation On{y}__. . _ ,
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Sunrey/Foatage)
<br /> Dcivewa}►a-Nat aver Counter if on pubiic roadways:.rieed"s E20W
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