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813aeo-oo7o City o�Zephyrhills Permit Application Fax 813-7$0-0021
<br /> +. � ' 8uitdiog Departrnent
<br /> Date Recsived . , ::'�Phan�"-CoTi#ac#-fot'Pacri�{ttFn
<br /> Owne�'s Name � , � � Q -(. thnrner hone Namber � :�11 — ��� �
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<br /> Owner's Address ' 1,,,,�� � S�' - pwner•Phone-Number !1J� ���� �
<br /> Fee 8lmple Titleholder:Name � �� Owner Phone Number ` �
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<br /> Fee Stmple Tltleholder,Address ' °" `
<br /> JOB AdDR6SS !.J a G � � t,�LV � � LOT# ""1 D�_I�:
<br />� suao�ws�ow - �����3f`'i�{ C-�' . Paac��:��io#� C� - :CD-- �—' 1 ��'�C.�OC�`" 3O
<br /> ' - - — �(OBTAINED FROM'PROpER1Y TAX NOTICEj -
<br /> WORK PRt}AOSED ,. N€W CONSTR °�`� ADD/A1:T �� SiGN' �] ' �Q','� DEMOL{SH �
<br /> , � ` ` INSTHl:4. 8._-. :REPAIR '
<br /> PROPOSED:UBE. [,�`- 'SFft [� COMM OTFtE12 ' "
<br />, TYPE OF C4N3TRUCTION;, � Q `BLOCK�',;Q . FI�AME ST,EEI.. Q:
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<br /> DESCRIPTiON OF WORK :`` �i�4/L.l,.,.�.�Q,, � C.Q� � \JZ,, .. ,
<br /> BUiLDING SiZE !�� � Sq FGOTAGE.��. HEI6HT`.���, � '
<br /> �. ,_ �BUICDiNG $ _-.�:-i,,.:.. __.T�k.,._.. . . - . , .
<br /> ��'. VALUATION`'OF`TOTAL'CONSTRUCT'ION
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<br /> �El.ECTRICAL $ J� �� AMP'SERVlGE �� � PRt)GRESS ENERGYI [� W.R.E.C._ .
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<br /> QPl:tJMBIN{3 $
<br /> QMECHANlGt1l $ VAk,i1i4T10N;0E MECMANICAL,1(�lSTA�LATtON -
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<br /> QGAS [� ROOFtNG.. [� SPEGIAI.TY [� � OTNEFt : .
<br /> FINISHED Fl.00R EL.EVATIONS ��� FLOOD ZONE AREA �YES. NO
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<br /> BUtl.DER COMPANY� �` '
<br /> SIGNATURE REGISTERED Y/ N Fee Cuttt�n" Y/.N .:, , .,
<br /> Address , ,: , , �Llcanse# �. � , . I
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<br /> ` ��ECi'RICIAN„_.� � ., � CAMPAWY �.J��l � � Q � c�{t,.1 l G
<br /> ' SIGNATURE � U�-�- . ��� GISTERED Y/ N FEE CURRE� " Y/N .` .
<br /> Address YJ G• � - � _. . � �License`#���,,���a��GJ"II
<br /> , P�UMBER ` . COMPANlf� ,' , . �
<br /> SIGNATURE ' - .. �Rec3�8.7EREp. , .: ..Y/>N.. � . �. .FEe cu�n -. Y/N: .: .
<br /> I �0.ddress .. � 4 .� L(cense# � ' �
<br /> MEClfANICAt: ' . - " ' , . -.CCIMPANY . � , .:: . _ �
<br /> SIGNATURE . . ` . , ` REt31�4TERED• ~..Y;/•N- - �FEE CURREk ' Y/N�_
<br /> Address: • _ . �i - ; _" ' . � Ucense.#��.�. ..�•. �I�
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<br /> OTHER - .._ - � - • . �. '_" ._G01yItPANY� .. . r� �.� .....,. -. - i .
<br /> SIGNA'TUttE. ''. . - " , � , � - , ..REGISTEREp ,. Y/�,N. �I,FEE'CURRE�-r � c Y:/;N=.' _ ,
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<br /> Addeess ���:�.�:::;:..r,•,s.:.r:;::r��� ;,. .. y . ,, ,. . ., . `l:icense#'��
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<br /> RESIDEN'FiAt�:,,_ TA#tacti.;(2)„Pto��P..lan§;:{2):sets�of>Buitiling�'F!lans;`.,(1.j,'set;uf�Enetyy��oiinst'R=O=W�Petm1#`for neu�+.constnictlon, .
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<br /> ,-,Mlnlmuin�.tem(�10.)1worlctn.g�;days;aiter�sut�;mitteGdafe:Y Required onslte;�f�onstru'cH�on�F?Iens;:SformwaterPlansw/�SIIt F�n�e tnstalled, .
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<br /> 'SanlfaryFa�lltlesa8���t;c#_umpsker�ulte�:Woik�PeirnlCfor:'sutidivl'sti�nstlargerprojecls'`.."_•;;::;:�::?�`:`;:<"a�� _ . : , . .
<br /> COMiI+lERCi�l. r0ttach{3j`cbiiiplefe�sets'of`Bu'ltiiing P[ans pius a�Cife�Safsty Page;(1}set of Energy Farrns.R-d-W Parmitfar new coriatnic�tion.
<br /> Minimum ten(10)working days'after submittal date. Required onsite,ConsUucBon Plans,Stormwater Plans w/Silt Fence installed;
<br /> Sartitary_FaclUties d�1.dutnpster..Sfte-Wark-Permit�tgr att'nev+r�ptrol8cts:Rii cammerctal.requtremenis must meet c�mpltance _ .
<br /> 31GN.p�RMi7 Attacii(2)'s`ets ofE'itgineeired;Pl"atis;�•:;*:=r`.=;;��.,:,_� �., - • , . . .
<br /> ••'*PROPER71!SURVEY require4l;fqr.all„NEW.c:apstructloo.,,.,...•..� - - ��
<br /> DGectlons: � . -,� __. . W - �
<br /> Fill out applicatlon complately. ,
<br /> Uwner&Gontractor slgr►bactc-ot.appilcatlan.notarized
<br /> ' if.'over�2800,.a Notice af�Commencement ts require�i. (AIC upgrades over 57500)_. _. �. - -
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<br /> Agent(for th'e aontracti�r);o��Power of Attoirisy(for ttie�owner)would be someane.wnth natarized letter from owner autho�iztng same
<br /> � ,DVER'THE:COUNTER.PERtYl�TTING;r:�.;,.(Fiont`of�ApPl�aation Orityi) ,. - ,_ � .
<br /> Reroofs if shingles, ,,•,.Sewer�g;.. �;Service Upgrades AJC _ Fences.(RIoUSunrey/Footage) �,
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<br /> �, Drivewaya-Notaver,Counter,�if.on��publicm�dwiajis�..needsROW, .� � , . . , ..7 '��,= ' ,' °'..,'� ;`�w -,
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