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s�aaeo-aozo Ci#y of Zephyrhills Permit Application Fax 813-78p-0021
<br /> Bultding Department
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<br /> Date Recelved _ � 'Ahone=Contact'=for'Permtttin`:`. ` � - - �
<br /> Owner's Name !1C/'G I�//�-27M� Clwrner Phone Number ��� "7t�t �.!� -
<br /> Owner's Address !� �'v e/� 'C_.,`� 'QwnerPhone Number, � ' �
<br /> Fee Slmple Tltlehalder:Name ' ` ' Owner.Phone Number � ♦ ;._� �
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<br /> Fee Simple Tltlehalder:/�ddress � , �� �*�. , ` � -
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<br /> JOB ADDRESS 4G��� � [�7�' G� � L� 1 GL.S' � LOT#
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<br /> I sueoivisioN ��!� �zr3�z�� � ad � Pa�c��"i� I D�' � �I D�IEg dl� ���
<br /> , • � �{OBTAINED'FRqMPR01+ERTYTAXNOTICE� •
<br />� WC?RiC PRqPOSED �` ` '" � NEW CONSTR .•. i ADD/Ai:T Q S1GN DEMQLISH •
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<br /> , e INSTAI:L :•� .REPAIR' - --
<br /> PROPOSED:USE , Q� SFl� ' � 'COMM ` � OTHEF2� .
<br /> TYPE OF CONSTitUCT10N�� "Q` BCOCK�' ,'Q:`. ,FRAME �.�� STEEL Q' . ; .
<br /> DESCRIPTION OF�WORK ` ' .. L�/I�L,s j}[�. 9�/l e �G�L`e.�. O'C /C//� : G'�H''Z` �/!7-� , o� �D7'Y7 j> . .�
<br /> BUII.DINGSIZE `'� � SQ�,FQOTAGE��, , - ,HEIGHT•=�:_��. - .
<br /> QBt}ILDING $ ���.�_.. .�r,� '' '.
<br /> - �VACUATION"a�lJTAL'"GONSTRUCTION
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<br /> QEI.ECTRIC�. $- �� A{NP SERVICE Q PROGFtESS ENERGY [^,] � � W.R.E.C._ ,
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<br /> [�Fi.tIM81NG $ �
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<br /> MEGHANtGAL ' <_� ,
<br /> Q $ � �� D� VAR:tJAT10N;OF MECHANICAL II�tSTAL•LATlON ��� � y��/
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<br /> ( OGAS j [� • E200FiNG:,�Q SP_ECIALTY Q OTHER. � ,
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES. NO -
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<br /> , BUii.DER , , . . -
<br /> COMP
<br /> ANY'
<br /> ' SIGNATUR� REf31STERED Y/ N. �E CUR�n'�_„„ . Y l.N..:- :
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<br /> � Address . :.�'. , - . , Llcense# 1 " ' � �
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<br /> E�ECTRIClAN��_ .� , . - „ . COMPANY - -
<br /> SIGNATURE M REOISTEREU Y/ N �CurirtE� ' Y/N
<br /> Address ' ` ' J . : �4 - , .'.Licen"se#�:1� =� = =� � a ' I
<br /> PltlMBER . COMP.ANY, � ; : ; - t:- .
<br /> SIGNATURE ' ' � •` ' , ,REa�s�REa� _ , �.:Y�/�N , ,�e cuRR��:., .Y/N: '
<br /> Address F .> > .� , =� ' ..Ucense#F� -- � II
<br /> MEC!{�11+1lCRL•' �Yyr.F .._ ;COMPANY; j�'!'4�..R. S;1f'"!'D�?,�/\}�, _��G���
<br /> SIGNATURE - � , . .. .;.'; _ " ,
<br /> , REGISTERED;' . ,Y:/�.N,• �FEE CURREN 'Y/•N:�-
<br /> Address:, ����f`����/V � l/+ t � '� , , .. l:fcense#����-��3�.`�'o,���
<br /> OTHER � --- -. .. . � _ _ ' G01�APANY ' �� ,. ., :. :,^:�.,.,, s - .. - _ .
<br /> SIGN/ITURB , .. �., . . . .k ,. h:�: ,_ ,. � ,:�.,
<br /> REGIS7ERED: , �Y/ N=s. ' rFEE CrURRE� -,� =Y:/;Ns�
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<br /> /�11ddPess :U;�;�°,,, • -- ,`�`=,:. . , , . _ � -- .<'- _" .
<br /> f � 2 . �`License#��� �
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<br /> RE81pE�I11At::., - fAi#aeh;2,:I',�at�Plans;�2�'sets;of�B�uttdin"�'Plans��,:i�`setof�Eiie �Fonris��R-0=1NY�+ermi#:for ne`"constnictlan-
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<br /> a,:.`_Mlnlmum;tenY(AQ)j,wor�tingftlaiys�,a;tte��„'suticnittal�d'ate:$<Requlred.ons(te;-.GonstnicHon�Plans;Y3tn'rmwate'rPlans:w/SIItFenceinstatled, - .
<br /> � San{tary FacllltlQs�,B�`j1.,�umpater-Site�,WorkaPer.mlt:(�r,..,sutidi�islonsllarge projects .��;:��r;'":-'�.:::: : , _: °,�, �� �' ., � .
<br /> COMMERClAI_ Rttach(3}`ccniptete sets of'BuD'citng`Fiaits ptus a Life Safstyr Page;{1 j set of E�iergy Fqrms.Pt-O W Permit far neW cbnstnlctlon.
<br /> � Minimum ten(1 p)working days'after submittal date. Requtred anslte,..Construcdon Plans,Stormwater Plans w/Sllt Fence installed,
<br /> Sanitary Fadl(ties„8��1.dumpster.,.Site Wark_P..err»lt,for ali newiproJ�cts:AI!'�mmerc�a�requirements must meet comp!lance �
<br /> SIGN PERMlT Attadi(2j-sets`ot"Eng"�nia�redrPiai�s;3:s°~�„,�:;`,-° .. . - � , . . .
<br /> "`"PROP.,ERT.1!3U.RVE.Y..:requlred�fio�;aJI;NEW;cons,WcUoi�.,, .• ' _
<br /> Dlr'e;.c#tons: ,is{;:,;.�,,�:::.:;:�. .. .e. ._ _.. _ . � �
<br /> Ffll out applicallon comqletely.
<br /> tOinrner&Contractar slgn:back of applicaUon,notarized
<br /> � tf over 5�508,a�Nottce,cf:Cont�mencament ls requiresi. :(A1C uPBrades over-57500)._ _. _ �,. ..
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<br /> �qent(for ttie'con�tra��otoc)`or'Pouv"er of Attoiney'(fni=the:owner)would�be�someane with notarized lstter.from owner_suthndzing same- -- ��
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<br /> :DVER"TF{ECOUNT�RiPERMITTfNt'a::._.�.-'.{Fi�o,nt<af•ApP1lcaHon'Oniy):.�; . ��; . �. , . � -
<br /> Reroofs If shingles Sewers Servica Upgredes.A/G Fences,(PIoUSurvey/Faotage) ; , . ,. _ . . - � , �
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<br /> priveways-Not aver Counter if on pubila roaduiiays.:needs ROW t '_ _ ._- ..- -- . •=.f�: �
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