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813-7804020 City of Zephyrhills Permit Application ' Fax413-780.0021
<br /> Building,Department"
<br /> Phone,Contactfor:Penroitttn
<br /> Owner's.Namer s.
<br /> �' /` Owrior'Pfion�Number>'`
<br /> ::Owner's Address
<br /> OuvrierPhone-Number:'
<br /> 41
<br /> ADDRESS;
<br /> ;SUBDIVISION PARCELID#: _ \
<br /> ERnr:razlNiXn-t(013TAMED IK,6:.ROP CE1
<br /> ,WORK:PROP,-.OSED;:.. ivEW'.CONSTit'� ADD/ALT>,=' ;=SIGN`'" -=pt5MOLISti' '
<br /> B' ::INSTALL.;. 16.
<br /> PROPOSED'USE;. .Q; =SFR; 0 .::GOMM';; OTHERr'' —
<br /> :: TFYPE40FNS COTRU4TION''.: BLOCK i FRAME'' 'STEEL"`;
<br /> 0 '. '. ;.
<br /> ' DESCRIPTION"OF�INO'RK�::
<br /> + BVILDING.SIZE SQ-FOOTAGE: r `s
<br /> BUILDING•. .... ' $:;.'.. ._... : •- .'.': „:;. • , .,,... �:r,•.
<br /> i VALUATION:;OF`:TOTAL.CONSTRUCTION'
<br /> CT RI $. AMR'S"ERVICE. DUKEENERGY:.
<br /> Qt?LUMBING FF.:.:
<br /> =MECHANICAL $ VALUATION OF MECHANICAL'INSTALLATION'.'
<br /> =GAS ROOFING--...© ,,SPECIAL,TYti ];.'. .OTHER.
<br /> FINISHED FLOOR;ELEVAfIONS L'•OOD':ZONE`ARF�1- "' YES '.NO
<br /> �.'. .
<br /> .BUILDER CO PANY. :.,; : "!:. Q / C��•.7/
<br /> SIGNATURE : , REGisReDt
<br /> ' a '
<br /> Address" W S 14_ Ucense'#; ;�.�G�
<br /> ELECTRICIAN :..COMPANY:.
<br /> SIGNATURE ` :REGISTERED' Y'/ ;FEECURRE�:; N;x
<br /> 'Address tictense'#,`I'". - .>": '_....
<br /> a:
<br /> PLUMBER ' ' COMpd1�iY' ;
<br /> .r. F ,,
<br /> SIGNATURE :R 'GfsieaEo:" Y%=N:'' = .FEE:CURREb: ;; <Y°l N
<br /> _.
<br /> ;Address:" - :.. . ". ,.,: ::. L�censeaf - -
<br /> MECHANICAL F:.. a. ,,COMPANY
<br /> i
<br /> 31GNATURE": :�' - '� •': .. EGis -.
<br /> -Address,: ".'Ugense
<br /> OTHER.
<br /> SIGNATURE':, FEE,CURREA
<br /> License#
<br /> •l
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<br /> ,I
<br /> `•:� `�ts" f� "I d' ':'A ans,;`1�`:�ef'f.Eiie rhos- •fo��n n
<br /> RE$IDENTii4L' �Atta�ti:�•�i?Iot'P.,laiis. �`/,§e .o„�UI P .,,[ ..,(.). .o .r9Y'.F ..� ..W- ,.
<br /> .::2t�(.�:,�t',� .�Y"+,.�i. n:hr':iii i •:�' ;.";i'.4: "•-Iw �J.f11 'u d..fYe lAr=°;n.•'sii:,✓,• Y�''>%'� .1 . . f,.Y n.7., ... -
<br /> AirllYrium teri lr0)'S�Jorking?days;afFerrsUb`rlii l;bate 'Ft �lre(l ons�te;Constltictfon,_Plans;`S�onn afefP..laHs'v�i/:Silt Fence�fristallsd,`;.:
<br /> Sanitary;FecilitiesaT;�.:dumpstar,�5tfe.Work Permit fbrsUbaliirsron3na.►ge•pro)eots
<br /> COMMERCIAL Attach(2)completesets o1:8u1ttlingPlans4plusa Life Safery;;Page;'(1)'`set`of2EnergyForms:R-O=W Permit for,newcconstiucdon..,, .
<br /> Mlnfmum tern}(;10)rvuo(liing da.; afters b� ttat date,Regii)red Qnslte;CorisfrucQoh P(gnsrStorinwafaFPlans w%$ijt,'Fenceinstalled;
<br /> Santtary;FaClllttes&1_ilunlpa xSit�e /ork permit fog all new:proJects:All commerclal:requirements muht.meet-compllance,,
<br /> SIGN PERMIT Attach(2) ets.cf Engiiieered`Plans: . >,, ri:.,:.,.:;.;• _ ...
<br /> ••'"PROP,ERTYSURVEY n3qulred for all NSW cghstruction.
<br /> ..,
<br /> Directions:
<br /> Fill.out application completely.
<br /> om*Fh&-t nk for gl6n;back,of application,notarized,
<br /> 'if over S2$00'a"Notice of Commencement is r®quired. :(AIC.upgrades oyer$7500)
<br /> «:.
<br /> °• Agent;(forthezoontraetor.)or;Power of,`Attomey for,the owner):would tieaomeone with notaHzed letter from owner authorising same
<br /> OVER.TIIE;000NTER=PERMITTING;, ... .:(ggp.,79fiDontrat;t.requtred):.
<br /> Reroofs if sfitngles Sewers Service Upgrades°A�/C``'='Fenbes(Plot/Survey/Footage)
<br /> Driveways-Not over Gounte*if'on`publio'roadways::neWs ROW
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