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<br /> a�aaeo-oozo City of Zephyrhills Permit Applicatian �ax-813-780-0021
<br /> Building Department
<br /> Date Received . _�b-� �j ' p�one Contact for Permitting Ul� ��� -- tlJ� t�
<br /> t�wner's.Na�e ��}?`1" '�- �'��e.J Ct�C}��� Owner Phane Number (�� '��-�� ! °� :
<br /> � . - °] � .
<br /> , =, . s� r n,. 111e�hanisb��j
<br /> Owizer'sAddress i, I �1 (�'rUlYlUJO� ✓� • �?0.55 Owner Phone Number �j�3`3 c�5'd��o-] �
<br /> ; ... _., .
<br /> Fee�imple 7itleholder Name pwner Phone Number�— �
<br /> Fee Simple 7itleholder Address •
<br /> JOB;ADDRESS�, �S� �QU.� �Of1ZC�`�j �(.)�V� � (h��15 �I '335yj �.oT# ��
<br /> .. �..�..: ; :. _
<br /> sueoivisioN �� .C'�.r�d N�r� �.u�s � 1PARCEL:ID#. 3�I+�S'"�� �I�C���'(�WOO ' b�(3C�
<br /> � ' �(OBTAINED FROM PROPERTY TAX NOTICE)
<br /> VitQFtiC PRt7i'OSED: e NEW CQNSTf2 e ADDIALT Q SiGN Q MOVE Q DEMOLISH
<br /> ��� ` ; INSTALL REPAIR j
<br /> PRt?POSED USE , � SFR Q COMM [� OTHEt2 � �'.-('D '
<br /> TYPE OF CONSTRUCTION Q BLOCK [� FRAME Q STEEL Q OTHER
<br /> DE,��,GRIP,.TIONQFsWORK; ' ��QraF�F �e-roo� �D �a«s �AF As �Qlf h� ({5 �( � 1�1�`1• I
<br /> BUILDING SIZE, . �� , � '. ^SQ:FOOTAGE (� ��� HEIGFIT ���
<br /> � BUtLDING • r$,�<;;;:j���'" '��-` � ,:';� �VALUATIQN'OFTOTALCONSTRUCTIQN • ,
<br /> I ( `',��d'�;.��' ..
<br /> Q ELECTRICAL � � AMP SERVECE [� PROGRESS ENERGY [� tN.R,E.G.
<br /> [� PLUMBING ($ �
<br /> � �
<br /> Q, MECiiANICAL $ VAGUAT}ON OF MECHANIGAL.(NSTAL.IATtQt�! �� ��� �
<br /> � � " ' .i �/
<br /> Q GAS . Q FtOOFlTtIG Q SPECEALTY Q 4THEF2 � �� �I
<br /> FINISHED FLOOR ELEVATIONS � � FLOOp ZONE AREA QYES QNC►
<br /> BUILDER G�flNlPANIf
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License# � �
<br /> ELI�CTRIGIAN GOMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License# � �
<br /> Pl,UMBER • . COMPANY
<br /> SIGNATURE ' REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address L,icense# I � �
<br /> ME�NANtCA! COMPAIVY
<br /> SICaNATURE REGISTEREb Y I N FEE CURRENT Y/N
<br /> Address ' - License# � . �
<br /> OTHER;�i . (.t, IV 1�.J0�(/� Gt}NIPANY .t'�1� 1�OUt'1�7 �1}(� .
<br /> �.
<br /> SIGNATUFZE'� �� REGISTERFD Y N FEE C REN7 Y/N
<br /> ,Address � �f �� �t` 5� r i ( r i t{�� �( 3� 5�/ �`license# �f�Z:�J�,���
<br /> RESIDENT1Al. , Attach;{2)Ptot Plans;(2}sets of 8uilding PEans;(1)se#of En�rgy Furms;R-O-W Permlt for new cansErt�cfian, (
<br /> , ,Mi�imum ten(10)wprking days after submittal date. Required onsite,Canstri�ctian Plans,Stormwater Plans w/Siit Fence installed,
<br /> ' Sanitaiy Facilitles&1 dumpster;Site Work F'ermit for subdtvlsions!large proJects
<br /> COMMERCtAL 'Atfach(3}sets o€�Building Ptans;(1}set of EneFgy Forms.R-O-W Permit fornew construcfian: —
<br /> w_... .-••- Minimum ten(10)working days after submit#al date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed,
<br /> . � Sanitary Fac3tltles 8�1 dumpster.SEte Work Permit for ai!�ew proJects.Ati commerciak requirements must ineet camp{tance �
<br /> �', S1GN;�ERMIT Atfach(2)sets of Engineered Ptans. g; '="=• , , '
<br /> ?:': � �`�='• �;j *'"*PROPER7Y SURVEY required for ail NEW construction. '+�° , '
<br /> ;, �- - ,:
<br /> x Directions�: ' •_""'� �
<br /> >. ',. :Fill o.�t application compietety. , . � �
<br /> `' ' {}wner&Gon#ractor sign 6ack af appltcafion,notarixed
<br /> s�,_ ._ ,. ��
<br /> ;;�- If oye�°$25D0,a Notice of Commencement is required. (A/C upgrades over:$5006) ;}
<br /> '.�'`" Ag�nt�(for the contractnr)or Power of Attomey(for the owner)would be someone�with natarized letter from owner authorizing same
<br /> ;'QVEFt TFi�COUNTER PERMiTi'fNG (Front of Appltcation Qnly) ;:�,�' �� � �r%q
<br /> �' � Re�oo�s Sewers Service U rades A/C Fences P,lot/.Surve /Foota e -
<br /> �, . P9 � Y, } 9 )
<br /> �{�_ , . :t .. - ,
<br /> ., � �� .
<br /> ����;, ti privev�►ays-Not over Counter if on public roadways..needs F20W � :. •.ry�`� • :I .
<br /> j�� �� � �: .. _ _. �, „ .;,,�;;.
<br /> i,�. .. .-..:���. 7 ._ :_. ,
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