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<br /> e�aaao-ao2o Ci#y of Zephyrhills Permit Applicatian Fax 813-780-002�
<br /> Buitding Departrs�ent
<br /> Date tteceived. �' ! �'�a `Phone Coritack`for"Pormittln"� 702� ��ir"�}'� J�.�-L� `
<br /> �f�r� �s - - . . .. . .. �(�-7�8-o �'
<br /> Owner•s Nama � �7; Owner Phoae Number ��.�..
<br /> Owner's Address � � G.G.-S �`. ���h�� QwnerPhone Number �! �
<br /> Fee Slmple Titleholder'Name = � � - Owner Phone Number � �� ��
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<br /> F�e Simple Titlehalder�ddress
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<br /> JOB ADDFtESS �r0y� �T�LL B�, ,7�Pf��(�2f-fit�.-5,�z., 3��� I , �or# .�
<br /> SUBDMSIt�N � � PARCEL IDiR . ` �
<br /> ' �(OBYAINED FROhI PROPERTY TAX'NOTICE)
<br /> WORK PROPOSEQ � NEw CONSTR :�' ADD/ALT � SIGN `Q _` Q, DEMOL.iSH
<br /> .�- � e �INSTALL 8��... �REPAIR� - . .
<br /> PFtOPOSED:USE. �` SFR � COMM � � OTF{EFt"
<br /> TYPE OF�ONSTRUCTION„ � Q' 'BLOCK�' `Q �� ,FR/�ME �� STEEL Q� -�
<br /> DESCRIPTION`OF WORK .f �T� �^—�.�-�L �,Ar�l�t"� `�',,ld"," ,
<br /> BUILDING SIZE ,� ��$Q F.00TAGE�: . :HEICiHT,�,�- '
<br /> QBUILQING $ ,•�:rn�:�_ _•�rT-. .:,._ � . ., .. . .. . . .
<br /> �. VALUATiON'�O�TOTAL'GONSTRUCTION ,
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<br />, QELECTFt1CAL �"� AN1P SERVtGE [�' PROGRESS ENERGY `[�5 W.R.E.C. ,
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<br /> [�PI:UMBlNG ;� � -
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<br /> �MECHANIGAL $ •���`�� VAI.UATION.DE M�CIfiANICAL,,IN3TAL[:ATION _ � �„�..��
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<br /> ' QGAS � :ftOOFliVG;t Q SFECIR�TY � OTHER '
<br /> FIIVISHED F1.00R ELEVATIONS �� FLOOp ZONE AREA �YES. NO ;
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<br /> BUILDEFt COMPANY � . , -
<br /> SIGt�ATURE REGISTEREp Y/ N �e Cutut��' , '.Y/.N..
<br /> �d��'$ . . . "Llcense# (- ' �
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<br /> E�ECTRIClAEI�;:, .. �, GONIPANY �' ' ` � - � ' �
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURRE� `.Y'/N ,"
<br /> Address � . . r .. °.License.#�,�(� � � �
<br /> P�tilN8E12 , COMPJ4NYr- , .. � ,.
<br /> SIGNATURE � " - .. _ ,RE(#IS.TERED' , w 'Y L-.N.= • �E.CUR��' .. , Y/N: '
<br /> Address . _ � . l , - .Ucense# � - �
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<br /> MECliAhltCAl:_ ��"�i5�/�- � ~ _, � ' � .t�'I1 Dt7S 0��O�'TIZc��L?'�j2���C_S
<br /> th,•t,c:.,,�:,. -.�QMPqFlY : ; ;�:� ,_ ,,
<br /> SIGNATURE . REGI�SrertED.-= Y:/�N- ; °-pFEE�CURREA' � � Y/-N<
<br /> Address � �O�'j�"' tNtCYs.�,i`:'�` 3 ;:,�: � . , . -. �'�"�
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<br /> � ,, ,:Ucens,e.# 1, ,;.- _ '�.
<br /> OTHER � . . .. _ ' . , . .. _- ���Ctt�ANy- ��� � "" � � ` ' . .. ._ . . . _
<br /> SIGNAYURE ., - - . " " REGISTERED Y/,N-..�' �..FEE CURRE�� :,YJ.N::.., ,
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<br /> ' , . � , . ,x,., '�y'� _ �e - *•. �^ ;1 ��
<br /> �1tlP8$S �;ay:; - _ " ' ., UCi:n$9#
<br /> R�SIt}EFlTfA1»-. -�A"dh 2 RIo:P„lans"2' e #x ut 1 'f� �:: � _ _ ,s;;== - ` r�.4' r=;<.:�< - �:r,: . _ .. ,... ..
<br /> �., _ � „{,,)., _� „(.,);s`tsro E3 li!ng F?tans;`,{i};seti'oftEnei�jyt�Foiins,>R�0=1N°Permi#;for neuy,,conshuctloii; _ ,
<br /> ;;SMinimum�ten;(1�Q�woriting�;day,'s�,a#ter sutiiiiiitfal=date�Retjuired on'site CansfiucBon;Plans:tStbrmwater Plans'w%;Sllt Fence�installed,
<br /> . �5aiiltary.Fed�ttles,&�1S,dumpstar�Site�Work;;Petmit:forsutidivl'slotisAarge"proJec�s'. `..;fa;'�-_ .. ._ _ . ' _ ; � -
<br /> �. CORfIMERCII�I.— Attach{3}�c6inptete sefs ofBu`1!�ling Plans pliis a"C'�fe Safety P'sge;t1j set a#Energy Farms.R-O-W Permit for new construr,don.
<br /> MiNmum ten(70)working days'after submittaF date. Required anslte,.,Construcdon Plans,Stormwater Plans w!Slit Fence Installed;
<br /> 8anitary Factlittes 8�_1,dumpster.,3tte.lNork-Persnit for.atl�neiivyproJ��;All;cammer�a�r�quiremenis must maet c�mgitance . ;-
<br /> 31GAl.PERMIT At#ach(2j�setso#`�ngii�eer;ed=Fla�ns:+.�;���of�•:�_`.,'.�; .�.�. ,
<br /> •«'"PROFERTI!SURVEY requir�d•for�all•NEW:ca�strucGori.. „ , - " , ;; , _ ,
<br /> Direettonsc _y.,�::,,:..:t -. .. ... ._ � . - - - -- ._ . - •
<br /> 1=111 out appllcaUan completely.
<br /> Owner&Contrac#ar sign.back.of appiication,notar3zed
<br /> tf'over$2500,a:Notice af.�Commencement ta requtre�l. (AIC upgrades ovar ST5p0)_ _. � "
<br /> �A .'.i:�w•.r.�:(."'��:'4.{ =_��_ -�.
<br /> Agent(for the"ai�tracto�)"ot=Power of Aktoiney(fii�the�ownerj would be someane with notarized letter from owner autha�izing same
<br /> 'DitER'THE"COURITER�PERMIYTiNC,= :-:=.(Froiit.of�A(iplloation Only).. �.-. _ � ` .,_ -
<br /> Reroofs If shingles Sewers Servlce Upgrades A/C Fences(PIot/Sunrey/Footage) �. -.-- »- r-
<br /> . .� .---• • - ..._ - - -,r.. - _;. _ ...- _' : . '• , ,.,_ �, ,
<br /> Driveweys-Not aver Counter if ompubila roadways.:need§RC1W
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