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a�saeo-oaao City of Zephyrhills Permit Application F�e�3aaaoo2�
<br /> Build9ng Depachnent
<br /> Date Raceiv� ' ° � `u �
<br /> . . Fhone`-Contact%for"Rarmittiri ��, ' � ��.�- �D c�{ ��� �J`
<br /> Own�r's Name �tJl d t�1'fb'j . �'�f�J'11�1�111�' t3vvner�hone Nutnbee O l�` f��" ���3 ' ' ..
<br /> Owner's Addres� � � �` . ��. —tT/LLLS �J�.�� : �t�waerAhons�Numbsr �— �
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<br /> Fee Slmple TlHeholderName'� � ' � � CJwner Phone Number � _ �
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<br /> Fae SiPnple Titleholder A+dde�s� : .. . � �
<br /> JOB ADDRESS �,� � ��' � , !'J /�/L,L,$ � � /,/-,� LOT# �.��
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<br /> susaivis�oN � . ��' -PARCEL'ID# �6 � -�l_%��1� j$�L�l� ���f
<br /> , � � - �.• . ,(OBTAINED FROM�PROPERTY TA!(NOTlCE), ,->. '
<br /> WpRK PROpOSEp � NEW CONSTR�.G ��� ADDIAL7 �;� S1GN `�[�` "� ; .Q'�x"Y ,':DEMOLISH� •
<br /> � � � e ' INS7ALL :�' ��REPAIR' ' . � . � `
<br /> PROPOSED>USE. , Q � � SFR � 'COMM' �] OTHER:" "' .'� ' - . "
<br /> TYPE OF CONSTRUCTION: � `Q ",>BCOCK• `�. Q' �� „FRAME `s� STEEL [,�.. `. ' .
<br /> DESCRIPTION�OF WORK x {
<br /> BUILDIFIG SIZE"� � $4 FOOTAGE M r� HEIGHT`:� �: . � . -
<br /> .�5,�,_'t :��'�- -
<br /> QBUiLDING $ "��:�.-.;:.� ,,,,,r. , -. _ ..
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<br /> .- . , VAG:UATIQiV•a�TOTAL'CONSTRfJCTION
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<br /> QEI.ECTRICAL $ , AMP SERVlCE ' �Q` PFtOGRESS ENERGY Q W.R.E.C.
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<br /> �PLUMBING $ , . - � - . � ';
<br /> � . -��' . ,. _ .
<br /> QMECHRNlGAL ' $ -YALUATtON:OF MECHANiCAL;INSTALLATIOiV -
<br /> �9�- ��� � -
<br /> �r�s , . Q , �aofi���:,,�tC] s��c�a�.rr-.Q ost��R � .
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA [�]YES. NO .� ,
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<br /> BUILQER GOMPANY ` " �
<br /> $IGNP►TURE R�GISTERED Y/ N. �E Cutt�n' . .Y1.N ,•� .•
<br /> Address , " ' �L:icense'# � �
<br /> ELECTRIGIAN:�;;; ' ' � �A ' '`CQMPANY �x. , _ � �.
<br /> SIGIVATURE "' REGISTERED Y/ N �cutittEn ' `°Y'/N "' ' , .
<br /> Addres$ ' + - � . . . - - - , . , '�.L•Icense:#=-��'=°� _ � ' Y� � � I
<br /> PLUNABER � , , ` . . � : COMRANY�; :;:.4 � .
