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� ���asaoo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � , � euitdtng Departmer�t
<br /> Date Racelved _, . .� _,.._ �
<br /> � ' Rhone Gantact'for'-Permlttiri _. _ _ ..'..... .. ._ . _ . .-- - ,.
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<br /> Ownec's Name ���-- r I!'�rti.' � - Qurn��Ptione Number � ._.. .
<br /> Owner'a Address O (l� 7 j�t� ' Q C--' �wnerPhone Nembar - , . ry'�
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<br /> Fee Slmple Titleholder Name O�unar Phone Number � _ �
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<br /> Fee Simpl�-Tltleholder Addr�ss " -_
<br /> JOB ADDRESS ��Z�- �P��(1`-R�7�"' �� _ - .� _ . L04#__. L.�
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<br /> SUBQIVISION �Ll �/� l/I/LH`� PARCEL.ID#" ���' S-=:zl�-- 0, -- -����;9 —
<br /> - " . . " (QBTAINEDFROM'PROP�RTYTAXNQT{CE}. ,� ,
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<br /> WORK PROPUSED , . . :: �a NEw=CONSTR �. :�� • -°ADD/ALT ��� S1GN'• Q``" � [�� ' 'DEMOC:ISH -
<br /> � IPISTALL �' REFAIR ..
<br /> PROPOSEB=Li3�, [� _�SFR ' '[� COMM � �� -OTHE12 . .
<br /> TYPE'6aF C�NSTRUGTION''; �/ BCOCK 4• 'Q� ' :FRAME , Q STEEL Q;�. :- .,, �
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<br /> DESCRIPTIdN OF WORK Cb2, ON�- .�� Do� ol..`�„ B�-S� W���'" ///M/i�',SIOf�-�'S"i`t/•�lr
<br /> BUILpING`SIZE -�� � SQ.FOOTAGE��. - -HEIGHT �..�
<br /> QBGICDING � �_''—� :��:-..:-3. . „ '. , , .
<br /> � I 'VALUATION"l��'F-T07AL`CONS�TRl7CT10N �
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<br /> L���L �_l
<br /> QELECTRIGAL � AMP�$ERVICE ' Q PROGRESS ENERGY :[� W.R:E.C.
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<br /> QMECNAN1CAl. � � VALU�►SION OF MECHAh11CA1.tNSTACLATI�N �I � ���t
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<br /> OGAS [ t,�'� ROOFlNG .Q SPECIALTY C�- QTHER � `�{��
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<br /> FINISHED FLOOR ELEVATIOPIS FLOOD,ZQNE AREA QYES NO ��
<br /> aut�o�� � coMpaMr �
<br /> I SIGNiATURE rte��5'I`E�o Y/ FI PEE CURFtE� .Y./N..
<br /> Addres� , �License# I �
<br /> ELECTRtCIAN COMPANY
<br /> SIGNATURE �' REGISTERED Y/ N FEE CUFtRE�- Y/N .
<br /> Addr�ss � `Wcense:# I �-�
<br /> PlilMB�R . CORBPANlf• . ..,
<br /> SIGNATURE , �clsreReo »�;Y/••.N -'� - �E cuat�n Y/�N. "
<br /> �,ddress , License# �- �
<br /> MECHANfCAL' . . . - ; .COMPANSt `YTif
<br /> $IGNATURE ' REGI37ERED Y:/,N: , FEE CURRED • Y/N`
<br /> Address�'' " • '� - � � �
<br /> , License:#.r-� �
<br /> UTfiER � ,� �' , .COMPANY. l�lj'1 �I��/,'�,f'1. ` �
<br /> SIGNATURE .ReG►STE�o Y/".N`., ; ..�E_GuRr�n ,:,:,�:Y:l<N�:. ,
<br /> dddreas .�. ��l`-�'�:t:1'.�[v,�� �i!ii�"`Cl� .: . Llcense#±I ��-'�����:�-y� �
<br /> RESIDENTIAt:: At#acfi 2,!..Pof?Pi �z 2` , �_ �,�,.._�.- �_- ,., �:::_�. ,,��,r:4. a-_,U„�. ��+���,.. �t:<' ..,.,< a�.r�.;�. , . ,
<br /> ,{ } 1 ans,`{.)'setsrcf>Biaililliig'�i'lans;�(1}`'sefbfEnergyiForms;`R�tj;1N'�ermitfo�r,riew;;conshuction, . _
<br /> - - •-.Minimum�ken::10-workin d' `` �.. � 'f�„%�'
<br /> �,�,„„(_,)„, g: �ys,atter;siibmlttalidat`e`.�Requlred onslte,:CoitistriicBon�Plans;�Storrnwete�•Plans w%511t Fenc�i installed,
<br /> :$anitery:Faci1{Ues;&:ljtaumpster;�-s�te*Wo�lc€Pe�inSt`.tvr='sti#idivlsto�stlarge:.pin�eats:`•.":=;y"�"°._- .-_ .
<br /> COi�EatERCIRI. Attach{3pcomptefe'sefs,of`Bi1ltdEng'P1ans'ptus�a�ife;Safety Page;{1j,set of Energy.Forms:R-Q W Permit fot new.�constrticflon:
<br /> Minimum ten(10)woHiing days after submittal da#e. Requlred onslte,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FacilfUes 8�1 dumpster..Site Work.Pennit_for ali�new:projects.�Aii cammerciaf.regutrementsmust.meet camptlance
<br /> StGN PERMtT AttacFi�'(2)sefs of"Engineeref3�P_,Iatisot;,;Y~rv<` � .. '
<br /> •""PROPERTY S19R17EY reguired for;all IV�W cqnstrucUon.,. .
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<br /> Dtrecttons:. - �:.*•,;.'= . ._ • - �;, _ ..
<br /> Fill out appNcaUon ccmpletely. � ,
<br /> 4wnet 8 Contractac slgn bactc-of apptEca�pn,rsotarized
<br /> lf over S25Q0,a_Notice of Comnaencementd�requlred, (AIC upgrades ovar ST500) -
<br /> u 'qi�.-.;.�.:r.�r:::h't.:;
<br /> Agent(for.#ie contractorj or:Power 6f Attotney(fiic ttie=owrier}woutd be someone with nntarfzad letter from owner author}ztng same
<br /> 'C3VER TME CdUNTER.PERMITi1NG� • (Front of�Application Oniy,) �
<br /> Reroofs if shingles Sewers 5ervice Upgrades A%C Fences(Plat/Survey/Footage)
<br /> DNvewa -Not over Counter if on ublic roadwa
<br /> ys p ys..needs ROW
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