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a��aaaoo2o Ci#y of Zephyrhills Permit Applicatian Fax 813-7$0-0021
<br /> • Bullding Depactment
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<br /> E1ate Rsc�iv�d .. ��,,. : . . �qhonaCoritac#�for`�Permittin°��} �� " �
<br /> Owner's Ham� �:. � _ . � . .. . , . . .. . W. � l�� — --� f` -
<br /> �?�"'� Ownet f►bone Number
<br /> Owner's Address �d: a,�.f� � �QwinerPhone-Number � � � �e
<br /> Fee 8lmple TltleholderlNam� �� � ` . � ' � • Owner Phone Number � ,. �
<br /> Fee Simple 7ltlehaliler Addre�s •, �� '�=- ' " � •
<br /> JOB ADDRESS �`o�C� . D/Z""�lf �' . L07# �,�,�.
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<br /> SUBDIVI3IQN � ,� �`` � 'PARCEL ID# ' d 5�-' �4a "�I^ L�'/�C'� —C���� "'�lq�
<br /> :: �(08YAlNED FRQlN PROPERTY TAX-NCTiC@j. �
<br /> WORK PROPOSEO � NEw CONSTrt ' �� ADD/10.1,`f Q� SIGN [� - [�"� DEMOUSH
<br /> e INSTALL 8� . :RERAIR� .' ` '
<br /> PROPOSER ttSE - •, Q' ' SFR � � COiUI{Ut� °� ' OTtiEFt #� .. .
<br /> TYPE OF CON3TRUCTION;� '.Q� BCOCK�'' ;Q..''�, FRAf�IE � ST�EC. ,Q, ' � - �
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<br /> DESGRIPTION OF WORK eV'SJ�� ' ` � ,�,'..l�Z 011.G rZ — ��'�—
<br /> BUIL�ING�IZE�,�^ �T SQ,FOOTAGE,� ...��. . . .. HEICiHT`C: �� , �
<br /> ,�x.
<br /> . �BUIIDiNG , $ -'�s�:r..;„�v.., .: . ��:_,�,;, . . ..
<br /> , , � VALUATIdN`�OF'TOTAL'CONSTRUCTION .
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<br /> �]ELECTR1CAt. $ . �,' AMP SERt/ICE Q' PROGRESS ENERGY . [� W.R.E.C.
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<br /> �t�i1MBiNG $ �` .
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<br /> QMECHANIGA� � $ �VAGUPiTtOPI OF MEC1iAP11CAl tNSTALLATIOt�! • ��
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<br /> Q�+� . . C�. - �oa����..,C] s�Ec�,a��r �, = a�K�R : . .
<br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA �YES. NO �. .
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<br /> BUiLDER Ct'iMPANY� ` "
<br /> SIGNATUP2E REGISTERED Y/ N- ' '�ECU�n" , YLN.,_.- :
<br /> Address �� � � �°' � `Llcense#�� ` �
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<br /> EtEC'fRtClAN.��._ . *y '.CCIMPANY � -� " . ' . ._ , - ' .
<br /> SIGNATURE '' ��is�REo Y/ N �cii�n '�.Y/N `
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<br /> Addres�s � . . ' a - _.:L-Icense=#«�'`. ,� -, � �
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<br /> PlUMBER ' . . COtNP<ANY° ., . . � . , �
<br /> SIGNATURE " .,,� . - , •�c#�s7Ert�p - -... �:Y%��N : -F.EE;,CURREA� .. .=Y/"N:' -
<br /> Addre�s .,. - � ._ ._ , `- Ucsnse#,� _ • ��� -• =1
<br /> allECHANIGAI:� . _�' . � ` � ' � .CCiMP14Pilf _ � - ._ , , .
<br /> SIGIVATURE ~ . '.' , . � , . , � , �R�G�srert,�o.� , . .Y;/�N�- ,,;��CURtten - Y/-N. �'
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<br /> Address.;t , ..., r . ..... _ ::, .. ,. _ . :L•icense# � - ��'
<br /> OTHEit �.�., ��~- ��r'��`_ ,-G01�liPANY� t-� ;.;v;GY� - .
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<br /> SI(3NAYURE. .-,-•' °: .,,��'' • .-- �.��.. �istEii�o. .'Y/.:N..: . .;���CUR�n� - ,..Y:/:N-.,., -
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<br /> Addre�s •�l�L��.�..:�";' !�� '�J `�'?I,� ,r � .. ..._ � ��ei��se.�:° :_�'��o�,:�.
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<br /> REStpENll'tAAL,:: �Attach(2):P1ot;P.lan§5;;(2):sets=of�8t�ili3�ng�Alans;'(Sj'sef,of.°Energy°Forrris;R-0�1lV�Perrrilt:fornewconsbuc�on;; �
<br /> tw.. •�:, •_ , . � _ ,.... .�. _. . .. :-
<br /> .-.;Mlrilmum=ten:(10.))worlting;days;afte��sutimlttaCiiate:�Requlred ons(te;�Consfr�cBori�Plans;�Storinwater Plans w%Sllt Fencednstalled,
<br /> ... >SanlfaryrEaci�4H�ss�8�:,1,,�$u�!�ster:Slte;Woric=Per.rr►it_.fc�:sutidlvl�lo�istlatge:pro}ect`s_.�i>:':,_;�'._" .� _ _ _. ._ _ _ . _ � _
<br /> C01WtNERC1�L Attach(3j'eoinptete=sets of'8u11diiig Pians'plus a L`ife 8afety Pege;(1)set o�Energyi Fqrtns.R-O W Permit far new conatnictlon.
<br /> M1Nmum ten(10)working days'after suhmlttal date. Requlred onsite,,Gonstrucdon Plans,Stonnwater Plans w!Sllt Fence Installed, , � ,
<br /> SanitaryFadlitles�'l;dumps:ar.>�Ite,Work.Petmlt.faPafl,s�einr`prcijeots.`;All,commerclai:requlrements�must=meetcompltance . „ ,
<br /> SIGN PERMIT Attadi"(2}set"s afEng1neer.eil;.Pians:��;:��rr��., , -- � . " -= "' -° � , . ... . � _
<br /> - """•PRQP_E_RTY SURVEYrggulred;for�all:NEVI/constructlon.... _ -_. ' - - ',.. � -
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<br /> Directlons: _<;�;•,.�. , . . ..__..�-- - .___ ..� __ �. , ..
<br /> � FIII out appNcaNan completely.
<br /> Owner&Contractor'stgn.bacic•of appllcatton,natarized
<br /> If over SZ500,a Notic,e,of Connmencement.ls requytra�i. (AIC upgra:de�over S75pQ),_._, • . • ...
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<br /> '• Agent(for�ie'contiactox)'o�=Power`of attom's"y(t'6r the'ownec)wauld be semeone wlth nohadzed letter from awner authadzlrsg same
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<br /> 'OVER'THE=COUNTER,.PERMITTING�=�=�;""{Fr�ont:bfAppllcatlpn•Only)=,,�`• �
<br /> Reraofs If shingtes Sewers Servlcs Upgrades A/C� Fences{Plot/Survey/Foatage) -�� , - -
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<br /> Drlvaw��rs-Not over Counter IE on publlc roadweys::needs ROW;�,,�"
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