<br /> SIGNA'TURE ' ' _y -���iS.�R�o,:. �;:� ,,;..Y./�;N :. � ��:Cuwzen' . ; '.y/N: �
<br /> Addre�s ,. • � ; - . , � .Ucense#+.�: - �� •
<br /> iYfECHAP1iC/fiL: ` �.iy�-�'"� ��Pi'K,Q•L•+ { _ t- :CONtPANYc:-_;< ��"�}i�'S /`' , f.�/Ij�`���,5.'D�,�.�G-'��C'a ,
<br /> ;:� .Y;l�N.- . ��;�Ecur�en Y!N•�.�
<br /> SIGWATURE R�oisre�a:; ,
<br /> Addre�s� =' :'��e.f-� /`y''j/G/C.p.,=��'� �h�1t.L5,�✓��«S�1' .. .:License#: C����7't3�T..C7�: ,
<br /> OTNER * „ ...�.. .. ., . . . .� - - yCOiNPANII' - - � � ,. . - , . _.. , . , ,
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<br /> SIGfNA7URE. �;, , - �;• . ,,. �• > . , jREGISTERED ,.,r `YL N,.er `FE�GURRE��I� :r. _�Y�I.I�L:�; ,
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<br /> Addr�Bs :'i�; �x�t'. _ . _ .. .�� ` ' '�I:ICensB#
<br /> .. - _ -=si=^'�.: �:c.,..�. -- •'-;:nz-„ �;f:"�'Y`�.:"�.:ZsF'•:-�:i:;µ:`.•�,;;�.;.rY . , n._, � ' . .
<br /> R SIDEN77At,',;.�=�'AttacFi'2 �P.,lot�Rlans�z�2�:setsiof.�8u0tilnf'Ptans•';�1 ;sefofEne'"��Fori»;:;R=C1=1N�:Rermit:forsnewoons#nic�on;,Y:�
<br /> E. ,. .,(. )._ _. ,t.). . ., 9 , . �,(...). . t9y . ,� ,: � .. _ . _ . ��,� -
<br /> � ;Minimum:.ten�t,A orkin �day,"s�after�.su6mitt�l:ilafe:.=`.<Requlred onsite`''��ConsUucdon<P,lans;<Stortnwat`e�`Plansw/Sllk Fenc,e Insfelled,
<br /> . .. �',�s�.,)K�Y. 9� . �. . � , �,w-- ,.
<br /> _ �;;:"Saiiltary�.Fec�ltUes�&�1 cjumpgter,.SltekWcrk�Per�►?�=:fiQc;sutidivl�l'ons%iatge:projscts: .1�����:. :���:�- -,`: .� ��` >° .,.'.� _. � � .
<br /> CpIVIMERCIAL Attach(3)�compiete"'sets ofB'uittl(ng Plans pius a Life Safeiy Page;(1)set of E�ergy Fom►s.RA W Permitfor new cansWckian:
<br /> Minimum tea(10)wrorking days after subm(ttal date. Required,onsite,�Construction Plans,Stormwater Plans w/Sllt Fenc�installed;.. ,
<br /> Sani#ary Facit�les;&1�,dum�tster:,.Site,Work.Permit,for�lt=newiprojeCt's:A11�commerda�requEtemeats�rnustmeeYcampltance � -
<br /> SIGN'PERINIT AttacFi(2j:set`s of'Eng,�rieer.ed�pta[i$T;°���s�'�` ;'• .: - , , , . . . .
<br /> �,-.
<br /> "•'PROPERT.Y,SURI7EY.�reguired forall NEW;ccnstnucti,on.;,, ' - •
<br /> =DI��►ctlons. . .U.. , . _ _ . ____... � _ -- - -- - - �
<br /> Fill out applicaUon completely.
<br /> Ownar&Contractor sfign.back of applicatEon,natarized
<br /> If over�2500,,a•Notlae of,Commencement is>requlred. �ac,��,�reaa$a�e��rsoo�..,_ _ . ..
<br /> tt "'f:"�P�'ii':<•.`;��?`:i,:. :.:.........................._.�'...:_'..;... �,....__. • ' _ . ' _..
<br /> Agent(for ttCs contractti'r)'or:Powe��of Attomey(fci ttie owner}would be someane with notarized tetter from owner authorizing same .� • ,
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<br /> DVER THE COUNT�R�PERMII'1'ING�-=`-.:":(Front of�i4pPlication:Only):�y ; � : •�; , :
<br /> Recoofs 1#shingles Sawers 3er,vice Upgrades NC Fences�(PIoUSurvey_/Footage) �` �� • ;,.,.-.- - - .
<br /> ._ , ... ,._._...µ -..�,.,.;--_t, �;�; �.::.;.��;7:==,;=�=�'>.,_:._":t:..,';5`_,,,:� . .,�_ :, - ` ' , , ., , -.
<br /> Drlv�wrays-Not over Counter�if on public roadwrays::needs Ft4W' , ' ` �� - � � ° �
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