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8��-�so-oo2o City of Zephyrhills Permit Application F�s�saso-ooz�
<br /> L , . � Building Department
<br /> Date Recelved ,° .. ;; =�. ., ... _��_._ .__...._
<br /> �:_; _, • Phone•Contaot'for`Permiltin �-,_.�` ..-. _=-�-.
<br /> ' Ownec's ldame : �` � G�.' _ .,�:., �---'Owrier Ptione`Number.�µ��v�J"����� l` �
<br /> Owner's Address, � `=Co�-W 1� Oarner•Phone Number. . �t�^—,^�.O a`t 3���2c�—
<br /> Fee Simple Titleholder Name Owner Phone Number - _
<br /> � , •.� ... . _, ,_ . --= - - ,:,.. � -
<br /> . t .. , ,_ . , � - : ._.�..._....�.- ..- � ��.__..a..... .-.__
<br /> Fee'$Imp1e Titliholder/4ddresa � " `-
<br /> JOB ADDRESS -l `'C a-C.p. .��. 4 ,. .:._. _._ .��_.�. _.. ._ .;.-...�'LOT# :,_.� ,
<br /> . _ , - ':;`
<br /> �SUBDIVISION � � ' - - PARCEL ID# �� •. ' `-- . --` '. "
<br /> � -- ' " „_. ' � . �(OBTAINED FROM PROPER7YTA7('NOTICE);. �. �
<br /> _ - '" ' ,.,�. , �,; :- .
<br /> 'i.�.�; ' ~;"i';�.= ' �._. -,
<br /> _WORK�PROPOSED � �.NEW:CONSTR� •�`-��ADD/ALT �Q� `SI�GN'• Q'k "" " `-Q` � DEMOUSH -
<br /> � ��� . INS'TALL � eF ' REPAIR _
<br /> PROPOSE4�U.SE� , Q� :SFR' `Q�' "COMM ' Q �-' 07HER , ., '_ " �a�. -�--
<br /> �_��r; ._ `:;. ." .
<br /> TYPE OF CONSTRUCTION'• � '~BLOCK �'" •FRAME STEEL , .���;.`�"r��`"` � -''"
<br /> �o�= .o�: _ o . . . ::o.;,� .
<br /> DESCRIPTION OF WORK y���v ��rl'V� ��-. , �
<br /> /�- '
<br /> BUfLDING`SItE' ����O ` � - SQ.FOOTAGE:�.,. � , =-HEIGHT _ - � '
<br /> .�..�,�- - �,
<br /> . y� . ._ ,. -,.-,_ .:. ' .
<br /> �BUILDING $ ' - :. �' ..�;N'-:-� '. ~ •; --.:dr;.�.,;s:.�-.,,t _ - - .,
<br /> - =VAL:UATION`�'F'TOTAL`CONS`TRl7CT10N:;'
<br /> Q ELECTRICAI. $ � ~AMP'SERVICE � Q; PROGRESS EN,ERGY •:Q �W:R.E.C.
<br /> OPLUMBING � $ . �- ` _ �.
<br /> . . - . : �� "1 ��, �
<br /> QMECHANICAL $ . �,VALUATION OF MECHANICAL•INS7'ALWTION.
<br /> OGAS Q,-; ROOFING=,. Q. - SPECIALTY Q� OTHER "
<br /> FINISHED FLOOR ELEVATIONS �' FLOOD ZONE AREA QYE$ NO
<br /> - .�. , _ -
<br /> � ,
<br /> BUILDER /'j � �` COMPANY /1�'�-✓C�
<br /> SIGNATURE C� C`- REGISTERED Y/ N . FEE CURRE� �:.Y1.N�:..
<br /> Address ` ` ' License#
<br /> ELECTRICIAM ' � COMPANY '
<br /> SIGNATURE ` �' REGISTERED Y/ N FEE CURRE� Y,/.N .
<br /> Address . � ' ' - '"L•tcertse#� � � • ` ' ,
<br /> PLUMBER - COMP.ANY* •• .. . .., . - �
<br /> SIGPIATURE � „ ,REGISiERED � �: =�=:Y-/�N �s V� FEE CURRE� Y/'N: . `.
