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e�saso-oozo City of Zephyrhills Permit Application Fax 813-T80-0021
<br /> � Building Department
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<br /> Date Rsaeived 'Ph`an��Cantact'for`P�srniti#iri ;:`, � D 1:,J ��O o� — ..t v t � �
<br /> t}wner'a Name �F.Y��� . . _ Owrner,Pha»e Numb�r a l�'"" �!� "'7�rs
<br /> Owner's Address ��� -� L ' e OwrnerPhone Number � , •� �
<br /> FeeSlmpleTltleholder:Name- �'� !�_ � Ownar.Phone.Number � .,�� . .,�
<br /> ' ' a „
<br /> Fee Stmple Titleholde,r.��iddress - �
<br /> JOB ADdRESS �7«'J� "T . _ G�-- U�. . 1.07# �� .
<br /> sueoivisioN I�6Y/�f/1J 7')� lD�[!ZL?/�� PARCEL:ID#" � , ca�J� oZ� C 7 � �� '�,�3Ca
<br /> . � , ., �(OBTAINEDFRGhf°pROPERTYT�U(`Nti7lCEj: ,
<br /> WORK NItOPOS�D : NEW CONSTR ' ` ADD/ALT � SIGN Q` � 'Q � DEMOLISH -
<br /> _ � e .`_� INSTALt - ����.-REPAIR - - . �
<br /> PROPOSED�USE.. . Q� SFR ' [� COMM� �� Ct1`FiER'.- " "
<br /> 7YPE OF CON$TRUCTION.. �Q '�'BCQCK�' 'Q' � FRAMEI �� :STEEL. .Q: .
<br /> .. �
<br /> DESCRIPTION"OF WORK E'�f.�l'.'N%//�f-L �L°.Uf7f} e UGQT , l � o , � �
<br /> BUILDING�SIZE,-'C�, ��SQ FOOTAi3E� ,�,HEIGHT`�. „
<br /> _ 4�: �
<br /> QBUtLDING $ �fi:,�-;;.., ....a_,.y.,�.,;. ,.' ,. .,Y >. ,
<br /> � �, ,�y �VAWATION'0��1'OTAL CONSTRUCl'ION
<br /> ��J
<br /> QElECTR1CA� �� AiV1P SEFidiCE Q' PROGRESS ENERGY [� W.R.E.C.
<br /> QPLUMBING $
<br /> ._- �W�' � �
<br /> [�MECHANlIGAi.' $ �y VAIUA't'i0(st+OF.MECHANIC�4I.,IWSFALtATIOi�!
<br /> ��. � �l��i��: . . , ..
<br /> ��S C�, �.-�ooF��v�..�;.p s��ciat�nr-� oTH��., .._ � -n
<br /> FINISHED FLOQR ELEVATIONB �-1� FLOOD ZONE AREA [�YES. NO . ,
<br /> BW�DER COMP7a►1�1Y , _ ° � ; ,
<br /> 8113NATUI2E REGISTERED Y/ N. ' FEE CURRE��:,� "'.Y/.N: ..�: .: ,
<br /> Addreas ' � Cicense'# I � ` �
<br /> s
<br /> EI.ECTti1CllaN;-�. �- , G�INPANY ', - . : � _ � - .
<br /> SICNATURE ��' REGISTERED Y/ N �cuRit�� - ' �;Y'/N'
<br /> Address � . , _ ,, � ` `.Ucense�{ `� �
<br /> 4 , . +}r'•r--� .
<br /> Pt�UMBER COMBANY; .�' ... ' � ...
<br /> , � ti =• : ,,_ ..
<br /> SIGNATURE �' �' :REGIS7ERED� �i" -:Y'/�N:�- ,.�EEE:CURR� � �'TY/-N:
<br /> Address - • _ - � : � _ Ucense.# � . �
<br /> ;�, . . c •� �:.� .. �/� � . ! :z � ;_ • . :
<br /> MECl�lA�NtCAL,, . - .COMPANY�-. 1�7�1�i'�S.. /`L9 �C�.•�`�"'��G� �fv r
<br /> SIGNATURE '�rn'e %+���)'L.QJ�.�`'� ' aE�isTE�o:. , .:Y<I'N� ".:,FEECURRE� .� Y./-Ns;
<br /> Address;`` `.� .: /L -..:Ucens.e# ���a�3���'��I, ..
