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813-780-ao2o City of Zephyrhills Permit Applicatian Fax 813-780-0021
<br /> 8uifding Dapartrnent
<br /> Date Recelued - ' ` ' ' /��j
<br /> , � -� Phone�ContacNfor"Perm(tNn ��
<br /> Ow�ner's Nam� G� ��'✓L ,E',�' Owner P,ho.ne Number �G.� -
<br /> Owner•s Address � C� / Qwner•Phone�Number � � � �
<br /> Fee Slmple Tltlehalder'Nam�'� ' ' _' • � '� ' Owner.Phone Number �� ,���
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<br /> Fee Slmple Titleholder Addre�a. . � � - - "" � - � ' "
<br /> JOBADDRESS 7�� � /' /b '� �C_.. L.OT# ��.�
<br /> SUBDIVISION C-�,.%r//!��^'„��"�� y PARCEL ID#' ' , ,-, _ -- . �
<br /> ��/���Gr/ . . � : {QStAlNED'FRt?MPRpAERTYTAXNOTtCE}
<br /> WORK PROPOSED' � NEwCONS7R :"" �" ' ADD/ALT Q SIGN` Q� �'Q�j� DEMOLISH • _ M-
<br /> . � . ' e Y' ' INSTAkL 8;:-.'��REPAIR' ' ' ` -
<br /> PROFOSEp�USE Q; ,:SFi2 � `COMM-� `� OTh{ER� `.
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<br /> TYPE OF CONSTRUCTION__±_�Q�'y "'BLOCK'"'. Q��� �FRAME. STEEL, r� - _ . . -� .
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<br /> DESCRIP110N OF WORK � �(/� � ! J/'��"�°� S�/�
<br /> BUILDING SIZE`"�� ` �,$Q;FOOTAGE .HEIGHT ����y ��`v��
<br /> � .. . _ "��• l�V' .s'��.2_
<br /> 08UttDING $ .4; -k�:-�, , ..,r� t - . . _
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<br /> _. VAGUATIONy"OF�TOTAL CbNSTRCJCTION
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<br /> Q�LECTRICAL $ �. AMP SERViCE y Q' ' �PROGRESS ENERGY �.[�, W.R.E.C.
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<br /> QP�UMBING � $ .
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<br /> QMEGHAiVIG,4t + � $ G�����VAI.UATION.OF MECHANEGAL.INSTALLATION ._ =- ' j/j���
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<br /> o�� o - ��o����.,.�o ��EG�,�n-�o o���R.. � � ��I �
<br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA �YES. NO ,
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<br /> BUiLDER GOMPANY'� '' ' � 4 � � � �
<br /> 81GNATURE R6GISTEREO Y/ N.. , -�e cu�n'',;_ '.Y l.N..-.- . ,
<br /> Addreas - - ' ,Cicense#�� "" , -� ' �
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<br /> ELECTRICiAN:.. ` . .„' COMP�INY ' ' " '
<br /> SIGN�►TUFI'E �' REGISTERED Y/ EV FEE Cl1RRE� �.Y`/N : �
<br /> Address ` . . ,� I � � .. . �.Ucense:#-FI `�• - , � �
<br /> PLUMBER, . . , - � . -- COMPANY> :;� , , . Y , , , ' ..
<br /> SIGNATURE � � ' ' ' REoi�T�ED: , •-�Y I-�N. �E cuw�En � `Y7 N:�- -
<br /> Addre�s . . , � -. . , .License# � �
<br /> MEGHANIGAL. ` �., . -,CQMPANY;� !'.%'�-/► :-% ° �- ,
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<br /> SICiNATUR� RecisTert�o:;. .,.Y,/.:N, :.�Fee.Cuwten�• . ° Y/-N;.•� - '
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<br /> Addre��� 0 .� C�'�/� .r�.. ;,�`�.�✓'� ... . _Llcense#;1�--'" ./ c-.�2-->�/�`��, :
<br /> OTHER " , �_" � . , ,.. _... ' .. - �COMPANY ��� . , ,_, .. ., . . . .� . .-� }.
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<br /> SIQ�NATURE� ,`., _ . : „ ` .. ,REGISTERED,.-. ,1 , �: , .
<br /> Y/.�N.�; ;Fe Cuw�n ,..e-�,:Y.I.N�
<br /> l�ddreas r: ;.;.::,; '-�;,;Y�s1:. . �,. .. ,. ....,- _ � � . e ._`Llcense#`� = .. . �
<br /> . . �.t .p�:.. ..;�c.�.. :e�§. ,..R•_ _" d.i;t4� L"a:.}�..,T.1'tii�1;=xvy:m" ri:r' _ .. � ,-...,.I . ,
<br /> RE8ibENT1AL,a.'���Atta`cti'(2):Plot;P.,lans;:�(2):sets-of�Butidiny'�F?lans;':(1:};seif of EriergyrFortin�;R=a1Al�Peririif:for�rie"vir„construcfion;;. :, .
<br /> �:,.. .....a..,�ti, ,.� . . ,A,;,��...
<br /> '-.Mlnlmumc.ten�(:1A.);working;day;srafte:r„'s"utimlttal�d'afe:�:Regufred onslte;�Consfiu'cUon�Pla'n's;�Stoimwateir'Flans'"w%`Silt Fence Installed,
<br /> _... „Saii[#ary-:Facttttias.;&�1�Sdut}�pst�,er,,>Site�,,WoikzPemilt.f�r;suti�ivtsEonsliarge?projects�;:�-:M�e�.�•.��; �- . _,_ ,_` , ' , � -. -
<br /> C.OMMERCIAI. Attach(3j'`ceiiipiefe`'sets"of'Bullii�ng"Plaos plus a'Llfe 8afeiy Pege;`(1)set of Energy Farms.R-0-W Permit far new construction.
<br /> Minimuin ten(10)working days'after submittal date.,Required onsRe,.ConsWcdon Plans,Stormwater Plans w/Slit Fence Installed, �
<br /> --Sanitary.�dtitles&,.1:dumpster..S1#e Work Femnit far�11,new`proJects:All ccmmerclai,cequl�ements must meet compilance
<br /> SiGN PERMt? AttacFi'(2)`settig`of'Eag7jieer,�edJF.'tan�;�,�.�?'� . �. . , � _ ,.
<br /> »•"•PROPERT,Y.,SURVEY:requir,ed;iqr,all_NE1N:construcdo�..;_. -�. . .�. _ _ _
<br /> Dlrectlons: .�.s , _ -� ......._ . ---- ._ __ _ .
<br /> Fill out applicaUon wmpletely.
<br /> Owner&Contractor slgn back�of applica8on,natarizzed �
<br /> If over$�500.a�_Notice-of.CommenaemenE(a requlred._(A/C upgrades aver i7500) t�. "
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<br /> " Agent(for the cantractor}qr:Fow`er'of Attomey`(for#he:owrier}woutd'be someone with no#arized letter icnm owner authadzing same
<br /> � � W.,.;_._.w�. ,,. ... _ . _ .
<br /> 'OYER'THE COUN.T,ER:PERMITI1N13�==--•:-�(Front�ofiAppllca�on Only)=� � '
<br /> Reroats if shingles Sewers Service Upgrades AIC _ _Fences{Ptot/SurveylFoohage) --y -- . --- , ,
<br /> DNvaways-Nat.aver Counter if on%publlo roadiivays::nerad's ROW J t,.� - . - � � Y- ' , �
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