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813-780-oozo City of Zephyrhills Permit Application Fa�c e�3•�saoo2�
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<br /> � Building pepartment.
<br /> Qats Recelved : - - _
<br /> � - ,`Phone�Contacf.for'Pe`rmittin'^�` � . .
<br /> Owoer's Nae►�ce ! - �+D� yF''p1 .' , pwner Phone Number �'S I�3� ��� �'�'! .��. '
<br /> Owner's Address c3G/�r�� �'Y/���D t�,1 �pD , Qwng�-Phoae Number � ` �
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<br /> Fea Simple Tltlehalder Name � �'� '� � ' � Owner.phone Wumber
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<br /> Fee S(mple Tltleholder Addresa _ � k� �r� � • - �
<br /> JOB ADDRESS ���U�?� ,y ` �Gc�IOc�J �Oc� . - �.OT# C�
<br /> SUBDIVISION �_ � ,�: � PARCEL ID� �. . . � � �
<br /> , ' � - � �, �{QBTAlNED'FROM PROFERTYTAX'NQTICE} �,
<br /> WORK PROPOSED ", NEW CONSTR . � `� ADD/ACT [� �SIGN Q '' ` Q, �DEMOLISH -
<br /> ,. • � � e , Y INS.TALL - 'e:- :�REPAIR` , - . `
<br /> PROAOSED USE -�< SFR �Q COMM` � OTHER= ' " �
<br /> TYPE OF�ONSTRUCTIQN:� ��Q ` BLOCK _' '��] '` „FRAME, �� ST�EL. Q' .:" .
<br /> DESCRIPTION OF WORK .x °s���'� �I�i" " GYi �. D!>�`�
<br /> BUILDING SIZE '�_��'SQ;FOOTAGE._ , - � �HEIGHT=. . . Y� . .
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<br /> 08UILDiNG $ ` a�,�~�. _ , -.'"�r.,._�--•� -_ ..;
<br /> VALUATION�b'F"1'QTAC`CONS7RUCTI4N
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<br /> Q�LECTRICAL $ � � � AMP S£RVICE [�` PROORESS ENERGY CJ ��� �W.R.E.C.
<br /> QPLtJMBING .� ,,., ., .. �f 2�� �
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<br /> [�MECHANIGAL � $ r �.�O�j _ ; �VAI.C)AT'lON.QF tVtECHANtCAL:INSTAlIATION } •��� �'"l��"
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<br /> QG1iS ,Q. -,ROOFtNC�,�>_�.�� �SPECIAL'i'Y Q -OTliER �I3,r��y��'
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<br /> FINISHED FLOOR ELEVATIOfVS FLOOD ZONE AREA QYES. NO• �1�7�;2-�Y�""�I
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<br /> BUtLDER COMPANY ` ' ' , ' _ . _, _ ,.
<br /> SIGNATURE REGISTEREO , Y/ N_. FEECURRE�',�,, ',Y.f N. .�;_ , _ , , . ..
<br /> �ddreas ' , - ` � Llcense'# I � ' ` � �
<br /> ELECTRiCiA�!t:�•r, - COMPANIf ''' _ ` � - ' � . -
<br /> SIGNATURE „� ,` REOISTER@D Y/ N FEE CURRE� Y:/N .
<br /> Address - { , . . - :•.Llcense.#�-�� - ' �
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<br /> PLUMBER , , r - .�- - COMP<ANY� : , ,- . �
<br /> SIGNATURE �� , � ..� �,�Gis7E�p: � �. :��Y/.,N.=- ; �E;CUwten' - 'Y/N.- " -
<br /> Address ,,. � . - �. ' ' � License#� " ,�
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<br /> MECHANICAl:; ,. '��uJs�;?�?R—;,. , �.COMP14NY� ��'���'�; �:_��G2u3,��-.::;.,,,,�-�tr.�}-� tc�col Gex�l� .
<br /> SIGNATUR� • . REGIS7ERED;� .Y./��N. � ." ,,EEE:CURREK' , ° Y/:f!���-,�� - .
<br /> Addrass� � � , r ...�_ � .. . � , ... � . < � I:Icsnse# I. , --. .. �.: �
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<br /> OTHER • _ -�`'�;; _ -, .r^^. j.. .. - ' CO PANY� _ - .� . . ., , : -- , ,
<br /> SIGT � ,_ . ._ , . .,, , .. � .. . . , . . �..:� . .,. . , �'. � ��� •• ,� ��:... . •� . _.
<br /> NA URE -" REGIS7ERED Y/=N. rEE
<br /> - . � �:Gue�n' -Y,:/�N;. t , ,
<br /> Addre�s , . , -,. _ ,,s;+y_ ._. . .k� ,. ...., - -- - , � l:icerise�#�1' _. ... ,�
<br /> REStDEN'i7A1;`: _ :Attacti:2;._P._,1ot;P1'ans;:2A:sets=ofyBuitdl'n�'°Alans•`� z ' §-,��<"-y_� . ,;�,�: -. :. ��;: ;�."`fi`:"�.;:'`� ~:,f�f . . , . �, . .
<br /> _( } . ( ): g . . ,(1 jjseti.of�Energy.Forriiis,R-O�W:Permft forrneW,cons,h`uotion,.r: -
<br /> . .�,�,Mlnlmum=ten;(�40)�woilting;day,ssafter,.submiftal�date=Required onsite,Constructlon�Plans ,Sto}�nwater Plans w/Sllt Fence,in:stalied,
<br /> Sanitary fiaci{itles&�1,dur�pster,��Sife*Woik Permif,f�r.'sulidiv�slorisltarge'projects:-;.�=`s;�`��:�;-;.,.` " ., .` ` � , .
<br /> COMMERCiAt Attach(3)''oomptete sets of"Bultding'`Plans plus a Life Safety Page;(1 j set of Energjr Forms.Ft-O W Permit for neW construction.
<br /> Mi�imum ten(10)working days aRer submltfal date. Requfred onsite,Construcdan Plans,Stormwater Plans w/Sllt Fence Installed, �
<br /> 3an(tary,Fac�[iUes;&.1,odumpstet..,S1#enW.ork_Perm(tfar�H�new'projecM:AlLcammerctal.cequlrements;mu�t;rneet'compSlance �� ,
<br /> SiGN PEftMlT AttacFi(2)se`t§of'�nglji�red;�.P.,..lans:};;;�:;,�`�:�,,,� . - .. • .i: " - - .
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<br /> """PRO,P,ERTY._SUR�Y r uired, r.all NEW�canstrucUon:,:..y�-� ���� � '�- . -'
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<br /> Dlrectlons: -.... , . _ y U ,...., ._.__ _ __..., -- --_., ., ,
<br /> Flll:out applicadon completely.
<br /> Owner&Confcactor stgn bacic=of appltca#1on.noharized
<br /> If over 5�500,a;Notii;e af.Commencementia�requlred. (AIC upgl'ades oyeP:T500),.
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<br /> Agent(for ttie cci�iUactti't)ot''Fo�iriet of�Jlttoin"sy(fcr#tse:ownerj wautd'be someone with notacized letter from awner authortzing same
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<br /> OVER`THE GOUNT.ER,PERMITTINC#•�=-:".(Front�of�ApPlicadon Onlyj.� .'_ .
<br /> Reroafs If shinglea Sewers Service Upgrades.A/C Fences,(Plot/Sunrey/Faotage) _.
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<br /> DHveways-Not over Caunter if an public roadviiays.:nseds RQW
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