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e��-�ea-aozo City of Zephyrhills Permit Application Fax 813aso-oo2�
<br /> Bultding Department
<br /> Date Recetvad � . �� `Phone C6ritactrforPermlttin '`,',,• . - � .
<br /> Owner's Name �:� , �jr'�o �- . . . . t3wnet Phane Nnmber . . . -
<br /> Owner's Address b S 3 (�� � �S"�' j S Clwrner-Phone Idumber � �
<br /> Fe�e Slmple�TlNehalder Name � ° ' � Owner phone Number ' � .,��
<br /> � _'�7— . . � _ .
<br /> � s , .
<br /> Fe�Stmple Titlehalder Address ' -
<br /> JOB ADDRESS � � � �'P 4 � �^-�~ s I v L--, �f 1 G" � �.aT# ��
<br /> su�o�vistoN �- �� PaRc��i� � �3 Z� 2� � —2.i — DoS G �oo�o �-- o�o
<br /> , � •(OBTAINEDFROM�PROPERTYTAX'NOTICE) �
<br /> WORK PRt�POSEp ,. NEVVCONSTR��.� ADDIALT •C� S1GN [� ` Q DEMOLiSH
<br /> - -� � e INSTALL 8 ��� .REPAIR �
<br /> PROPOSED�USE Q:, �SFR �' Q COMM' Q OTHEft' ' .
<br /> TYPE OF CONSTRUCTION,' `Q� ' `BLOCK�' '[� "'�� FRAME � STEEL. Q; �
<br /> DESCRIP710P1`OF WORK �b- tl� � +�✓ 11 �� I��.�•ti�ta•1��•• t � .S.: . �
<br /> �
<br /> St11LD1F1C,�SiZE.'`'�- SQ.F,QOTAOE � ,.HEIGHT � ., 4 - f
<br /> � �� .
<br /> ._.. [�Bt1t�DING $ , �'--� -�,::�,:A,=� .._.s=,�,..,_,_..'' , ` - . .
<br /> C �Q�5� � � �. I; VALUATION`aF'�TOTAL GONSTRUCTION . ,.
<br /> � �
<br /> QE�ECTRICAl. $ AMP SERVlGE Q PROGFtESS ENERGY Q W.R.E.C. ,.
<br /> ,, ��'
<br /> �PLUMBING $ � , - ���
<br /> QM�CHANICAt. $ ' VAt.UATION;OF.MECHANIGALf[NSTALtAT10N �� �� �1��`V��
<br /> � ����,`��
<br /> QGAS :� . E�OOFlNG,._{Q SPECIALTY'� OTNER� ' ��jJ�
<br /> FINISHED FLOOR ELEVATIONS FLOQD ZONE AREA �YES: NO
<br /> �s�.�, , .
<br /> BUILDER COMPANY � � ' �
<br /> SIt3NATUPtE REGISTERED Y/ N. FEE GURRE�`., "Y LN.�: �
<br /> Address ' "� � . License'# I ' � I -
<br /> E�.EC'�RICtAN�:�. . > ,, COMPANY � , - ; �. �. �.
<br /> SIGNATURE M ftEGISTERED Y/ N FEE GURRE� '"Y/M .
<br /> Address , ' , , ":Ucense`#;I ' � - � —���
<br /> _ �
<br /> , , . , , , _. , .... .
<br /> Pl.UMBER GO[dlttP�1N'l� .` � ,> °` :. - � ., `° '
<br /> SIGNATURE " - .., . �REGIS�TERED � �� .%.�Y,/«N . , .FE�:GuttRen' . Y/N:- ,
<br /> �ddres� . .- .� , I- , ,l:icense,#:.I , - ' � ' I �
<br /> MECHANIC,AL`: ' " ' . . � � _.GONIPJ�t�1Y. � _ _ _ � _ , ,
<br /> SIGNATU�tE ' ". ` ' . RE�� o , Y;/���N;,. .1;FeE cu�n� ,Y./N:•-°�.:
<br /> _. ._. . .
<br /> Address�- , ' . ,� ., . _ , Ucense#.� , -' •-I� ,
<br /> o�e� � - „ _ _ 'co�r�amr t� :r`f:,d3j��G�.�.�. ;:°�''�'�.o� �r�f:, . .�c�.� -
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<br /> SIGNATURE ' � . . .�i��GisteaEo � _ Y/. N--�. , ��GuR�n� . :Y�I:N:<.:, ,
<br /> AdtiP988 'C3��� ����; •ca�, `l9�,1�=�;;;�G :,��:�,G:33 :�t� � .. ,uce�se#'.:C'�`�v;�'7 y�'� � � `
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<br /> E �;'�t;5'r�" • •,Y.�'r'
<br /> RESlDENTIAt.:._ :Attacti�2;P1ok'Pians�:2 :sets:of>Bul�il�n°�`�'Plans::1�.aetiaf,�Ene� �Fariiis:=R�0�1N..Permit:foi��sew;.con�tru�tlon,.:. � ,.
<br /> ... t..)_ y ,t.} . . 9 . {._.}.�, r9Y.,;. .,,,..... . : t,�
<br /> ,:;Minir�u'm,ten�(1�Q)�worltln.g;days,:�after�'s"ubmittail�dafe:�Requlr.eil o,'ns(te;%ConsErucBon�Plans;^Stortriwate�'Plens w%"Sllt Fenc,e.installed,.
<br /> '�� ��Sanifary Facj�4Ues&€+1 dumRster,Slte�Wortc�Per,mit�or'sutidlvl'slnrisllarge`p_ncJ+actsl: �,,�. i:":.:°:.� �:_ _ . ' , .� _` ..-
<br /> ---- COMMERCiAt At�ch(3}camplete'sets 6f Bu'ltiting F'lans ptus a l�fe Safetji page;(1j set of Energy Farms.R-O-W Permitfar nev+t aanstcuctlon.
<br /> Mtnimum ten(1Q)working days'after submlttel date. Required onsite,,Construcdon Plans,Stormwater Plans.w/Silt Fence installed; • ,
<br /> Sanitary�FaclliUes.&1�dumRster..Sfte.Work_Permtt for all�new`piojects:All,comrt►erclai.requlrements-musfineet comp!lance , ,-
<br /> SFGN PERMlT Attacti(2)"set�af`Eng,i`�iiaeredj,Pi'8ns¢.,;anrr��`...;}: j �, � , , , , , •
<br /> "•••PROPER71f SURVEYrsgulred.fur all_NEW:construcdon..,. _ „ -. �
<br /> � <Dlrections: ",t'�.. . . .. . • ,..., -- - _. »_,___._ �
<br /> Ffll out appltcadon completely.
<br /> Owrtier&Coatrac�r sign back:of appltca�on,notarized
<br /> If over 52500�a:Notice�ofCommencement is requiresl: (A!C upgrades over ST500).._ , �.� �
<br /> �. -.i;,;'.>�-.�..,�,,, _.. __._. .. �_ - `
<br /> Agent,(for ttie contractor�:or'Fa�fver of Attomey`(fo�#lie�owner)�woulcl.be_some�one with notarized letker from owner authorizing same
<br /> OVER�THE'COUN.T.�Rr�PEFtMIT11NG�= '-�:��(fiont:ofi-App�ication�Only}�� ,� _ ` . -� -
<br /> Reroofs if shingles Sewers Service Upgrades,AIC�� . Fence`s:_(PIot/Survey/Footage) - •
<br /> Drlvewrays-Not over Counter if on;publlc roadweys:�:needs ROW., 4 ,
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