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` ' 813aao-oozo City of Zephyrhills Permit Application FeX-813-780.0021
<br />� Building Departrnent
<br /> Date Recelved ., . - ' " �(3 ., 7�a _ s��l�
<br /> � ' � -� ' Phone�Contact�for'Permittin `tr
<br /> I Owner's Name �i9'S% pF}SG'8 �� �/v �� Owrner.Phone Number . (� �^ �d r.� `
<br /> Owner's Address �O 1 ��� �U� ' �Owner•Phone Number �
<br /> Fee Simple TlHeholdecName � � ' � ^� Owner Phone Number -
<br /> . , �.•7 . , , . . . .
<br /> Fee Simple T(tleholder�Address ; " ., � . '
<br /> JOBADDRESS ��I�S ` � /�jf� ` ,.�1 �/�/L.��j' ��• LOT# �
<br /> susnivisioN � � Pa�ce�in# /` ��v � �l �bl D OD�'DC) OD���
<br /> ' � � "' �(OBTAINED FROM PROPERTY TAX NOTICE) > �
<br /> WORK PROPOSED . NEW CONSTR �°� ADD/ALT Q SIGN ��Q ' Q _ 'DEMOUSH
<br /> ' - K 'B ` ' INS7'ALL � • • REPAIR -
<br /> PROPOSED�USE Q' SFR °�] COMAA Q OTHER
<br /> � ,, . . :.. ... :.. _.
<br /> TYPE OF CONSTRUCTION., -Q `�BLOCK�' '�Q' "� FRAME ��� ST,EEL .
<br /> DESCRIPTION OF WORK i' fl �Yl�f d U� �' �4e lac� S�"o-» s �'� R
<br /> /� - � ea� o�e,�s
<br /> BUILDINGSIZE'= ` :SQ.FOOTAGE��, . ,,,HEIGHT:'�. ...•.
<br /> QBUILDING $ -�5�,:;�,:.._ �-�":r,�:.... ' . .
<br /> , , VALUATION'a�OTAL'GONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY �] � W.R.E.C.
<br /> OPLUMBING $ '
<br /> QMECHANICAL �' ` I$ p 'VALUAT'ION OF.MECHANICAL.INSTALLATION � I ��`��
<br /> ��0�, Q�_ ' �
<br /> D�S -Q. ROOFING:.,Q SPECIALlY::O� OTHER� � '
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO �
<br /> BUILDER COMPANY ' ' - • . �
<br /> SIGN�4TURE REGISTERED _ Y/ N FEE CURRE�''R Y/.N .�-.< ,
<br /> Address � : , .
<br /> Llcense#
<br /> . , . ., , _ `
<br /> ELECTRICIAN,... .� _ COMPANY � ' + � - , . , - � � .
<br /> SIGNATURE - ��"' REGISTERED Y/ N FEE GURREK '.Y.'%'N
<br /> Address _-.License#-:: ` � -
<br /> _ - -
<br /> PWMBER ' '.' ,. _ COMPANY= � . � _ _.., .
<br /> SIGNATURE � .1 ,. tREGIS.T,ERED:. _ ..-':. -::Y.'/-�N. .� , .F.EE:cuRR�. -. `Y/'N:
<br /> Address . . �. ..License#� � �. -_ -..
<br /> MECHANICAI: ` Y , -:� . � _.COMPANY l�/,�'�.: S�� '�:- ��
<br /> SIGNATURE ` ��'"e ` ` � REGISTERED.� , .,Y!'N , CUR�tEn � =Y/-N��<°'.,: - • =
<br /> Address�"=`�.� y4��/� A//en7' � - -.�itl.s`:-�.�.• ` , , ..License# A-� :��. ..,5 .
