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, a�aaeaaozo City of Zephyrhills Permit Application Fa�t 813-7$p-0021
<br /> • Building Deparkment
<br />� Date Recaived . - � . `-Phona-ContacC�for`#ermitfin'��' • ' ". . ` �
<br /> Owner's Name YG.f �' C3wner Phone Number gf.�.�""7�'��10�--.�.
<br /> Owner's Address ��' � � �j�����'�&��
<br /> � � � f�lil� " '�( dwnerPhone-Numtier
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<br /> Fee Slmple TltlehalderName-�� RANcr i5 -�1"����2`" � Qwner Phone Nu'nber' ':! � - ,
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<br /> Fee Simple Tltleholdee-Address 7!b: ,`"$ ���= j,. r •�"�'�S �-��-• �� Z`" � �
<br /> JOB ADDRESS '�� � l S�� �c � � �► I,g� � , LOT# �,� 1
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<br /> SUBDIVISION � .`` � PARCEL ID# J�`���'r..��-- �U' C.� {C'.:r��CTi�QC3 " a r c7•�
<br /> � �- � � = �(OBTAINED'FROMPROPERTYTAX'NOTtCE),
<br /> WORK PROPOSED NEW CpNSTR : `ADD/AL:T L� SIGN Q Q" DEMOLISH �
<br /> - � � '• INSTAL;L �,`-� REPAIR ` - - •
<br /> PRQPQSEQ tlSE, Q` =SFR- ,� ,:.� COMM `�� OTF{ER^ ,: ` . .
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<br /> T1fPL�OF'GONSTRUCTION�� ='`�` 'BCOCK"�'..'�� �`.�RAME �.Q STEEL Q�-„,- .
<br /> DESCRIP710N OF WORK"'-'J� � r��,.,�� .i -1��,:'... � . V/''). � h r�`(� �
<br /> BUILDING SIZE " a� �`.3�` � �"SQFOOTAG,E -..�.��'b + � HEIGNT•;��.:,._
<br /> 08UILDiNG $ -w�;t�;;fw... . k,r_.7K,.., . . '' . Y_ . , --
<br /> .VAI:UATION`b�TOTAL CQNSTRqCTION
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<br /> Q ELECTRtCAI $ �� �`� -. � AMP BfRViCE �p� Q` pROGRESS ENERGY Q W.R.E.C. .
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<br /> QPLUMSIiVG $�� �C3�� . :7� . �j �" /���l/�l'liinr►.
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<br /> QMECHAtiVlGAL $ y ��� • ��V11t.i.lAT'ION.OF MEC�31ANICAI.INSTALUITlO�� a.r,�, i�� �I't.q✓Y'LtS �L,✓,Z,Pi
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<br /> QGRS [� - ROOFING_�;.;[� . SP_ECIAl.TY�C�-° OTNER ��"l � �,l���,-�t a-��lw.,�l
<br /> FIfVI$HED FLOOR ELEVATIONS FLOOp ZONE AREA �YES. N� . . ��,,,,,,.j �r ��+2$j l�"�
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<br /> , 8U14.DER COMPANY � .
<br /> ' SIGNATURE R@GISTERED Y/ N.. �E'Cutttte�' : 'Y l N.::• , .
<br /> Addr�as . ".;' • - � .
<br /> , .. 'License# I . � 1:. ��:, I
<br /> ELECTRtCiAN� �iy�rj�%G2`'/.;� . „ `:�"=*COMPANY ' / t� `'�� 'l Jr��, . S�IY'� ._
<br /> SIGNATURE �G �'''� `' REGISTERED Y/ N �Cuw�n ' `-Y�N �
<br /> �i Addre�s Ll tu/ =/�l ,% :�C �!''ld S1' . ..Ucense#�� -I �''l�/,�''(�U 7.�7�
<br /> � ��uMeE� �' f°� � �� � �. �coMenrnr= `f ���2.�-r0,��� -1�``�
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<br /> SIGNNTURE ' crd%'"'--.= .��"� . . . . _ .,.c - - , . . . . ` .
