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e��aeo-aozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Buitding Department
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<br /> Date Recelved . ,,,_�`��4 . `'-Rhane-Cocitactzfor PermtEtin�°`;'.� , � ' _� �
<br /> Owner's Name - • . ��r}P� pwner.Phone Nnmber �tP ! ��1111�"'' �'�, .
<br /> Owner'a Address . 1' �� � (� �wrner•Phone-Number "O�'�J—���,oq;,`���
<br /> Fee Slmple Tltleholder Name�� ' ` - ' OwnerPhone Numbe� O�� '- .�`,��J.'..j���! I �
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<br /> Fee Slmple Tltlehplder/�ddresa : °�'� � _ � �
<br /> JOB ADDRESS cJ""1 ��o� l.11� LOT# ��
<br /> suaoiv�sioN . LY Y tP�C`�,�.�.�.�Dc]�� PARCEL'ID# �—��-I"�I�O^6 D G�CY�-=U�i+�U �
<br /> . � • , '(OBTAINED'FROMPROpERTYTAX'NOTICEj �
<br /> WORK PROPt}SELi ', NEW EpNSTR �� �� ADD/A�`f � S1GN "�] `Q. " DEMQLiSH •
<br /> � ,. �Y ' INSTALL 8 ��� ":REPAIR'�`- �
<br /> PROPOS�D�USE= � � SFR ` Q " 'GOMM' � O'CHEF2;, " . . .. �
<br /> TYPEOFC4NSTRUCTION; , '[� ' BtOCK�' ��Q� FRAME '� STE,EL. ;Q: �
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<br /> DESCRIPTIQN OF IIYORK ` � -Q. . 1 / p� � ' c�c�
<br /> BUtLDING SIZE '!� Stt.FOOTAGE��. . . � ;,HEIGHT •.�:�•-
<br /> ,. 8llllDtNG $ .�:�;�,w�._ _.�='=-,��- ---. , _
<br /> � �:����r�; VALUATIOiV�4�TClTAL GCMh1STRCICYION' , ,, ,
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<br /> Q � � AMP 3ERVICE Q PRt3GRESS ENEI2Gl' [� � W.R.E.C..
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<br /> EI.ECTRICAL ._ ..�-
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<br />, QPkt3M61Na $
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<br /> ONiECHPiNIGAI , $ . VAI.UAT'ION�OF MECHANICA�.INSTAL�ATlC}N . ��°� -' �
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<br /> QGAS . ,[� F20QFlNG_;,Q SFECIARTY--�� OTHER � �""�✓
<br /> FINISHED FLOOR ELEVATICINS ��� FLOOD ZONE AREA �]YE3. NO .; � j t I
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<br /> Btltt�DER a , � (�, COMP7lNY i ��G���t�L.r _ .
<br /> SIGNATUR� � �� REGISTERED Y/ N ' FEE CURREA' ,^1 Y l.N _;; , � ;
<br /> �lddreas � �. � . Llcense# �,`.—.._�
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<br /> EIECTRlCIAN:r= ,� �„ _�' GOMPANY . .
<br /> SIGNATURE � REOISTERED Y/ N FEE CURREA �:Y'%N. .
<br /> �ddress � . _ , � f , . ..'.License`#=.;� e � �
<br /> PliIMBER � . • , COMPANY= : ` :� � - .
<br /> SIGNATURE ' � ,. _ �RECiIS.T,EREp°� . >d� .�Y/�N• - , :F.EE.CURREP:''.r 'Y/N:
<br /> �►ddre88 'r, ' . . . .. ..LICenS9#��' . �
<br /> MEGliANIGAt:` ` - .. , . :GQMPANY, � . : ' . ,. , - , .
