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813-780-pQ20 City of Zephyrhills Permit Application Fauc 813-7$0-0021
<br /> _ -� ` � Building Dapartment
<br /> Date Recetvad .. � -Ahone.Contacttfar�eri»tttin ' '� �
<br /> Own�r`s Name .;�� �2� c) � t'J 2..�� . . , Owner Phone NUmbe� �}���J 2-31'� 1 �
<br /> Owrner'sAddress SJr • � fY�oor j�i J. OwnerPhone-IVumber � � �
<br /> Fee Slmple Tltleholder Name ' ' _ • � � OwnerPhon�Number � �
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<br /> Fee Simple Tltlehalder l�ddrese , d °`� = -
<br /> � ^ �JOB ADDRESS ��y ✓ !�N�''✓ 1✓r LOT#
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<br /> SUBDIVISION ����� 'C9c../�.S ;� PARCEL:ID#' - ' ' - '
<br /> , � '(08TAlNED FROfY!`PRQPERTY TAX N�TICE1 - .
<br /> WORKPRC3P.OSEO' :. NEwCONSTR "� �" ADD/AIcT � SIGN Q [��� DEMOLISH
<br /> .� ' e INSTALL ,8�,�.=':REPAIR
<br /> Pt20FOSED�tiBE -Q. `SFR � CAMM' "� OTtiEi2; ..
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<br /> TYPE OF CQNSTFtUCT10N. 'Q' "-BLOCK'�' `�]�' , .FRAME � ,ST EL ..
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<br /> DESCRIPTION OF WORK } � ' ��G-'l h �`^'�� �e �r�e-. �� . ,
<br /> BtJ�LqING•9fZE� ���� 6Q.FOOTAGE.��a . =HEIGH7'`.��. •
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<br /> .._ QBL1tLDINCo $ � _,.;,,�-;; -.._ . .rr�,,.�..,.. ... .. , . .
<br /> , 23�v VACUATION`;0�'T`IOTAL CONSTRUCTION
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<br /> QEk,ECTRICAL � � AMP SERVECE � PROGRESS ENERGY �] W.R.E.C. _ -,
<br /> QPI»UMBIhlG �� .. , _
<br /> Q MECHAt�IlGAI $ � 1(A�tJAT,14N,C}E M�CHAMGAL,ENSTAlLATIOIV � -���
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<br /> QGAS Q EZOOFtN� �Q SFECIALTY'� OTNER �
<br /> FINI$HED FL.00R ELEV�4TIONS L��- FLOOD ZONE AREA QYES. NO .
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<br /> BilIF.DER ` � ��CQMP�4NY� . ' l2��.. 1� ¢r
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<br /> SI(iNATURE REGISTERED Y/ N.. FEE GUFutE�' ,, ':Y/N..:.
<br /> �ddre�� ,' :'Lic'ense# I � . .�
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<br /> EtECTRtC1AN : .,�� - ' `` COIVfPANY °, . . . .
<br /> SIGPIATURE ��'' REGISTERED Y/ N �ctirt�n ' Y/N .
<br /> Address � _ . , '.Gcense.#�,t ' : a. -�
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<br /> P�UMBER '�t CQMPAHiY=. - � ri'',0�''t L'G�%�J?'1P�fL. - �--
<br /> SIGNA7URE ro ' ��o�S.TE�p. . .•�Y/�N_ , ,FEE.CURRE�,� , s 'Y YN: ,
<br /> Address :5 � �� - _ ,.� . Ucense#s l . � �
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<br /> MECMAt+tICAL`' ' - � - ', - „GQMP/�FiY = ..� , - .
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<br /> SIGN,ATURE . � � ' - ' r3E�i�TEriEo, , .Y:/'N.. ;.�E Cuttrt�n . Y/�N.:•....
<br /> Address� : ' � �. �:s� _ , ' . . . - _., . � . , ; - Licensa#-�.. �`��: -
<br /> OTNER , t ...., ,: . , . -,' � GL11i11PANll�_ - • _. ,. r ". ' ' _ ' , .
<br /> SIGNA'TURE. - '�"'" ' �— , " . � . � REGIS7ERED — Y/'N--.�( °FE�,CURREA �,Y:/.N•:. _ , �
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<br /> ;,�•. ::��s;..;,;.., ..{. �License#:1:.. I
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<br /> RESlDEN'i9AL,. :=At#abh;;{2}„Ptok-F�lans;;(2}:sets'=of;8ui3ili'ng'Ptans;`.,(3,):seti;o#jErie* �Fomis;�R-OlUIt�Permit:fo"rnevy:con`stnuctibn; .-�
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<br /> '` ;.�.=;Minii�um�.ten3(�1�O�,worlting;days,after suti�iiltfsGdafe:��Required`nsite;-Con§trucBon�Plans}Storinwater Plans w%Sllt Fence instailed,
<br /> -- -,. San�taiy Fsdl�tles,,&���s�ar�pstar,,Sltst.WoriczPer,mlt`.�Q,r,:suti�lvt'slgns�args pro�ects�r='',::;;�;::_-,'•,_.��=. ��- . ..> _ : _ . - - -
<br /> COMMERCIAl. Attadi(3j eomplete sets oT Buildirig`Plans�ptus a Lffe Safety Page;(1)set of Energy Forms.R-O-W Fermit for new constnic�tian.
<br /> Minimum ten(1Q)working days efter submittsl date. Required,onsite,.Constructlon Plans,Stormwater Plans w/Sllt Fence Inst�lled, ,
<br /> Santtary,_Fadii�es 8�;1_dum�tster..Slte.Work.Permtt fo.r•�aA�neinr'prc�ects:All�c;ommerc3aG cequlrements must.meet compltance .
<br /> SIGN PERNfiT Attadi(2j'sefs of`�ngfi�eere�f.Pfai�s:;�;;�n~r�--•._;�;.: _ , .. < • , •- -
<br /> "'""PROPERTY_SURVEYrsquired•for,>a�I,:NEW:constructton.. - :� -.
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<br /> "Olrectlons: ;.- •,;; _ ; . _. _. _.. __. _.. _ �
<br /> FAl out appBcadon completely.
<br /> C3wner&Contractor stgn back:of appltcatEon,no#�uized
<br /> If'over$2500,a�Notice�af,,Commencement is required. (AfC upgrades over$750q)_,. . �s , '
<br /> �e '7:Cai.;;�^,�irk�'Lkr:.r._..,..... .�a.w_. _ .�. :..,. ,. -�. .:.,,.:�,.-._ ._..,,..._ . . ._. ,.__, - — •
<br /> Agent(far ttie contiactor)"qr:FoVirer of-Attoiriey'(tcar#he�oinwnerj wautd be someone with notarized letter from owrner suthorizing same
<br /> 'O.V,ER THE CQUN,Y,ER;P,.ERMIT�iIN�3�=�'�-."(Fiont�bf Applica8on Only)` _ ;� �. -_, .. . . -
<br /> Reroafs if.shingles Sewe� Serv(ce Upgrades NC, __. Fences,(Plot/Suryey'/Footage) _. -�-
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<br /> Driveways-Not over Counter if an�publia roadways..needs ROW
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