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<br /> e�aaeo-oazo - .. ' '. : � - ����`-��Gi�y°`of Zephyrhills�Permit Application ;.,; EaM�R13-7eo.002�;,, �,,�:.::;,
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<br /> . _ _ .. , � , �,,� > . �. ' :Building Department � �ji'f.- :'CN:;i}i�c+�i0ti d:.,. i 3:�.. �
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<br /> DateRecetved '''V;�;Y �;fj�;•;:�;` '}�.::,,,,�•�a�•: t.��::
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<br /> • � � ;Phbr�e Caiitact for Perntittin ;r:_�;�.�::;.::�i°�.
<br /> Owner's Name C� '}'QY► ` �..+PXtOYGt ,�'DL�QS ... • Owner Phane Num6er 8�3.��-8a-�!4
<br /> ��o� W�1SO►�'t �r, � � �
<br /> Owner's Address �e h ✓����.� 3 '��-Qwner Phone Number
<br /> Fee Slmple�Tltleholder Name � � Owner Rhane Number � �
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<br /> Fee�tmple Titlehalder Address
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<br /> JOBADDRESS �-I ����1'� �Qr• h ►�� yj 4�� 3�J`J�}� LOT# � I
<br /> suaoivisiorv �t�{ a� �.�phyrYt�t15 PARCEL ID# 1b-24-a�-t�oo0-(au9c�o-dca o
<br /> (OBTAINED FFtOM PROPERTY TAX NOTICE) I
<br /> WORKPRQPOSED � e NSTAI.LST�B REPAIR �,�,e�,,,a,� � � DEMQLISH
<br /> PR{�POSED USE Q 8FR Q CQMM OTHER _
<br /> TYPE OF CONSTRUCTION Q � BLOCK �] FRAME � STEEL C]
<br /> DE8CRIPTION OF WORK 1Se' 1"��� �
<br /> BUII:DING S12E SQ FOf�SYAGE ���"� HEIGHT `,V��
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<br /> , ' ������i��' '°���' - , . � VA�UATION OF TQTAL CONSTRUCTION
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<br /> QE�ECT12iCA� $ �';�,;;13MP SERVICE Q PROGRESS ERtERGY Q W.F2.E.C.
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<br /> QPI.UMBING � " __.�.� .�.t; .
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<br /> Q{1t1ECHAN1CAl r$ � < �'�%ALUATIflt+!QF MECHANICA�INSTALtAT{ON
<br /> L��,�..'�`�� �
<br /> QGAS � ROOFING Q S�PECIA�TY
<br /> � OTNER
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<br /> FINISHED FI.00R ELEVATIONS FLOOD ZOiVE fiREA QYES NO
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<br /> BE3t1.DER COMP�AtdY
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<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addrass � Lioense# � �
<br /> ELECTRFCIAN COMPANY
<br /> ', SIGNATURE REGISTEREb Y/ N FEE CURRE� Y/N
<br /> I �
<br /> � Addrass I
<br /> License# � `�
<br /> P�UMBER CQMPil4ldY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
<br /> Addrass � i.icense# I �
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<br /> �IIECNANICAI. CQMPANY
<br /> SIGNATURE �. �r�� REGISTERED Y/ N FEE CURREA Y/N
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<br /> Acld:ess, � � �� � License# � �
<br /> OTHER :•��. COMPANY R VYittA't �DO#'}Yi
<br /> SIGNATURE ''�'1'`""�`'I�"F r REGISTERED Y/ N - FEE CURRE� Y/N
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<br /> Adclres� �� � ,: ,',l't`�'i'h�'�15 Ft. 335it� License# ��.'.0 13�-S��i�'S .
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<br /> �i RESIDENTIAL Aftach{2)Plot R1ans;(2):sets�ofi Bullding,Plans;{1)set of Energy�FaRns;R-E}-W Pemnit for aew canshuction,
<br /> Minlmum ten(1Q)working;days after,sukimittal.date. Requi�ed onsite,Construation Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilikies.8�1:dumpster,Site Worti Permit for subdivisfansAarge proqects
<br /> COMMERCIAL AEtach(3}camplate asts af Bu3tdirig Plans plus a Life Safety Page;{1}set of Er�ergy Forms.R O-W Petmit for new cons#n�ctian.
<br /> Minimum ten(10)working days'after submittal date. Requi�ed ansite,Canstruction Plans,Storrnwater Plans w/Silt Fence installed,
<br /> Sanikary Facllities&1 dumpster.Site Work Permit for all new pro]eots.All commercia)requlrements must meet compNance '
<br /> SlGN PERMIT Attach(2}sets af Eagineered Plans.
<br /> "•'•PRQPERN SURVEY required for all NEW constructio�.
<br /> Dlreetions:
<br /> Fill out appAcaUon completely.
<br /> , +Owner&Contraotur stgn back of app4icaflon,notarized
<br /> ' tf ovar�2500,a Ftotice af Commencement is requFred. {A/C upgrades over$75Q0}
<br /> " Agent(for the canUactor)or Power of Attomey(for the owner)would be someone with notarized letter from awner authorizing same
<br /> OVER THE COUNTER PERM17'TING (FroM af Appllcation Only)
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoN8urvey/Footage)
<br /> Drivaways-Not over Caunter if on pubtic roadways..needs RQW
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