<br /> SIGN�ITURE � ` ' .'' , . � . ,.,` .. ' ,ReGI;�Te�D. , 4.YJ4`N.•- .�:F�CUR�n . :Y/-N�<. �
<br /> Address''* . . � ' ._ , •-_. . - ` ` _ . .:LIC9nse# �. �'
<br /> dTHER • ' � . .. .- - _ . _ . - .GOIMiA,P.ANY . ., , ` , ,�� �...�. � .. ,
<br /> SIGWATURE ,,. -� . ` " " • . ` � __ _ . 'REGI57EREo. . =,Y/ N_. - rFEE�URF3E�' Y�/,N°- , , „
<br /> /iddresa N +,.. .;:.;�-:;W�:,.-. _ - h . ,�.� � . _ _ , � • Llcense#��`' . �
<br /> ;,r -,,4` - :,r.: �-i `�&>;'+7:...2+-_,<::2i.�j,�.'i::;' +.5-"�;`-1ni.5,. ,-.a;.�_�';%: - >{'::°; . • .... . _. ,
<br /> �RESIDEN'i7At;�<:. ../�ttach;(2):;.P,„lot�P:,lans,.(2);sets-of;Bi�tltli'n�Plans�°;(1j:set'of�Energy�Forms,?R-0=1N Permit.fcr new;;oon�truc�on; .
<br /> �Mlnimum+ten:�10 w.o in� �:d :afte�w8�timii�raate:�!Requited onsite;;�onstriicNon�Plans;-Sto'imwateF;Plans-w%Sflt F�n�e installed, .
<br /> . �.._ n �:�..0(r.)k_ �k .9,,�ys� , . . , � .. . ,. .. , ..
<br /> .�Saottaiy�Fac�ltdes;&�;txdu Rster,$ItekWarte�Pemt�t;(or:sutiilivlsions7large"pibjects',-,:a`�.��;' .`': ~ _ :`�
<br /> Ct?MMERCiAt ' Altach(9jteomplete se af'Bu"1Ciling�Pians pius a 1:Ife�Safety Page;(1 j sat of Energy Fotms.`R-0 W Permit#ar new construction.�
<br /> Minimum ten(10).working days after submlttal date. Required ansite,:Construcdon Plans,Stormwater Plans w/Sllt Fence installed;
<br /> Sanitary�acllitles.8�l.dumpster..Site.,Work-Permit7foe ail��ew{prqjaots:Aii commerdaGr�ec�ulrements�must_�eet.compilance � , .
<br /> 31GA1 PEftMiT Attacii(2)"s"etis�of`�is"g�ji�ered:.P_.tat�s�' �`'z�''��:`::�r i:`. - - :y-_ - °, ' .tl �-*•` -> ' t_ ......
<br /> •«"»PROPERT.Y._SURVEY_reguir+sci�fo��all�NEW cans.fhictid�..., = ��� ;;' �
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<br /> D.irections: .s:,::r; , � ,. - �._ . .. _ _. .
<br /> Fill out appflcatlon completely.
<br /> tlwner 8 Cantrectar slgn.badt of apptica�on,no#ar)zad
<br /> If over 5�500,a;Notice.af.Commencemant is requlred. (NC,uperades over S750q).. 4� . ... -
<br /> .,;�a�4�,��'•�_.;�h. �•r .
<br /> " Agent(for tfie cpntractor)°oi:Power of Attortiey'(fo�the:owrier)wautd be-someoc►e with notadzed letter from owner-authadztng same. , ti '
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<br /> 'D,VER 7HE CQUNTQR.PERMiTTINt3�===""-{�rori6;of�ApPlioatian:Only) � - ,�, �� • , , - �
<br /> Reroofs If shingles Sewerss Service Upgrades, ,NG � Fences(Plot/Suniey/Footage) �.�-. -- =-» - � - , .
<br /> _�.. ,..-- - . _. . - �;�- - , � - , ;� . . ' � '`- , . . . _
<br /> privewaya-Not over Counter if on public roadways::n'eeds ROW ' , � • ^' •• �• •-- ��•• : . ,. . , _
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