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� a�s-780-0020 City of Zephyrhills Permit Application Fax$13-780-0021
<br /> c . , • Building DepaRment
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<br /> ' Fhort��C6ritact'�for`FermittFn"r`.',: -
<br /> Oysrner'$Name � , .+!GL ..��+ . Clwoer.Phone�tumber ., ,
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<br /> , Owne,r's Address G� ��J !l�� pwner=Phone Ntimber
<br /> 1 Fee Slmple 7itleholder Name'� � - ' ' Owner Phone-N�umbe� �� � � �
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<br /> J09 ADDRESS cr� � � 3,j LOT# ��
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<br /> SUB�IVISION � , � ,PARCEL ID# ' - ` - � "
<br /> � - ,. ' - •. , - (OBTAINED FRON`PROAERTY TAX NOTICE)' ,.. .
<br /> WORK PROPOS6D 4 NEW CONSTR �'� '" ADD/ALT Q S1GN �['�� Q`;y. DEMOLISN -
<br /> _ � 'e�e . INST'ALL :8 °r� ;RERAIR' � . .
<br /> PEtClPOSEQ>USE, , �,� '� SFR � CONIM s ,� QT#iEi2, '.
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<br /> TYPE OF CONSTRUCTION���..��]�' �BLOCK�'`,,Q:- .,FRAMEf . '� ;STEEL Q. :�.
<br /> DESCRIPTION�OF WORK �', �� 6 C_. - �
<br /> BUI�.DING 51ZE"r� ��$Q;FOOTAGE� , HEIGiH�;, ; � . � . �
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<br /> � QBUILDING $ -Yr,�='M=,�r- _....>;,aM,: ... , � .. „ -`
<br /> �� ,. , VACUATI'OW�F"fCiTAL"GONSTRCJCTION
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<br /> QELECTRICAL ��i 'AiNP"SERVICE Q PRO�FtES$ENERGY [�,, � W.R.E.G.
<br /> QPi:UMBING .:$
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<br /> �MECHA1�ItCAL . $ . r �VAI:UATIOhI,C3F,MEC�'fANICAL ll�lS'Tl4LlA7'lOE1 ' `��t,,,� �
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<br /> QGAS �Q - RQOFING.,;;::� ,: SPECIA�TY=��"-• 07HER'. .` , -
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<br /> ; FINISHED FLOOR ELEVATIONS FLOOp ZONE ARE�► �YES. NO _
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<br /> BUI4DER GOMPANY " � =� . . . - .. ' � � _. .
<br /> SIQ�N�►TUF�� RECiISTERED Y/ N. "FEE CURRE�°'_, Y/.N.,.-, .
<br /> Addre�s , . , License'# I " , � � �
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<br /> ELEGTRICIAN._, -; , ,. • ' GOiVlPi4Nlf �'' .°,� , , ,i` - � . , ��
<br /> SI�NFITURE � REGISTERED Y/ N FEE GURREK Y,/N�'
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<br /> �,ddres�- � •- . . , .. _ . . ' � _ -.License;#::1.:",�`' , - � - ��
<br /> PLUMBER ; ` , , COAifP.ANY* .� _ . '
<br /> SIGNATURE�.- � „ . „ ' ,: �a�c�is�R�o .. .. �aY/s;NY , FEe.cuwzEn��'„ 'Y/'N:�� -
<br /> Address , - . j� , - , � ,_.Ucense#��,I:,._ .�° � �� �-�- �-� 1
<br /> lMECHANICAL'L _ � . :�QNtPMiY, . ,:{.�.Q ����.' _� ��,�,�. . � �
<br /> SIQNATURE ` ii��isTErt�o: Y.J~N� , _ � -
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<br /> O'iHER � ;. .., =:x , .. . ,-', :�GOMPANX, =f, - ��;.:..,;,� - - - .
<br /> SI�3PJATURE. - , `'°. � ` . , �,- _ � ,�REGISTERED , YI .N-� -FEE�URRE�' -tY.,/,N��s ,
<br /> Addres� s.K ':�' �.;r. „:;L.�;�S;:� - .. :f..,,;c<<:,. . - , ..� _ ' . : •_`Lic�nse#.,_. �- �
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<br /> - RESitiENTi�lL.4�,.`,Attach�2,P.:lot�Pians��2 ;set's'�of>8nitdln"�.'Plans;:�1�'set`'of Ene �Fortirs::R=O?tN�XRe tfoi��n�w„cons�ic�on,. ,
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<br /> � r�`�Mlnimum ten�(+1q)�wprkln9=;da,y�xa�ter,submittal�d"afe:Y'Requirerl ons(Ce;�Construcdon Plans.Stiormweteir Plans:w/=Silt Fence,insfalled, y
<br /> Sarittacy Fac�li�,�ss&�1��ur��tst�r�Sl�4W��o'ik�P..,erin�t.(or;$u6d�srlstgris/la�e.projeLts>=�.,�����:-;'_.�-�--�:.= . . . '� � . .
<br /> CQMfltiERC1At Attach(3)'compiete'sets'of Building Ptans pius a Life Sefety Rage;(1)set of Energy Forms.Ft-O W Permit far new constni4tton:
<br /> Minimum te�(10).working days.after submNtal date. Required onsite,,.ConsGvcUon Plens,Stormwater Plans wl Sllt Fence installed,,, -_ ,
<br /> Sartitary,Fac�tities&,1„dumpster..:Site Worlr-Petmi#,fo�,aii new'pirajects':A4t'.commerclai:reqult'ements�must meeYcompllance � ,. -
<br /> SIGN PEItMtT Attactt(2�'§efs ofi`Eng1i��ered;P�l.a"[is; -����:`�'�... ... .., . � - -�, . .. _ - _ -
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<br /> ••••PROP_.ERTY SURVEY regulredr.for;a�I�NEW�.consGucUon., - , " ' - : ` _ ., - . .
<br /> Dlrecttons: .,�::�:.��_=•:�; . - __._. ._ .r. ._ _.. .v �_ _ � �
<br /> "Ffll ouk applicaUon oompletely.
<br /> Owner&Contractar slgn.bac�c of appltcatEon.notacized -
<br /> � If over$2500�ta�Notic�a of,Cammencement Is requleed. (A!C up�rades_over�7500)_ ,_ �,r _ > � ._ -- �
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<br /> Rs�ent(for�►e'ccntractor)�or Power of Attoiney{for tfie.owrter)wouRd be someane with nota�ized letter fram owner authodzing same
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<br /> � 'DVERTHE'COUNT�RtP�RMITTINi's�-`-r-•-.(Franfr'of�APRltcahon�Only)``." -�.:.�J . ..
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<br /> Reroofs If shingles Sewers Senrlce Upgredes A!C � Fencesc(Plot/$urvey/Faotage) . __ . ..__ _ _. . - ..,_..
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<br /> Drlaeways-Not over Caunter lf ompubllc roadweys,:needs ROW
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