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s��-7$a-aa2a City of Zephyrhills Permit Application Fax 813-780-0021
<br /> , , • `' . Building Departrnerrt
<br /> QBte ReC81Yed . , :' :�_PI10fl9=C011t84�?fbr`Permtttin �'>'_ � - -_ � � . .
<br /> Owner's Mame ` ` , 'r�LG Owner Rhaee Number ' �.,' ..
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<br /> Owner's Addras� , � � � ' � OwnerPhone•Number
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<br /> Fee Slmple Titleho[der Name� ' " � ' - ' Owner.Phone Num6qr�
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<br /> Fae 3lmple Tittehotder..Addresa � - ''• - � ' .
<br /> JOB ADDRESS ,.,�'' .--. , ` � . � i.OT# ��,
<br /> SUBDIYISION ���^ . � PARGEL ID#' ' ` ' - - � ,
<br /> � ,_ - ' � � � - <"`�(OBTAINED FROIN PROPERTY TAX NOTICE)� ��
<br /> WORK PROPOSED °;' NEW CONSTR :" ��� D/ALT � �SIGN ['�J �[�"� DEMOLISH - _-
<br /> ,. ' � .'�. dNSfiAlt. - '�REPAIR' � - ` ,
<br /> PROAOSED;USE. . [�`� �SFR ' `a ;_COMM '[,,,� OTHER:� ' •
<br /> T1fP@ OF GONSTRlICTiQN: �Q`' `'°BLC�CK:, •'.,'�Q=r`_ FR11ME � STEEi. Q� '",.,: : -
<br /> DESCRIPTION OF�WORK V x. � �'tit.i�'t L ��`�l��.� .��1�� ., ��� � �SC�,�r�GJ
<br /> BUILDING SIZE�'�' �' � S,Q.F407AGE��� . ,,HEIGHT:_.. -a,��.- �
<br /> QSU1GDiNG $ --��::.:�. ...,�. ,,. . . ` ,
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<br /> VALUATION`�J�TOTAL`CONS'1'RUCT70N , ,
<br /> LECTRICAL $ JE_��� J� � �AMP SfRVICE � �' ' r � PRQGRESS ENERGY Q� W.R.E.C.
<br /> GIL (Q Oc� [
<br /> �PLUMBlNG $ ; ' � , _. ���(,\
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<br /> Q MECHANlGl1l � $ ' . ' . VA�UATlON..QE.MECHANICAL INBTA�LATION . ' �� : ��
<br /> OrAs C]. , ,�oa�f��:��;:.-(��. SPECIP►I..TY� -_[�J.'-" 'OTHEi2 ' � . �/1�J
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<br /> FINISHED FLOOR E1.EVATtONS FIOqD ZOR1E AREA �YES. NO .
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<br /> BUI�DEit COMPANY _ ,. ' -
<br /> SlGNATURE REGISTERED Y! N. ,� ��cu�"�., `Y/N.'.� , , , .
<br /> Addres� . _ .. . ,Llcense#�( � ' ��
<br /> EL'ECTRiCUW�.. �... �A „, � COMPANY `'��`'"��� ��t `,,. C � C.
<br /> SIGNATURE "' �" �G�s�REo Y J N �cutir�n,'"y "F.Y7 N �
<br /> Address � � n , �=License.#-� :����C�-��'��
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<br /> PtUMBER � COMPANY= :,- = '-. , ' ,� � ,
<br /> SlGNATURE '., . . . .REG13TEREP" - �� ��=�Y/�:N:<,. . ,�:cuR�t�° _ ..�Y!"Pl:�. ':
<br /> Address -' . ;� • , �:,q .Ucense#:!'� . ._ �
<br /> (YiECHANIGAt, - ' ' `"' ' • - � ' `, ���.'ry" .,.C.OMPANY; ,. , ,. � ,_ , -
<br /> StGNATURE . . ... , ` - � . j_ ���tsr�R�a:: .�Y;! N> ;a�E curtR�n,, -:Y/N�:::
<br /> Address= - .. .-� .�. � - � .;:t . , ' � ' �� ' ' " � ,�Ucense# - ` `.-• ,- ' .1
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<br /> SI{3NA�TURE. . '.. . . ':"� ,..' , ' '.RE�ISTERED- �: ^Y/•:N+. .r��`Gttt;tit�fi -Y.:l:K•:_. -� ,
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<br /> RESiD�NT1At.: - �A;tta`ch�.2:,Piot;Pians;k 2�:'sefs-of.�8ultdi`ri':Plaiis;`.�1.:se't'.of�Eiiergyi�Forrris;��R=aW�Permif:for�,ney+construciibn,�;�. - ,
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<br /> - �,Mtnimum�ton�(.10)�i++Warlting;iiays;atter;subinittEil"dafes�Requ(red"orisfte;�Goastiuction�Ptans;:StorinwateF'P1ans viri�Silt Fence.in�talted,
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<br /> '.,:SanlfaryF:�ed�IN,es;&�:ti;dur�npst�r3lteiWo�lc�;Parmit,fa .� _ r9_prol�'-�'�������"^`;:� . - . _. , _
<br /> COMMBRCtAt. Attach,(3)�coinplete'sets of'Bu11iling`Plans plus a L�fe Safety Pege;'(1)set of Energy Forms.R-O W Permit fo�new aoristructlon.
<br /> Mlnimum ten{10}wockirig days after submlttai date. Required onslte,Ccnstn►c8on Pians.Stormwater P1ans w!Slit Fence instailed,
<br /> Sanitary,_Fadlities&1,;.dumpster.,Sit@,.VMork-Fermikfor•�Il-new:proJect's:�Alfcommerctal.requirements�mustmeetcompltance , . ,
<br /> SiGN PERMiT AttabFi'(2)sets af`�ngi�eer�d�Pians:,;:�- :�w ... �. ' � �' � ' s ' _
<br /> »:••PRQP.ER7'Y.�SURVEY regulred:iqr,atf NEH.V�consU'ttcBo�i.: - - , ._ � -.':; . _ , , .
<br /> Dlre6tlbns: ��.�,sv. ..,..j;, ,. , ....__... _ ..._.._... _M .. , .
<br /> _Fitl out appiica�an oamptetely.
<br /> Ownar&Gontraotor slgn.back:of app!(catlon,noi�trized
<br /> If over 52500,a•Notice.of..Commencement Is requlred. {AIC upgrades oyer 57500)r ,_ " .
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<br /> Agent:(for ttie oontractor):pr:Power`of Attoriiey(ffii�the.owner)wauld'be som�one.wi#h.notarized letter from owner au o zing same
<br /> 'DV�R THE COUNT�R.PERMI7TING'-='>--:"(Front�of=Applicatibn Only)�~� "-' ' t _
<br /> Reroafs if shingles Sewers Service Upgrades_NC Fences(P..Iot/5urveyiPootage) . _ • - .
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<br /> Drivewaya-Not over Counter if on public roadweys.:�66d8 RQW
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