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<br /> e�saeo-oozo City of Zephyrhills Permit Application Fax 813-7$D-0021
<br /> Buitding Department
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<br /> Date Received " • � �
<br /> • `� Phbne CariEac#?far:�Perrinittin�°t''��,
<br /> Owner's Name � - . .. V�� Chwner Phone Number
<br /> Owner's�lddress • ' - • ' C9wnerPhane Number �_ � ' �
<br /> Fee Simple Titlehold'er;Name � ' ' ' � � • " " � � Owner_phone Number � �
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<br /> Fee 8imple Tltlehalder Address .. �� ' � - ' --
<br /> JOB ADDRESS �l,�J/ L01"# ��
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<br /> SUBDiV1310N .� �:,� � PARCEL"ID#' • • � . ' , - .. . �
<br /> , , . ; ' ; (08TAlNEDFRQM'PROP.E1tTYTAX�NOACE}'
<br /> WORK PROPOSED �s NEW CONSTR �-" ADDIAi:T �� SIGIV Q� Q 4, � DEMOLISH �
<br /> . ' e " ' INS.7'ALL 8.` � REPAIR ` . `
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<br /> PROPOSED.U3E� , � : Q` ' SFR • �] �"'CQMM [^� OTFiEl�;` "�
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<br /> TYPE OF CONSTRUCTION:;� 'C] : �'e�oc�".�,�p � "',;FRAME Q :ST.EEL, .p;
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<br /> DESGRIP'f10N''OF WORK F. , /1`� G�. ��� . � - � �!V 1. ^C� � �e C �
<br /> Bt71LDIPiG°SIZE�`� ' _ � $Q;FOOTAGE� ._�� n; ,;,,HEIGHT;`.� : �:
<br /> QBi11LDl�fG _ $ wk.�;,,,��.<_v.N , ..,,: ; , . � , . - -
<br /> � .VACUATION"OF TOTAL'CQNSTRUCTION ,
<br /> [�El,ECTRICAL � � AMP SERVICE � Q` PROGi�SS ENERGY [� W.R.E.C.
<br /> �PI�UMBING �� �.� -�� : • ,.. . .
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<br /> MECHANtGAL '��. VAk.tlATiON.AFM�CliANECA�.INSTALIATlON .
<br /> QGAS Q RflOFING:.,,C] SPECIALTY �" OTFIER '• �1" / / 37�
<br /> FINISHED FLOOR ELEVATIONS FLOOp ZONE AREA QYE$. NO .
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<br /> BUtCDER COMPAFiY ' � � .
<br /> SIGNATUR� RE131STEREp Y/ N. FEE CURREP' ' �.Y/N :-., , ,
<br /> /�ddress - �,: , ` • LlCense'#'�I � „—......�
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<br /> EtECTRIC!/W:;.-- ; � ' , ' CClINPANY ,. ,
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<br /> SIGNATURE �"' REOISTERED Y/ N �cu�n ':Y/N
<br /> Addresa` , ., . � � , 4. �•L•fcense:#;l ;' . � �
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<br /> PZUMBER x ,. , : . .�.,
<br /> . , � r-�� . CQMPANY� - . � �'jl.-) L:�}C3�I
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<br /> SIGWATURE � :RE4IST�Eo � �.;Y:/-xN , ,.FEe.Cuwt�t:. . -`Y/N:" _
<br /> Addre�s - ' - . .-License#,� - �
<br /> MECHANIG�it:`'�- , ., . . ,:> � , _ , . :Gt�MP1�NY-,. - ^;,. - `�� ,�. �. . ,'`;,: _ - ,.
<br /> SIGNATURE ' `r`"` '' +�' � � , , rt t r��rv ` � REGI57ERED'�� " ,Y:I'''N., _, ;�FEE.CURREn a �
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<br /> Address:::, , .... _� � `.:� ... - ` ; � . ' ` _ LJ.c:ense# �:: .. �: ,
<br /> OTHER ' _ _.�,r. �� � . _ . � _.. ,. �� ` ,GOMPANY, � ` .. � , , , � -
<br /> SIC3N�►YURE. �. `�" . . , .` � . . �_REGISTEREp Y/:N. FE�:'CURRE� , Y:/; .N-,;. :., , : � ,
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<br /> �ddre�s �'��"si� • . . " .'. �Ll�ci�nse�#
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<br /> RESlDENTiAL�,._��:�Attach.{2};.P1ot;Plans;;(2):sefs:ot'Buil�ing'"Pians,{(1;j`setof�Ene"i+,`gy:•Eorins�aR=Q»tN;Perinl#:fo_r�e conshvc�on�. _ ,
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<br /> ,r:Minimum�ten;(.1,.0)�working;days=�itterksutimittal�d'ate Required dns(te;=Constnu'c'Uon�Plans StormwateF Pians vir%=SIIt Fence installed,, :
<br /> .•= �rSa�i{fary�fad►iti,e.s�&:,1fldu� , ste,r,�Sitet.Work;Per,miC.for:...sutidtvi'starislla e`ptoJects�`�;:�'°t�,��;�:.�--,��°;=:.; . _ . _ , ._ . .. .-. .
<br /> COiVIMERCIAL ,�ttach(8�°oomptete sets c Buit�ing Piens ptus a Life 5afety Page;(1}set of Energy Farms.R t3-W Permit for new con'struction.
<br /> Mlnlmum ten(10)working days'after submittal date.,Requfred.onsite,.Construction Plans,Stormwater Plans w/Sllt Fence Installed;, ,
<br /> Sanftary�Fadlides 81 dumpster.,SiterWorkrPetntit for•atl��ew'.pro�ects:Alt_commerclat requfrements-mustrraeet compflance ; , , .
<br /> - StGN i�ERMiT Attadi"(2)sefs of'EngliieeredFf__!laitis:� ,��:�s.�,� ... , .- . ; ` , .. .
<br /> •••»PRQPERT_YBURVEY�reguirerl�for,;,all•NEW,�cons.WcUoo:.,_�: - _ �-- ' ' , - �
<br /> Dlrectlon�: �....,��a� -: ��, .. .. . -- __. ._.. __ __ � .._ -
<br /> Fill out appBcaticn completely.
<br /> t7wner&Gonttactor slgn.6a�c:of applic�aSon,notatized
<br /> If over�2500,a Notica,of CommencemenE is requfre�d: (AIC upgrades over.57500)._ _ _'� �
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<br /> Agent{for tfie�contrector)'0�'Pow`rer'of'Att6iney(for the owriec)wauld ba sameone with noharized letter from awner authodzing same
<br /> 'OVER'THE:COUNTER`PERMI -TTINCi:_::-:':-(Front�of�APPlication Onty)� ,.:.. ,_i..__. .�., --- -
<br /> ReroaFs if shingles Sewers� Service Upgrades A/C 1=ences:(Plot/Survey/Footage) - _ - -
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<br /> �Iriveways-Not over Counter if on public.roadways.:�eeds ROW ,
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