<br /> Address ' ' ^ . =.Llcense#��� � �
<br /> , _ . _.,��". , ,. -�:�'_ - . . . . . -�
<br /> MECHANICAL " " �COMPANY
<br /> SIGNATURE ` � �REGISTERED. .f Y:-/,N.�._. r .FEE CURRe� :• Y/iV.:._-�; �
<br /> Address�- • � •• . . . J . ,_c -- Ucense:#�. _ - ,
<br /> OTHEit -= , - . ` • - . - . .COMPANX•. �. . - - .:�' .-_,' - = _;:,• �.:
<br /> StGNATURE-' • � � - ` ' � REGIS�ERED� ,.Y l=N��,�` ,.F.EE;CURRE� `.Y;I::N::�`. _ '
<br /> Addresa .�':°�,�= ".", ' . ` _ .. . :. • ''Llcense#� " " " . .
<br /> - - - - `r�F:.k''o-,-',�it" "...c,ti.i�'., 'k:s'� - - -„��.y,.a.;,r,..:i�,� ..�:.�w �.�J.Y};:_- y:;g�. . . , . . - .
<br /> RESIDENTIALS:'=�=�'Atta'oki'.3•iPlot'Plan§�x"2`sefs=o�Bulldin `Plans;� 1�setiof.-Ene` `'Forms;�Ft=O=W}Pertn'it fo�`n,euv,;ao�s6ructton, -.
<br /> ..,.. (.).� .� ) 9 _ � ), �.-. �... Ep.._ x>.w,.>�-�� i�.,.... , � ,
<br /> '�'�`>� �:,.� � � S IYFence installed,
<br /> e:•rMinimumgteny(10);w�Qrlting;day"ssaife�:�sCibmittal:d"ate:�-Requliedonsite;`iConstrucBon-Plans;,StormwaterPlansw/y f
<br /> " " ' . : '-4,r.
<br /> _ r;�utidl,v'lsioiis7la e> io . x.�' . ..
<br /> 'Sanlfary:Fadltdes�&ili;dumpsterJSlte*Work•±Pemil.E�.�o_� _ ,[g:.p� Iects`:;:;:=`fi:":;�:>,'":;"°��''. -_ -
<br /> �.. - . .�. .r.7.. ,. .. '�t«:S.
<br /> COMMERCIAL A4tach,(3)'�i;omplete;s"ets'of-B311ding"�Plans;plusrapLtfe'$efe,ty`Page;�(1)_set.of.Energy.Forms:'RO-WPermitfo�neW�consttnction:
<br /> Mintmum ten(10)woricing days'after submittaF date. Required onsite,Construcdon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilttles 8.1 dumpster..S(terWork_Perrnil for all`neuv;projecfs.�All-commercia4reguirements:must.meetcompllance
<br /> 31GN PERMIT Attact�"(2)"set`s of`Eng1�;�,eeietl�P..:lans:�•��:;�:�" ,,. - _ , - - . .. -
<br /> ""PROPERTY'SURVEY_reguired fQr,;.all NEW_conshucUon...� „ . _ �
<br /> Dlre,ctlons� .. -4;;M-...: -� _ . __ .. , . �: .. � . ,.. _
<br /> FIII out applicadon completely.
<br /> Owner.B.Contractor slgn.back-of applfcatlon,notarized
<br /> If ov�r.;2500,,a.Notice.of.Comrqencemenf la r�quired: _(AIC upgrades.over i7500) ., �
<br /> ' :v.;�;,,;!>:,��iC>rtr«��:H. . • .. � ....v_._ _
<br /> '" Agent,(for,-ttie contractor);o�:Poviie"i�of Atfortiey(fo�tfie�owner)would'be someone with nota�iied letter from owner authodzing same
<br /> 'DYERTHE`COUNTER,-PERMITIING,---. ; ,(Front�of°ApplicaBonOnly). -., ,
<br /> Reroofs.if shingles Sewers Service Upgrades /UC' " Fences•(PlotlSurvey/Footage)
<br /> Driveways-Not over Counter7f ompublic roadways.:�eeds ROW
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