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a�aaeo-aa2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> 8ultd�t�g Department
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<br /> Date Recelved w �- � �, , , _ .
<br /> �c�' 1 ' Phane'.Caritact�fbr`Permi�tin ` - - -
<br /> Owner's Name � i'�J� {�tI� �"� . tiwner Phoae Number gf•��7�� 'to 7�%�'
<br /> Owner's Addre�s �b o^"• , �� � A /��U�S �� ' �GwnerPhone Nuinber � ' �
<br /> Fee Simple 71t1eholderName''� � ' '' � � ` � � Ownec Phone Numbe� .
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<br /> Fea Simple�Tltlehalder Addr��s . � �F • � -- � ' •
<br /> JO�ADDRESS ��`2"�p �tJ�A�- /''US �lZ. 2c�P�i 2 _ df�..F`� 3s''�j �o�r# ��—.I..
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<br /> SU9DIVISIQN � �"';. � �PARCEk ID#' - - � � , ,
<br /> , ' � - � � , ={OBTAINED FROM'PRppERTY TAX NCTlGEj
<br /> WOt2K PROP.OSfD 't NeVv CdNSTR � ..�: `ADD/AG�T � 'SiGN ' [� .. [�;`. DEMOLtSH .
<br /> . e '.�'INSTAI:L �:�' '• � RERAIR
<br /> PROP4SED�USE-.< , � �_ Q' SFR� ,. :Q GOMM"` �� ' OTNER`. ; _ .
<br /> TYPE OF CONSTRUCTION;� °� ' BLOCK�" ;Q-� '`FRAME � STEEC: ,C] �.: .
<br /> DESCRIPTION OF WORK � C� L .. .."� �,�� ., i?L� ,�.�?'�� - �
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<br /> BUILt31NG°51ZE:'�� �rSQ.FOOTAG�E�� t .;,HEIGFIT�.�..� +
<br /> __ QBllILDING $ 'G.�>=:c��,.- r:,�:nt.a,. ..` , . .. _ .
<br /> -�� ' � VAL:UATI'ON`"OF 70TAL CONSTRUCTION , _
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<br /> QEI.ECTFt1GAL $. ANIP SERVICE j [�' PROGRESS ENERGY ,[�� �W.R.E.C.
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<br /> QPLUMSING $ '� ' . .
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<br /> QMECHANl� $���� U��,, _VAl.UP►TION.f3F MEGHAPt1CAL.ENSTALLATION . ._
<br /> Q�►s �- [�.: �aoa�i�►�::�..�.�.p SFEGIAl.'FY�Q ' OTHER � •
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES. NO
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<br /> BUII.DER COMPANY `: , � .
<br /> i, SIGNATUR� REC3ISTERED Y/ N_ FeE Curtrt�n" , Y/N ;-, � ,
<br /> /�ddre�� ' , �, . :LJcense'#'�l ' �
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<br /> EtECTftIGlAt!1�,;.. ._, � ` �* CGIMPANY � ' � � _ . .
<br /> SIGNATURE M RE(31STEREp Y/ N �e cu�ten Y/N , �
<br /> Addee�� . . �., � .. _L•icense.#:�� - * `"- I
<br /> PIUMBER .. . � . . �COMPANY4- " ' - - . .
<br /> SIGNATURE ' _ "-� . � � . . REf31STERED �.�- ;:Y'/raN.- � FEE.CuitRen' „ .-Y/N:
<br /> �ddre�s '�. , � . . ,.I:Icense#�� . , �
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<br /> n��ct�aRv�c�t: � - ., , � :coMPa�v �9�:��.:�.'S��s�ve.�� �PZ.,1���`.� -
<br /> SIGNATURE ° � RE.f31,57EBED:' _ .,Y../ N�,: :;EEECUR��.. . '�Yl�iV�.�: = � - ,
<br /> �Addre�s� ., . �; . - _._._.. - . � ..t ° _ ,- - � �1�,.. -:License#,� .�; .�� . . .
<br /> _,�a:�;; - . .. .—�`v,�<�x. . ._ , � , : :: . - . , • . , ,.- < < . • �
<br /> OTHER " -. -_ .G�QIEPANY �� '. ,. ,.. . .,.>>�;' -.. , .
<br /> SIGNAYURE,. E.. � . � .., - , ' : . ., ` y�REGIS7EFtED Y/�N_ :FE��CURRE� ;Y/:N::,.-- , ' - ,
<br /> - . .. . � �_ ';'�ist`; `���. .. ,.t ���.':i'�` a- �, . ,... i... ' = � : , . `•�� - '.,. ..� ., "�� _
<br /> �idress fLicense#�� I
<br /> - =� .:5� r�ra ::ti� _ �t� c.i+� -"'�;" - .�k;F_<.b..,a�:< :�_�";;.i.s�r.=e';r,:;v`Y�i'.:`..;'r�.&:r�p��,r . . .... -, . , �
<br /> . RESlDENTt�t:>_ -At#aoh�'{2},,PIof;Plans;:,(2};sets=:ofiBul!`iling�Plans,.(1:j;sef;of�Eneigy�Foirm�►s��R:O�W°Perml4for.new;.construc�'on�= ., - ,
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<br /> ;; Minimumxteri(;10)�worlting;dayssafter;sutimlttal�date:�Requlred'onslte;�ConstrUiictlori�Flans;;8tormwater;Plansw%�Siit Fenqe tns4alled, ,
<br /> ,.. 'Sanf'tary Facl4iUe,s'r,&:1:,du,lm ter�Si�e!.Worii,Per.ri�it.for sutidivlsion�lla e;` eds' 'Y.:+=:��`` . - ... _ ..- — - - -_ � .
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<br /> � Cflh9MERCiAt Attach(3j`complete`=sets cf'Bu`iEiltng Pians ptus a Life Safety Page;'{1)set of Eneqgyr Forms.R•n-W Pecmitfor new cafisaucdon. �
<br /> Minimum ten(10)working days'efter submittal date. Requlred onsite,:ConsUuctlan Plans,Stormwater Plans w/Sllt Fence Installed,
<br /> , ' Sanftary,FadiiUes.,�,1_dumpster.�Site.Wotic.Permlt tor aii new'priije�ts:Aii:ccmmerctal.requirements-must meet compilance ,
<br /> SttiN:PERMiT Attac�i"(2j`setsof�Eng��eer.ed�Plana,::;�;s::c�;'::.',���.-�.,`<`� - , _ `t�,. _. _ _ .
<br /> •`""PROPERT.1!.SURVEYrequir�gd;,for;all;,NEW,cqnsWcUon:;_. . " . •
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<br /> `Diiecfion�: :.�.r,-=:t :. . � ... :--�_ _ _ _ . _.
<br /> FIII out applicatlan completely.
<br /> , Owasc&Gantraotor.slgn bacic.of�appllcatEon,nctatized
<br /> � lf over�2500,a Notice,af;Commencement la requleexl. �ac���ae$ov�r s�5oo� ._ - x .
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<br /> " �4gent(for tfie contracto�)'Gr:Powei'of Attoiney(ftif it�e"ownet)wauld be someone wiUt natacized letter trom owner authodzing same
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<br /> DVER"fHE:GQUNTER.PERN1iTI1NG��='�=:�`�(Front�of�Af)pIICB$p�:Ol1Iy�' . � -
<br /> � Reroofs•If shingles Sewers Service Upgredes A/C Fences.(PIoUSunrey/Foatage) -. - - -
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<br /> � Driveways-Not over Counter if on•public roadwiays::needs ROW
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