<br /> _ ,.�Q�ST��Eo ,s. <�:Y l-aN: � � -FEE.Guwt� = Y/N: :
<br /> Address �� .�r=...o2 � �4 S� - .lJcense#�C.it"G�� �L,L�`'�,� �7�-- I
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<br /> SI(iNATURE ` ' "'y%'���� _ E , -
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<br /> RECqISTERED:' ,,.: :�-Y.:I N ,,".�:,�:FE CURRE�; . �.Y�.M.: '.,
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<br /> OTHER =� '` • . - _ . . ..-- . , -�.r ,COMPANY _ � : . _ . , , . . . .� , .
<br /> SIGNATUR�, '�: n, , � - <_., • ,, . . ` � .J ., µ _Y_�REGIS7ERED Y/-.N. - �FF�E.'CUR�n -YJ:N�.: ' _
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<br /> REStDENT{AI:�. _'°A#tach'2' .lot�P„ians��2 :'sefs=oi�8uildtn'"Ftans�` 1j'setiof=Ene �foritis;'.R-O-VN'.Rerrrilt:for.'r�euv"canstriicilon;. � -
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<br /> _;Mlnlmum,tens(.10),�work(ng::da,ys;after„"s'u4�,inittel:dafe:i:Requi�ed onslte;�Constiuctlon�Plans;�Storinwateir�Pians�w%�§ilt Fence,installed,
<br /> .:.. . ,..., ..�.... . .
<br /> . �Sanitery:F.adlitie�&��tjuqtpster;;Sifeittltoric;Pei,m1#.�Qr,sutiditirlstgttsltatge"projects.;,-�;.��„,�a�,���; ,:,•. .: ;_� _ � � - _ . � � � .
<br /> GOMMERGiAI Atcecn�sj`c:ompt'ete'se�s of'Bullitling Plans ptus a'L{fe Safety Page;(1j set of Energy Forms.R-O-W Permit far new canstnictlan.
<br /> Minimum ten(1 Q)warking days after submittal date. Requ(red.q„nsite,.�onstrucUon Plans,Stormwater Plans w/Silt Fence instailed, � ,
<br /> Sani#ary,Fadiities.$9.,dumpstec..Stte Work.Permit=for�ii`new� ra eats:All:ccmmerctal�oequlrement�mustmeet;compliance ,,
<br /> SiGN PEitMiT Aitar.iii'(2)sefs of�£ngln�er�d�Plans`mr."�r .. � `. .. � � ; . . ,
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<br /> "•""PRORER7Y SURVEY:required.fgr�all_NE1N;.construcdo�i::_ _- - _.- -_" .. - . -. -- ,
<br /> Dlrectioris: ,Ei':��.. __ .. � _ .._._. . , �. __ _ � �
<br /> FIII out applicatlon completely.
<br /> fJwner&Contractor slgn:back:af.'appitcatEan,natari�!
<br /> If over 5�500,�Notice of Commencement is requlred. (AlC upgrades over_ST500),,, � �
<br /> .. :�c:';t-:r,':»,:tt;;:.,
<br /> Agent{for the contractar)'or-Power of i0.ttoiiiey(fc��#he�owrier)�woul�`be someane with notarized letter from owner authorWng same
<br /> 0'VER'THE COUNTER:PERMITTING�=-•;.��(Frcnt'cf�ApPlicatlon Cfnly)�= `.i_,.,,t. _ _
<br /> Reroofs if shingles Sewers Service Upgrades N!C 1=ences{Plot/Survey/Footage) L� �q.t.c fj�1 '�-�.(+�t g.t�.-Q,,,
<br /> Driveways-Not.over Counter if on publla roadw"rays..needs ROW'
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<br /> I r A�J- � D�'GIS�Z 1
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