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I 813aeo-oo7o City of Zephyrhills Permit Application FeX-813-780•ooz�
<br /> • ' Butlding Department
<br /> Qate F2ecelved - •, -
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<br /> • F'tiane-Cari#act�for`Petmt[tttn �°� �
<br /> Owner's Nams t} , Q . . ^ Owner Phone Number �3 ` - ��.,:, ` , _
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<br /> I Owner's Address . � Z KCl' � A. � Owrner•Phone Number � �
<br /> Fee Simple TlHeholder`Name' ' � Owner Phone Numbe� ,.l � � ,-.�, I .
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<br /> Fee Simple Tltleholtlec Address • a '" �• `
<br /> JOB ADDRESS Z ��C�-f - �e �. 'l G ,3 2 �aT# d3
<br /> S�aawiSioN ~ �.r��,r � P������ o Z� w �2.1 =az3o�-000 a c� -oz � .
<br /> ' '' =(OBTAINED"PttOM PR4PERTYTAX NOTICE) �r
<br /> WORK PROP.OSED � NEW CONSTR �. ' �' ADD/ALT �� '"S1GN � �] � Q'�, DEMOLiSH -
<br /> ... ' :e y4 �• INSTAI:L 8-`�- .<REPAIR � -
<br /> FROFdSED�USE Q -SFR � - COIUIM'`. � OTl1EF2`,Y : .
<br /> TYPE OF CON3TRUCTION;; '�] BL'OCK'�' �Q F,RAME _ � STEEL. Q: - -
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<br />' DESCRIPTIQN-OF WORK _ ��l(.leFia= �}' I� � D4,y , �
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<br /> BUILDING�3IZE,-°�- � SQ,FOQTAGE .o��I . :� � , ,,;HEIGHT:, . �¢- �...�..� . �=
<br /> . ,.. QBUIlD1i�IG $ �-;.;,�r;,.��._ �LL,._,M ; .
<br /> ,VAI:UATIOtV"aF TGl'1'AL'CONSTRClC710N ,.
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<br /> QELECTR1CAl � � A141P SERVICE Q PROGRESS EIVERGY �] W.R.E.C..
<br /> QP1:t1M8tN{3 -$� - " . ' � .
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<br /> � QMECHAlVlCRL ' „ $" :" ` VAt,Ut1T10N OF MEGHANIC�I tNSTALU1T10N � � .
<br /> ' QGAS , [�: ROOFING. ,Q SPECIALTY-�C�" OTHER �'
<br /> FINISHED F1.00R ELEVATIONS FLOOD ZONE AREA �YES. NO . ,
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<br /> BUtl.DER COMPAFIY `� � ' ` � � ' � _
<br /> SIGNATUR� REGISTERED Y/ N � FEE GURRE�' ;,,; Y/:N.::;
<br /> Addreas � ` 'Llcense#'t ' '` � �
<br /> E�ECTRICiAN;,_. , , . 1, ��CCOMfPANY° ex � � . . � � , ' , :�, ._ .
<br /> SIGNATURE "' REGISTERED Y/ N FEE CUFtREA Y./N ,
<br /> Address , • ~ - , ` �� , �.:Llcense-#�,�'^ .' ` I
<br /> PIUMBER � , COMP.ANY.; -_' " • , - .
<br /> SIGNATURE ' ' .. �; ,. . .. :REc�1.S.T,�EO��• � ��Y.I�N.- � ,.FEe:CURRen�:, •`Y/N: ' .
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<br /> Addreas - � ..- . . , ..UC�nse#.•�. �4, �
<br /> MECNANlCAL'��. -:u`� �. _ . - .. ,. :GOMPAFIY;.. :.�: �-` :; `f .';::: . f� ' , . ,..t�j. , .' ,
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<br /> , SIGNATURE • ° , � . , '� Re�i,�TE�n.�, -Y/:N. =,�eCu��. �.Y/N � �
<br /> ' Address' � � .. , . : �r; , ,._ -a. . , . r .. r , . ' ,. ,�Licens..e#��^ . ., .,�.-
<br /> IOT�tER .�.....�,...., ,. - - COIMAP.-,ATiI�,.. �j � j `-'"`� �;;.,,y;,; � _; .t. .. _. � ,
<br /> : SI(3PIATURE� "�"��- ., � � }: ,REGISTERED � ,. Y L EE GURRE� ��Y�/�N:_
<br /> -___ -- �dalrssa - �` - lGi'�f't� - ; �/- " Z� f - - - f- ._ ;;Ltcense#'�� �
<br /> , . . _ _ '.-�':''w.�R._i'-- �p`S.' n .f�t:.»��..3�.:�.h�:9 ' .s. ..... . •
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<br /> �RESIDE9�- �=�=�`�Attacti<�`tPlot��Plans�;2;set`s'.af4Butlillri'rt?ians�`�1�`sef'of�Erie' �F,orriis�'R=0`=111i�Rerinitfor�ae`co stnic�cn;.. , ..,
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<br /> •`z Minimuin�ten°(�1Q)'w.orlfing,days�,afte�,:sutirrilttalj8afe.�R:equlred onsite;-ConstniaHon�Plans;:Stormwat'e�f?lans w%SIIt E�nce,tnstalled, .
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<br /> - ��'Sanitary,Fe Iid�s,l�ilti�; u � s er;FSlte�lNorkrPe }Ik:f4r;,sutidi�islOii&lla` er 'n`c n ..:�'';,,��"`'°::�.� :�-` - . ` - � , . .
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<br /> COMMERCIAL Attach{3)`comptete'sets"of'BuTtiling Pians plu's a Ufe Safety Page;('1}set of Energy Forms.R-0-W Permtt for naw cor`�stnicttan, --
<br /> Minimum ten(10)working days'.aftar submittal date. Requfred onsite,Construc8on Plens,Stormwater Plans w/Sllt Fence installed;
<br /> Sanitary Fadlttles�&:1„dumpster.,SitewWork:Petmtt for ail�new,proje�t's:�All commerc�ai:requlremenis-must meet compllance ,
<br /> StGN PERMlT At#acti(2)sef`s of"�ngl�,eer.reil.Pla�s:�'::����'"1�;�: _ " . . - ,. '" � ,
<br /> � ••"'PROP�RI.Y._$URVEYreguir�d•fo,�a)I�NEW�„constructioii:: - � "_ ,. ,
<br /> �'= -.°_ �:r�„°,
<br /> � ,Dlrectlons: ;,:'..=<�,,:,- , z .. ...�_ _ w _ � .
<br /> � � Ftll.out applicaUon completely.
<br /> tlwner 8 Cantr�ctor stgrs bacic-of appitcaUon.notarized
<br /> (f over a�500,a,Nottce.of.;Commencement ta required. (AJC upgr8des over s7500)._ �i ,.,-_-.
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<br /> :r':rr•'.�;+v.1;*>a;:,,"�;.-- .......... .......... , ,
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<br /> Agent(for the contractor):or'Power:6f Attcrtiey'(forlti'e.owner)would be someone with.noNarized lette�.from owner authorizing same
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<br /> .OVER TIiE GQUNT�R:P.ERMiTTfNii��_-;':.(Front�of�ApPUcatioii�Oniy)�µ . .� .
<br /> Reroafs if shingles Sewers Servica Upgrades�AIG Fences°,(PIoUSurvey/Foatage) _ . •. - , - --- � : •~
<br /> Driveways-Not aver Counter if on pubtic roadways4:need's ROW�,. , ; • -- � .,„ � r` , .. p J ' , '` . ^
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