|
e�a-rao-floso CitSr of Zephyrhills Permit Application Fa�c-613-78d-0Q21
<br /> BuUdlnB Gepartment
<br /> � Oate Received phane Confad for P�itt{�g
<br /> T'T1'7'TT I-TT-7�7
<br /> Ownefs Hama J1'�r1 /"""�'%��f D� I Owner Phane Number �1.��7f r�
<br /> Owner`s Addtr�ss Sf��a a Q � ' � �Li .33 Owner Phane Number � �
<br /> Fee Slmple 17Ueh�lder Name � � i t)wner Phane Numher �!� �
<br /> r
<br /> Fee Simpie T{tieho(derAddresa �
<br /> �oe aonr�ss 5"�3� 2��' �T•'2c .0 d:/ff �J,i 33sya La�,� /.,�-i'6
<br /> sosuivis�oH � � Paac��.in� Gjl''o2��I�O�DrO�-1���-� olsz?
<br /> � toaraNm Fae�e veoP�en rax�nc�
<br /> WQRKP�ROPOS�D e NEwCONSnt� AdD1AE.T �� SIGN Q [� DEMOLI8H
<br /> INSTALL REPAiR
<br /> PROP08ED USE [� SFR [� COMM �[� OTHER
<br /> TYPE OF CONSTRllGTTGN Q RLQCK Q FRAME i� STEEL Q
<br /> OESGRiP7TON OF WORK -�/�3'T�� S��6IT" tT.�`4'4`�.1;
<br /> HUILDlNG SIZE ���r� SQ FOOTAGE�,,,,� HEIGHT ��,�
<br /> �
<br /> [�8Ullb1AlG � ����.��� VALUAT1diV OF i OTAL CONSTRUGTkON
<br /> QE1-ECTRICAL $ AMP SERVICE (I Q PROGRESS ENER�Y Q W.R.E.C.
<br /> QFLUM8IN� ($ � , ��4�
<br /> �.�.____ � �
<br /> OMECHANICAL 3 r VALUATION OF�MECHANtCAI INSTAELAi'ION �
<br /> [,�j�,as � Roo�ir�� [� sP�cu��nr, � on�E�
<br /> FINlSHED FLOOR ELEYATIONS ��� FLOOD ZO�tE AREA QYES Ft0
<br /> �
<br /> . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br /> HUILDER GOMPANY L•/�Cd��•+�GCr,w,u.f J�`FiPL/f«J �' C
<br /> StGNATURE ___-__!� r�GRST�ED Y! N �E CuRREn Y!N
<br /> Aaa�s v �d Da�3 ,��U,r's�%I 3 ' u�e# C'r�c�a s�3 9d'` ��
<br /> �__.._.,_._., �
<br /> ELECTRICIAN COMPANI'
<br /> StGNA7URE REGISTERED Y! N t'EFCURttEr Y/N
<br /> /�dfCSS � �./C@t1S9# ���`�-
<br /> PLUMBER � � COMPANY
<br /> SIGNATURE REGISTERED Y! N �cu�en Y!N
<br /> Address � 13cense# � �
<br /> MECHANtGAL � � COMPAHY
<br /> St�NATUR� Re�lsr�o Y! N �CUwten Y!N
<br /> Address I Lfcense# t �
<br /> I
<br /> OTHER ���� CQMPANY
<br /> SiGNA'ti1RE REDISr� Y! N F�CUft�n Y/N
<br /> i
<br /> Address License# ���
<br /> Iiltli / IIIIt / t # 1111l1li1t11 / / i1 / Ittiiti1 / 11 / 11f11 / ! ! 1 ! M ! ! lIJIl / 1111
<br /> --- R�SIDENT1Ai. Attaah(2j Piaf Ptans;(2}sets oi 8utt�ing Pi�ns;-{1}set of Energy Farms;R-4W Permit far new construcUan,
<br /> Mtnimam ten(10)workirtg days after sobmiita!date. Requi�ecl ansite,Canstntctbn Plans,Stormwater Plans w!S[It Fence installed,
<br /> Sartfitary Fac111tlas 8�1 dempster,Site Work Peanit for subdlvlsionsllarge ptajects
<br /> COMMERGtAL Attach(9)campteta seYs ai Buifding P�ans plus a t.ife Sa'Fely Page;(1}set of Energy Forrns.R-O-W Pertnit for new consUuc6on.
<br /> Minimum ten(3Q}worldrrg days after submlttal date. Requ(rec!ansite,ConslrucUon Plans,Stormwater Pians wI Sllt Fence installed,
<br /> SaniYary Facilifiss 8�i�dumpster.Site Woik Permlt for all new projects.Al!commerclal requiremems must meet compliance
<br /> SlGN PERMIT Aftech{2)sets ot Englneered Plans.
<br /> ""'PROPERTY SUR1lEY requlred for al!NEW cotuU�uctian.
<br /> ._�. . .� . . . . ._. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br /> DlteCtlons: , ..
<br /> Flt out application canpletely. ' �. ,
<br /> Owner b CanVaator sfgn bac�cc o1 appilcation,notar¢ed � � f
<br /> If aver 52500,a NoUoe oi Cammencement ts requCred.,� (AI�Gupgrades ove7 57306j . ;
<br /> � ... '
<br /> Agent{tor the c�tractor)or Power of Attomey(tor the owner)'iwould be someone with noterizal lerier from owner aufhoiizing same . ;'''Eaa
<br /> QVER THE CUt7NTER PERMI'FTfNC (Front cf Appticatlon Only) i -- - . .-.�� ..., . -. :?
<br /> Reroofs if chingtas Sewers Service Upgrades.;AlC �Fetice's(PloUSurveylFoata9ej : ,.,.,�... =_: �.
<br /> � , � :t •I , , ;�. . ls,,�., , t:� x
<br /> Driveways-tJoi over Caunter if an pubtic roadways..tteeds ftOW . i , , , - �. _ `�
<br /> o x
<br /> � � _ I ;� .. � , �:; -
<br /> - � ,. . .. . � . ._.." , � .�. _ .< ,_.. . ,.. ,....,�.,�..,.,.. ,..--._.
<br />
|