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813-780-q020 Cital of Zephyrhills Permit Application Fax-813-780•ooz�
<br /> Buitding Department
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<br /> Date Recgived . � - � , ` -- -
<br /> , :�:':Pbons_CocitactFfbr'Parmittin �r' V .
<br /> flwner'�Name { . C'� �C.� t3wner Pbon�Number . _�t.. ���,'"J��
<br /> Owner'a Address - � �� O�rrner•Phone Numtisr. � �
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<br /> Fee Slmple Tltlehalder:Na�me � �• � " " -� � � Owner Phone Number � . _�
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<br /> Fee Simple Tltlehalder Addre�s ;, f" '{,; ,. � " -
<br /> J06 ADDRESS ��`""( ����I�.� LOl"# ��
<br /> SUBDIVISIQN �5tW1`���,� �� �� � PAR'C�LJD# _ ' ' � � ,� . • " �
<br /> - - . - �` _ � ':"�(08TAINED FROk1 PROP.ERTY TAX N0710E) = �
<br /> WCARK PFiqPOS�D '- NEW CONSTR• w` ADD/ALT � �S�GN -Q [�� DEMOLISH
<br /> ,., ,_' e INS7'ALL 8�:' REPAIR , . /•—' '
<br /> ��o�os�u.usE � , C::] ..sF�a � °C] conn�i�A � o�rt�r�,��= - . _ .
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<br /> TYPE OF C4NSTRUCTION,;;_'Q' ' BLOCK�' ;Q; " ,FIZAME � ..STEEC Q ...- -
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<br /> DESCRIPTION OF WORK ' �iJY1._
<br /> BUiLDING SIZE"'�'�i X �� � . , ;. _� - ' `
<br /> SQ FOQTA�E �, .;;HEICiHT•.
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<br /> -. .. OBiJIt.DlNK`s ��-7�s?7t.� �;, -'"�,=�.,_- ..i��:. . . .. �_ .
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<br /> i `VALUATION dF TlOTAL'CQNSTRCiGTION
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<br /> QELECTRiCAL � � 'AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
<br /> QP1.t1MB1NG L.._ 4�,, . ... � - :
<br /> � � ! � - ,' �~737�
<br /> QMECFiANICAi� ' $ ' � , VAl.tJA7'ION.OF MEGHANECAL INS'FALLAI'!QN -
<br /> C��� ;C� �ooF��v�.:,.p • sFEc��.r�r � a�rs��t�
<br /> FINI$HED FI.00R EI.EVATIONS r'�� FLOOD ZONE AREA , �]YES. .t �70 �/
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<br /> BUitDER rl�,� �,^�..�,�. ca���nr .. .::,.� .,.::
<br /> SIGPIi4TUR� "''�-Z��'� REGISTERED Y/ N. ` �e CuwtEn' ,� , .Y/,N. _ ;,,; , ,. ,
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<br /> Addree� - -, - - . ClCense# l I
<br /> EIEC"fRIClAN�.: . �- ` ° �, CGiMP14NY "A� , "` _ � . "
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURREA. " ".Y/'N
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<br /> Addresa � , , _- L•Icense:#:�� � ' �
<br /> PLUMBER ` � . . - CQMPANY�: . : - _. ,. ,
<br /> SIGNATURE � . , . ., ,lt�G15.7�xED „ u�Y/-•,N , ;FEE:CUR�n' ', -Y/'N_
<br /> qddress �. - . _ . . . . � .l:icense#,�� � � �
<br /> M�Cl1APt(CAL'.;� - . - ,.. .. .�. ' .. _GOMP/;�NY .. .,+:,;' _ . ;- ,_ _ _
<br /> SIGNATURE "'": . , , . � • ' ttEGIS7ettEDs: ,Y./°N:- ;��E.Cuwten . �Y�/N_ '
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<br /> �ddress' � , .. __�,. � , � _ _ . . " - . .License# ��. �-. •:�. , .��
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<br /> OTHER , ��•- . ., r'.��:. -- �•�''rv . ' COMPANY. - , . _. - , . , . - . . :, , . _ �
<br /> SIGN�TURE. . , .. . . . . ...:.:. •. ,, .. ..
<br /> �,�• . REGI87ERED . �Y'/-N.�. : r f��'Cu�n� ,_YJ.N:�.
<br /> Addr��s ����: _ "-�.s --?:�"us�r-i ". - ,.. < ,. . _ '~ r Lliu,fiSe#'��`{— . �
<br /> ' _ _ _- _ ;�r� _ .i�..,y- ��t "`�._ _ _ .L.,�:..,._,: , ,tis,e:��_r. ..-.. ,. ., � .
<br /> RESIDENTi�At: �°Attai�i��2 ,Pl"a".t:P..,lans�;2:sets=oFBu1ldi'n�'Plan's;,�1s set,'of.�Ene �Fortns;'R�O={tV;Rerinit:forn�w;:construc�on; -
<br /> �::. ".i t } .� ,t ) . 8 {.) r9Y :;. : ; .:
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<br /> `: -Mlnlmumrten;(�1,p);worktng;days;,atte�.:sutimiEtal=tlate:;;Requlred orislte;�ConstnicBon�Plans;�8tormwater�Plans'w/'SIIt.Fence Installed,
<br /> . `. Sanitaiy Fact�ktles&�1#clumRster�Stte?Woiic�Permltfor subditiri'slo�isHerge'Rrolects'.:::�-_..,w�' ��:� , r - " ,. '., � .; _
<br /> C.OMMERCtAL Attach(3)cdmptete sets of'Suilding Pians�ptas a't�fe'Safety Page;(1}set of Energj►Farms.R q-W Permit for new cbnstrvc�on. _
<br /> Minimum ten(1 p)working days'after submfttal date. Required onsite,Construc8an Plens,Stormwater Plans wl Sllt Fence installed;
<br /> Santhary Fat�tttles&,1_dumpste[.Sfte_Work.Permtt;far.a0'new pioject�„Ail'commerciai.nequfrements-mu�t meet cosnpilac�ce . ,
<br /> SiGN PER[YIIT Attach(2)sets=of`�ngi�eered�f'ta'tis,r;y:�;»r�`�-� - , ._. . . . `. � . , -. ,
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<br /> •"*•I'ROPERTY,..SURVEY;requir�scl,for,„all NEW;cansWctlon;...�;,...� ,. ,- �. - ' -. . .
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<br /> Direatlons: ;ti;._�z„ . , ,,k� .. ...,..._.._.,.� . _ ..
<br /> Ftll out applicaUon cqmpletely.
<br /> Clwner 8�Contractor slgn bacK-of appllca�on,notar�zed
<br /> If over 52500,,a Notice,of,Commencement is required. (AIC upgrade�over 5750Q),___, . �.� ,
<br /> �f t`:E.,:','u$�,n'F3s!i�.1T�.,.' .
<br /> Agent(far tf►e coatra�to�);or:Fower`of�Attomey(fai#hs`owiiscj waald be someone wr(th notacized tetter,trnm owrier authodzing same
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<br /> DVERTHE=COUNTER:PERIWITTING�=-;=:_::{Front�ofAjiPiicationOniy)::',."� �:-� ' - .
<br /> Reroofs If shingles Sewers y Sen►ice Upgrades A/C � .�Fencesc.(PIoUSurvey/Footage) . � - ;- ;
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<br /> Drlveways-Not aver Gounter if on•pubfic roadways::needs ROW y'� ,; � � - �_-- �
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