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a�aaa�-aozo City of Zephyrhills Permifi Applicatipn Fax•813-780-0021
<br />' � , •� Building Departrnent_
<br /> Date Rec�tv�d . _ - � Phone Cont�ck:for`Perinifttn``°°��� " -
<br /> Ownar's Name � rh•� �.1 �w c,v tf.wner Phone Number '
<br /> Owner's Address 2 �b ` - � . C� .
<br /> �{. /`7�~� �7 � l;lvvnsrPhone Number �
<br /> Fee Simple TlNeholder;Name� `� • � `' � �' �, Qwn�r�Phone;Numbar �� �
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<br /> �- ,. , - �Y � _
<br /> Fee Simpl�Tltleholder Addre�s .� - - � - " • - ' -
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<br /> J08�1DDRESS � „ LO'�#, �� .
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<br /> SUBDiVISICIN F PARCEL ID# '� ' - " . '-_ '
<br /> , • , , ` ., ' � .. • �. �(OBTAINED:FROM'PROPERTYTAX`NOTtCE};
<br /> WQRK PRt'>P05ED � � NE1N CONSTR �:� � '' �tDD/A[T Q �SiGN ,.�Q " "_; Q:�. DEMOLiSH , �
<br /> . .., e i� , INS?A@L :;8:-� �:�':REPAIR� - . r .., . = W
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<br /> PROPOSED�ifSE. : . . ,
<br /> , Q� 'SFR. � ,GOMM'' � OTH�R -
<br /> TYPE OF CONSTFtUCTIOW�� -�"' `BCOCK�' ;�CJ.. FRAME � STEEL.;"Q': �,v .
<br /> DEBCRIPTION OF WORK +� C...�- C':�'1 G� �' C, �.. C� . . � , ; +
<br /> BUH.DING SIZE ✓ ? ��� ��`SQ FQ07AGE, �� � , :HEIGHT� L..'�__�. , - _ .
<br /> ��__��a:SLJ. -,
<br /> . _, QBUILDING � �=�r=�-�_ �..��-=_r- - ; , , • : , • , ` `
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<br /> � - : , VALUATION OF'`TOTAL CONSTRCICTIOiV ; _
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<br /> �]EI.ECTRICAL $. , 1 AMP SEitVICE `}Q � �PROGRESS ENERGY ,`_[�. VN.R.E.C,. ._ �
<br /> . �� � - � T, ; ..
<br /> �PCUMBING $ - . . - -
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<br /> 7;.g �� .. � 5: .:•
<br /> QMECHANI�A� � $ ' - � VRLUATION,OF M�GHAMEfi.Al.1N8TAltAT10N�, �
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<br /> QCa�18 . - .. ROO�ING.�;,.,.�< ;, SPECI�4,L7Y^': '. . OTFiER�. : : ��^ •`'`./�'
<br /> , . ,c� a � a o� � � � �'
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA �]Y6S. NO. . ' �"""�.L�/„/
<br /> ��"d:.,`-'° - .. �y�
<br /> '�T' .C'- ' !'
<br /> BUtk.DER COMPAMf ` . r � _. � . - _ � . _
<br /> SICiNATUPt� R6C31STEREd Y/ N�_ � FEE CURRE�;`�,,. I. Y/..N. :- �, , - ` �
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<br /> Address .. .�• � , � LiGense# . . . . � t :. : 1
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<br /> ELECTRiC1Ai!1,_ ,. ..�, . °�� a.``,CCITi+iPANY° - ` , " _ .
<br /> SIGNATURE ' �' RHGISTEREQ Y/ N �E Cut�ten;' ' � Y,/�N'��:' .
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<br /> Addres$ . • .., . . . .�. , `.� „ ,. .::Llcense:#='I:_=:: •:, , -: , ,
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<br /> �lUMBER � ,� ,�; '., - � . � ,. - '.COMPANYt- '_�::: .:. , :..; ,. ; ' � ,
<br /> SIGNATURE �",.. =R�t�iS�Rep - -. ... �:Y/�N eeE�cuw�n= � X/"N:.: : .
