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a��-�so-ooxo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Bullding Department
<br /> I Date Rece[ved �p Q-.
<br /> " PhoneCan#aaffoiFermtttin = ' I��+�� ��`� - �� l'�7
<br /> 4wner's Name � ��� C.-t.GtZ"�i5 + Owner Phoee Number �C�� �L�'S3�
<br /> Owner's Address �7"�t� �'N��-S �U�?- Owner•Phane Number � �
<br /> Fee Simple Titleholder,Name � � Owner Phane Number � �
<br /> t'� _ , :s
<br /> Fee 8lmple Titleholder Address '''
<br />' JOB ADDRESS � 6.J G � L,.A- Z�� S �C?. N� O/"'�'Z D/�S LOT# ��
<br /> SUBDIVISION � � PARCEL.ID# �Z �°""� J �r/���/'' �dQ�• d7"Z""�. '
<br /> (OBTAINED FROM PROPBRTY TAX NOTICE)
<br /> WQRK PROPOSED '� NEW CONSTR ADD/ACT �� S1GN [� Q DEMOLISH
<br /> � e INSTAI:L •REPAIR
<br /> PROPOSED lJSE Q SFR � CQMM -� OT#iEFt
<br /> TYPE OF CQNSTRUCTION [� BLOCK " �Q FRAME C� STEEI. [�
<br /> DESCRIP114N OF WORK .' ��R /r`" � � � /�N ` ,�d7�'7 07'vG�1V �
<br /> .
<br /> BUILDING SI2E � SQ FOOTAGE� HEIGHT,- �„ ,�
<br /> QSt,!lLDING ri� �..� �_. .,:�,. ,_ _ �
<br /> L VALUATION OF'TCITAL CONSI'Rl1CTION
<br /> QEI.EC3'RICAL �� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
<br /> QPl.t1MB11�IG � � �r�j'� �!�Q�3
<br /> I
<br /> QMECHANICA! $ �� ,�b� VALUATION UF MEC1iAN[CA�INSTA�IATlQN �
<br /> �� �,
<br /> QGAS Q RQQFlNG Q SPECIAl.TY-[� OTFiER '�j/��`�
<br /> FINI$HED FI.QOR ELEVATIONS �-� FLOOD ZONE AREA QYES- NO
<br /> BUt�DER COMPANY �
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y./.N
<br /> Address License# �! �
<br /> EIECTRICIAN �OMPANY
<br /> SIGNATURE K REGISTERED Y/ N FEE CURRE� Y/N �
<br /> Address - , . - -Uaense,# �� � �� �
<br /> PlUMBER COMP,ANY� •. ' •
<br /> SIGNATURE REGISTERED Y/..N
<br /> � FEE,CURRE� Y/N
<br /> Address Ucense# �� �
<br /> � ��� s
<br /> MECE�l1WICA1: G��� �/%�x���, ::G{yMP.ANY, /Q �'f' �i-N�L�f-5 ��'!�- T11�iG�
<br /> SIGNATURE RE�ISTERED Y;/ N ,FEECURRE� Y%N'.:
<br /> Address '�7�f� < eN /aCLx ���''t; _ Llcense# �.-�'�s✓�'t'� C3 �
<br /> �TNEFi , COMPANI'
<br /> SIGNI�TURE ' � REGISTERED "Y 7 N.:. ; ,F�CURtt�� ; Y,/•N-...
<br /> Addres� _ _ , ._ " " , Ucense# � �
<br /> . �._ •..,r,,,. :,.,..�, .. ,.
<br /> RESIDEt�T1Al,: .� Atkach{2)".P[ot;P..lat�s;;{2}.set`s�of�8uitding`P1ans;'{1}sef of Energy=Farms;R-O=W.Permlf.for new con'stnicticn,;
<br /> , r,..,,._..: .,
<br /> ... 9; .�. , .; ..
<br /> �Minimum+ten:•(.10)�woricin days;after„sutiinlEtal�dake.+:Required anslte;:C'onstr�c�on'Plans;}Stormwater'Plans w/Sllt Fence installed,
<br /> ` °SanitacyFacil►6es;8��.lydumpster4Slte,Work�,Fermit.for."sutidivistonsAarge'proJects; .:=':�3; '. ; .
<br /> COMMERCIRl. Attach{3}°coiiiplete sets'of Bulfilliig Plaiis plus a E:lfe Safety Page;{'1}set of Energy Forms.R t�-W Permit for new construcUan.
<br /> Minimum ten(1 p)working days'after submittal date. Required pnsite,ConsUuctlon Plans,Stormwater Plans w/Siit F�nce installed,
<br /> Sanitary Facilitles&1 dumpsier.Site Wor1c PermlS for�I!new'projeGts:All c:ommerciat requfrements must meet complfance
<br /> StGN PERM!!T Af#acti"{2)"sets of Eogirieer,ed;Flans:;a:„,;�-. • . ..< . -
<br /> """PROPERTY BGRVEY reguired,for.ail�.IVEW consWation.;,
<br /> Dlrecttons: ._.. " .� : .
<br /> Ffll aut epplicadon completely.
<br /> Uwner&ConhacMr sign back-of appifcation,notadzed
<br /> i#ovsr�25fl0,a Not�ce of Commencemsnt is requlred. (A/C upgrades over 57500j , , „ .
<br /> .. .:�:�,�w:,::.<,:.. .
<br /> Agent(for th'e�contractor)or:Powe�of Aktomey(fa��tFie owner)would be someone with notarized letter f►tiim awrierauthorizing same
<br /> DVER THE COUNTER,.P_ERM1Ti'iFtG-•- - (Frorrt-of�Applicafion Oniq}• ' � � " � � � .
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Foatage) �
<br /> Driveways-Not over Counter if on pubtic roadways.:needs"ROV'V � �
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