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a�s-�8o-ooxo City of Zephyrhills Permit Application Fax 813-78p-Q021
<br /> Bullding Degartment
<br /> Date Racelved , "Phone Contacf for Per�ntttln � �1�� ���. = 1�
<br /> Ow»er's Name �7'lV���.'�. E.'' 1� b G Owner Phane Number o�.o � �����
<br /> Owner's Address I`�� � � ��.�� ��/� ��J� OwnerPhone Number r- �
<br /> Fee 8lmple Titleholder Name � � Owner Phone Number � � ,
<br /> ?•�t - �
<br /> Fee Simple Tltleholder Address °"
<br /> JOB ADDRESS �7�J GLIL TI l�,ti 'G 1'? � �� . LOT# ��
<br /> SUBUIViStdN �1 l 1�� C;./� •J PARCEL 1D# � �
<br /> �(OBTAINED FROM PROPERTY TAX NOTIC@).
<br /> WORK PROPOSED NEW CQNSTR ADDlAI.T Q StGN [� Q DEMQI.ESH -
<br /> e INSTAI:L �REPAIR
<br /> PROPQSED USE Q SFR [� CQMM [� OTHER �
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FRAME � STEEI. [�,
<br /> •. ��y �
<br /> DESCRiP110N OF WORK • �5.. fI C � A"l� �-'-'" �L�.-� � oZ lLi1+V �CD.� f.+�L'�/1I�S
<br /> I , �, „
<br />�� BtliLDING S12E � ' � SQ FOUTAGE HEiGHT . �
<br /> QBUII.DINC, .$ ��..n._a_ �M
<br /> , VALUATION OF TOTAL CONSTRUCTION
<br /> Q � � AMP SERVIGE Q Pi2t}C�RESS ENEf2GY [� W.R.E.C.
<br /> EI.ECTRICA! $
<br /> QFLUMBfNG ��
<br /> OMECHANlCAL $ ,t� �� � VALUAT{QN OF MEGHANtGAt.INSTAL�ATIQN
<br /> ��. ��
<br /> QGAS Q ROQFING Q SPEClAI:TI C� OTHEFt
<br /> FINI5HED FL.00R EI.EVATIONS ��� FLOOD ZONE AREA QYES. NO
<br /> BUt�DER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y./N
<br /> Address , License# � �
<br /> ECECTRICIAN COMPANY
<br /> SIGNa1TUFtE �' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres� -Ucense#;�� �
<br /> P�Ui111BER , �p�ypp�� •
<br /> SIGNATURE , REGISTERED ,Y/..N > F�cutt�En Y/�N. `
<br /> Address , License# � �
<br /> MEC#fANICAI: � c• �,/* COMPA#Y �1�12 r� p f}j�G • �`��,,',, T�l,�
<br /> SIGNATURE ��'�'�____�I�""���� � � REGI ERED .,
<br /> „s7 Y:/ N FEECURRE� Y%N
<br /> � Addfess �'�'�� � �N � � �1�,L �_ License# .�.-�/`i-�Z'��'"�'���
<br /> I OTHEit COMPANY _
<br /> SIGNATURE ' � ' ` RECaISTERED ' Y/ N... � FEE CURRE� ,.,�. Y/-N: .
<br /> Address - - _ -� - -. � , . - _L'icense# �� �
<br /> RESIOE�Ii'IAR:�.: -:-.Attach.{2}..Pld#'.P,lans;:(2)*set`s.of'8�uitd3ng`R#ans;{1)setof�Energyr;Fors�is;:Ft-O=W.Ferinitfor,nevir.constructloa, - ,
<br /> ::�;Minlmum?ten:(10);working;days;after;subiiilttal�tlate:;Required onslte,:CanstrucaomPlans;tStormwafer'Plans w/Sllt Fence installed,
<br /> . '.� �5anitary�Fadltdes>.&n1#,dumpster�Slte�Work>PermltforsutidivislonsAarge;proJecfis�',.":��'h'``=''- ''-- �
<br /> COMMERCIAL Attach{3}�iyoin�plete'sets of B`v`il'tling Plans plus a l:ifs Safety Page;(1}set a�Energy Forms.R-O W Permtt far new c8nstructlon.
<br /> Minfmum ten(4p)working days�after submittal date. Requlred ansite,ConsUucdon Plans,Stormwater F�lans w/Sflt Fence installed,
<br /> - � Sanlhary Fadlitles&1 dumpster.Site Work Parmit for all`new'proJects.All commercial requirements must meet aampllance
<br /> StGN PERMIT Attacli{2)"sets of'�nglrieei�}Ptans;;�4���t;u�,� _. , -.
<br /> """PROPERTY SUR1iEY regulred,for;all NEIN const[uadan.. _
<br /> ` Dtteotions: �t. . . . �
<br /> Fill aut appNcatlan completely.
<br /> Owner&ContracMr sign back-of applicaUan,notadzed
<br /> { tf avar 3�500,a Notice cf.Gommencement is required. {AIC apgrades over;7500)
<br /> I �� .�.ihti;_.,i.,
<br /> Agent(far ttie�contractor)o�'Power�of Attaimey(ki�:the�owrier).would be someone with notarized letter from owner authodzing same , ,
<br /> BVER THE CtitlNTER.PERMiiTING.-- -- {Fron#af�AppfEcaUan Onlyi}.`. '. . _ �
<br /> Reroafs if shingles Sewers ^Service Upgrades A/G Eences;(Plot/Survey/Footage) ,
<br /> Driveways-Not over Gounter if on putslic roaduvays.:needs RdW . r - ~ � •.,,.�. ,
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