<br /> �4ddre�s : ..� . � ,. � ,., lJcense.#��• , , . ,�
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<br /> IGMATURE .REG�S7EBED, . Y;��.N , ` .,;',EEE,CURREK� ,Y/N`:�.; :
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<br /> SIGPIATURE,, � . � - `` , .'" + � _ ���REGISTEREp Y,./;N;;.•;' �EE�'GURREA'. Y•/�N�� , - �
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<br /> �4ddreas ;4'� :�t=;:`�`� - Ll�en§e'#'�I� . �
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<br /> R EN Plot:P1"ns.z� ;se":of'B`u11illn`���Plaiis�`�1�'set.`of�Ene= `�Fomis�`R=0=1N=Permtt:#o�nsinr:;croiistruatton' -
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<br /> ' ��Mlnlmumr,ten'�s1.� workin +d"a' -a{t'e�sufi"`.Iftal{clAte:':R„�ulr".ed oristte;ConsUucUon�Plans;µStomiwater'Plans:wl-Sllt Fenqe Insfalled, -
<br /> ..u,:� , . ,,,a � Q�b , .9...=.Ys3._ !�! ., �!4 .: . ...: -_ - . ., . _ .
<br /> � �'Sanita rFadlitt�s;��;1=;dum ter�Slte�,VYork»Pe. �If#4 s�! l �{�;_'��::��:`y";>"=.��-`�_ _..._._� __ - .s:�_
<br /> rY .�:.;�i,,.T.�.:.¢�...,,�t.Fsrk,...ru:� ��:x�:�:�-A�!k:. r;'sutitlivi'slciri arg�'p_roecfis; .. ��. .,;: �= ; ..; n. .,:..., . ;_ ,` .
<br /> COMMERCiAt Attadt(3���:ompleta�sets of'Buitding Pians plus a Ufe Safety Page;(1 j set af Energjr Forms.R•O-W Permit far neW corisiructlon.
<br /> MiMmum ten(10)working day�'after submittal date. Required onsite,wConstruction Plans,Stormwater Plans w/Slit Fence installed, �
<br /> Sanitary„FaclliN,es&.1.dumpster..S[tenWork.Permi�rio.r-aN aew�projer.ts:`AI!'commercial.2equifements:must meet compllance _
<br /> S1GN:�EttMiT Attacti`(2j sets of fn9��ered Plans:��:;^�~:���>`��... �,:�.. - ° . .` _. . • - -` � ,
<br /> "«""PROPERTY.,SURVEYreguir+�d�:fora�I1�NEW�,cons,tr,ucUon.~ - , ` - � _� . r - �
<br /> Directions: ;;�-;x,,, _ , • _ ._..__..�.. ,. _._..m_ . ._ _. - .
<br /> � Flll:out applica8an completely.
<br /> <3wrner&Contrador stgn back-of applicaHoa,notartred
<br /> If'over'�2800,a Notice.of..:Commencement Is required._ (AIC upgrac9sa oyer 57500).,._ � ' . �
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<br /> �" Agent(inr ttie`contractt�ca`Oc:Power of Attoiney(fo�'#iie owaer)would be someon�with notarized letter from owner authorizing same
<br /> , : ��;e,,; r1 .. � _ .
<br /> `OVER'THE"COUNTER.PERMITTING'>-"::=;"{Fiontiof�ApPllctationOnly) .'.� "� -� �� -
<br /> Reroofs If shingles Sewers Servfce Upgradesi.AlC Rences;,(PIoUSurysy_/Foatage) _. •-
<br /> .__.._,.._,_._...__� _w,.W,R.:._. . ... ::. ... ME_ .:_'.:.-.i,x��;:-:,:a:�y ; .<.�.��.,,�. ., _ . - - .
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<br /> Driveways-Not aver Caunter If on public roadways::rieeds RQW
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