<br /> OTHER ' � _.a , � . -_. .. , _ ' COMPANY : :. , �. ;% : , :. ...._- ,. , �
<br /> SIGNAT R 'f' ,,. . � . . . - ,. -�- .- �: : -_, . , . , ,. .. , ,. :. , .,•.� - . -
<br /> U E REGIS7ERED ,
<br /> _ . . . Y,/ N,.: ;�ECuR�n=� .,. �.Y�/.N�-_ -
<br /> Address ,... _; .,,i,.;. :.,. r�, .,,;u . . � ,.:;., _ � • �License#�� '
<br /> �;,=�s:
<br /> RESIDENTIAL�.. .;:AEtach •2'Plo^ ,�,` :,:� .�.. .,�. ;i'��6^:"s1;-.e ri= t.y!.,,d;c�'S"..,y..�;:s,a` ,,tc,,_;. , .... .
<br /> .,.._. (,),._,_.t.Plens,,(�)se�of`Bullding�'Plans;;(1)serof:Energy�Forms;:R O-W Pertnit for neyr con§huction, . . ,
<br /> ;��.,,Minimumy�tem(�10)�woriting;days�aite�w"suti�iilttal date�Requited onsite Construcdon Plans;,Sto'rtnwate�Plans w%�Sllt Fence installed,
<br /> _ :.. .,.
<br /> �.....x�.. ..-. . , ::- ,
<br /> ,. �..,: ,
<br /> SanlfaryrF,-,acJlid...;&�1fic�umPster,,,Sifekyllork�Perrniti.(or.�sutidicrisi6ri�Herge'prioJecZs ••,.:�.<�:'�°`-� -.- -..- ... -'_ .' . ,
<br /> �,�,�,. �-, �:�, .,,x�.,�-.�....:a:•>:
<br /> COMMERCIAL Attach(3j c;omplete sets'of'Bu7ldfrig Plans plus a Lifa Safety Pege;(1)set o�Energy Forms.R-0=W Permit for neW consUucUon.
<br /> Minimum tea(10)warking days after submittal date. Requ(red onsite,Construcdon Plans,Stormwater Plans w/Silt Fence instalied;
<br /> Sanitary.Fadlitles&:1.dumRster.,Site,Work.PermiGfor;all�new�p'roJe�:�i411;commerdal.requlrements must meeYcompllance .
<br /> SIGN PERMIT AttacFi(2j sets oi"Eng'�n�ered�,Pla[is:;,;r,��r��: � •. - - .., ' - . _ -
<br /> •'••PROP,..ERTY_SURVEY-required fQr,a11-NEW:cons.tructlon.....,__ - - -
<br /> _ _ . .t: .. - s-� ..
<br /> Dir�ctlons: .... -_� _ . ._..._. ._ . �. -. .-- -- • - . _ .
<br /> Fill out applicadon oompletely.
<br /> Owner 8 Contractor sign back.of appl(caUon,notadzad
<br /> If over 52500,a•Notic,o of-.Commencement la requlre�l. (AIC u�grades over 57500).,__, •,. . . __
<br /> H �"l��tii'�bs'jit`St=C:" ..a�.._.._�..... ... ,__� ....v...._.. _ .._. . _ -
<br /> . '
<br /> Age�t(for tFie contractor)pr:Power'ofAttoriiey'(for the�owrier)would be someone with notarized letter from owner authorizing same
<br /> .. ==�•; �.:.:�.,: �° ._ -___ . ... .... _ _
<br /> 'D,VER'THE COUNTER.PERMI1TINti`.��-"=- -(F'rontof•Applicadon Only)��;- �
<br /> Reroofs if shin les Sewers ,Service U rades:A/C Fences Plot/Suryey/Footage) .. - - --
<br /> 9 P9 .� ... - ......_... _ -
<br /> _".. ._ .. .� . ..... . .. '�:...F.� '.:""'^ t.+.'.���� " .. . 'vF� � , .'u . ... .._ .. . _ .. " ,
<br /> Drivewrays-Not over Counter if on public roadweys.:need's ROW "�
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