<br /> ,.., _ €r. _ .�, ,, _ , : ,._ , . . - ;�-� t - . . : ; _ . . , .
<br /> o��� . _ . , . ._ .. .. ., .. . . � .:co�t�aMr . .; ... - .. �-_�. :.: ::,.:-. _ :: .
<br /> SN3PIATURE -. . . ' .�, " ` � � . .REGI87ERED Y l N«, ��6�uR�tE�:. ,.�,Y./:N::,_ � •
<br /> Address - � .:r;sf: ,,�:�,:. - :.�5 ';'...:. ..F : . •- . .Licerise#���` '�
<br /> z - _.j;` =i� _ •-SJ���:•rr-,�;.�:: ��..f :�'.t.�-..:�;'iei•+`s�.s�;;e�;z-. ,i�;,�.- .._ ,
<br /> ��E$1DEF1TiAl,y:�=��.�Aitacn�(2};p1ot:P,.laiis,-�(2)sets,iif�Builtl�ii'g��F?lans;`..{1)set'of.�Energy�Fpr`ms;'i2=0=W°Permi for" � , - �
<br /> -- t.. new.con�tniatlon�:;. �. .
<br /> ,v.�;.,.b F.,..,;., �.��.;;,
<br /> -, rv;lMinl�tuiit7ten�(+1rQ)}wor{tl�g�day;s,;atte"r,�subriiitkail�dafe:��>Requited'o'neite;%Consirucdon�FlansrStoRnwate�Plans"wrLSilkFence,instelled, .
<br /> - � SanlCary Facjll��s.8�s�1,c�u�m�Sster:Sl�eYW�;orlc�Per�ft.�qr'�su6divislbt�li8rge ptqJecls;�.:_:;4Y�.� " "��. � - ; ..,:- • _ - �. . - - -
<br /> CC?MMERCtAL Attach(3j=cortiplete"set's`cf'BulCtiing'Pians plus a Life Safety Page;(1)set of Energy Fortns.R-O W Permit for neW c+onstnictlon.
<br /> Minimum ten(1Q)work(ng day�'after aubmittal date. Requirad onslte,,Construc8on Plens,Starmwater Plans w1 Silt Fence installed;, -
<br /> Santtery,Fadlitles�.t..dumpster._Slte..Wark F'ermt;,fqr•ail;new'p'roJect's:;Aiircamcnerdal.requlrements°must meeYcompilance'
<br /> SlGN:PERMl7 Attacti(2j�s`e`f"sofEng"i�ieer.edsPlans;s�,�w^�s:'�'``�- . . . . .. , _ , , ., , . .
<br /> ""••PROPER7X.SURVEY reguired;fia�;�aJl_NE,„W.,:co � - - ' _" : . _ ,, �
<br /> nstcucyon.;
<br /> ,:
<br /> Dti�;+ctions: ,��-;'�.�. . , • . .. .. . _ . ._ _, •
<br /> FIII�out appflcaUon c4mpletely.
<br /> Qirvner&Contractor sign back of applicatlo�,notarized
<br /> tf�ovar�2500,a�Notice of:Commencement la required. (A!C upglrades aver S7S00), �� �
<br /> I�BR�����18t�<�}tr,.�.;zec,: => ,....... . ........ .... , _ . .
<br /> " � � ntractoi)�or"Power of Attoriiey'(fo�'tt►e.owner)would be someone wtth.notarized Istter from owner autharizing same
<br /> `�VER'THE:COUNTER.P.ERMiTTiN�:== ;.(Front=ofAppiica6on Only}.,.� .. � . _ . . ._ .__ _... ._.
<br /> Reraofs if shingles Sewers Service Upgrades A/C Fences:(PIoUu,urvey/Footage) _ _.._-- .... -.--. . -
<br /> ... .. .. .. . .. . -. .t;_ �°� : _ -_ : - �... . . � -.. _ .. �, .. , � ., �
<br /> :'.}•,,�.;�=,�% �.. , �
<br /> Driveways-Nok over Counter if on pubilc roadwajrs,:need§RC7W
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