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a�s-780•aozo Ci#y of Zephyrhills Permit Application Fax 813aeaooz�
<br /> Bullding Department
<br /> nacg Rg�gi,►�a " ,�Sl..� 782. �D l.�.
<br /> ' . ` `.Rhone Gantact�for"3�►ermittiri`
<br /> Ow�ef's Name � �G S � � , 2�-Y��t� pwrner Pboae Number �1�- �� f��� .
<br /> Owner's Address ��.� �- �� J� Ownsr•Phone Number � �
<br /> Fee Simple TltleholderName�� � � Ownec Phone Nuriiber�-'( _.� I
<br /> Fee Simple Titleholder Addres� ��, � � �
<br /> JOB ADDRESS �L� � T'r/��/�.) l�, LOT# ��
<br /> SUBDIVISION . �r, PARCEL'ID# �� �� �� -��a� ����,.�a�o '
<br /> ` , � •(09TAINED F1tOM PROPERTY TAX`NOTIRE}" ``�
<br /> WORK FROPOSED : HEw CONsra � �D'D/AL'f �� �SIGN 0�' �. , (��'* ' DEMOUSH .
<br /> �� e A ,f�INSTAL-L '- -REPAIR ' � ,
<br /> PROFQ3ED=tlSE Q �`SFR Q .COMM' [;� 'OTFiER' . _ . .
<br /> TYPE OF GONSYitUCTIpPI_ '-Q � ''BLOCK�' Q. . FRAME; 'Q S7EEC Q.
<br /> DESCRIPTION OF WORfC } � � GS�,L° E,', Y. �� �. �a�f
<br /> BUIIDING°SIZE''�� '� SQ.FOOTAGE � , , .:;HEIGHT�`. . . �
<br /> OBUlLDING $ �,�,f..�:.... _....r ; . _ .
<br /> , �• VAkUATION`a�OTAL CONSTRt9CTION
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<br /> QELECTR{CAL �� =`AMp SERi/iCE �Q PROGRESS ENERGY a, � .W,R.E.C.
<br /> [�pLUM81NG • $
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<br /> QMECF'IA/tlttJ'ti{. .� C�? ,� � VAt.UAT10N;OF MECFtANlCA��ENSTALtAT10N n�
<br /> QGAS Q FtOOF1NG:,;�O SF.ECIAITY•'[� OTNER
<br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA �]YES. NO
<br /> BEIILDER COMPANY ,
<br /> SIGNATU�E REGISTERED , Y/ N. ��;CurutEh'_,�, :Y/.N _�;
<br /> Addre�s � - • � _ "4lcense# t �
<br /> ELECTRtCiAN�-; - ,� ., �' COMPI�NY 'x � .` i- " �
<br /> SIGWATUFtE � REGISTERED Y! N FEE GURRE� Y'/N
<br /> Addre�s , _ ,' �'.�Icense#;�I �-, ' " I
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<br /> Pl.UMBER � . �C,OMP..ANY�� -,':...; • . , , .
<br /> SIGWATURE ' . - REGI3TERED. - .:.Y'/-.N < , .�:cu�E�' .- '-'Y/N: �,
<br /> Addrr�ss , � , ` .l:lcense# �- � �
<br /> MECFlA�1#GALP � ``.�/Gt.*.�.0�!'�.�.h:i CQMPqNY:,_. !.�!�-fi�/2�s, I`r?O .�}lUG.- -f �f� -.�ll� ,
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<br /> SIGWATURE ' R��ISTE�a, , :.:.Y::/ N_. -, ,•�E CUw�n Y./-N .�:�
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<br /> SIt3WAYURE < . . - - - � " REGISTERED�, . . Y/�N._��f :EE�.QURREA _.Y:/,P1:- ' .
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<br /> RESIDEg1119AL,..��a�Attacli(2),Plot?Piana;,(2):sets`af;8utldin�'Pians;``(1}set"of�Energy�Forin�;'R�{N�.Pernnit:fof.new�constriiction,.,., „
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<br /> t"��Minimumrten;,(;1,0.);worit(ngidays�,after�,sutimittal�dafe:=:Requlred onslte;Cons't'rucdon=Plans;�S#oitriwater:P.lans w1.;;Silk Fenc,e installed, .
<br /> ... , �,:-_�• ;,- . . . , .
<br /> � �Santtary�Fac�4tl�s&�'1 du,�mpster Si2e�11Yoitc�Perrn�t fQr;:'subi!(vl§toiis/targe.'project's.:`�:=-'„�`::�'>`�`"�::..: ._. _ ,. . .. ,,
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<br /> CONtiNEi2CIAt Attach(3)�compiete�'sets afi Buiiding'Plans ptus a L`�fe Ssfety Page;(1 j set of Energy Forms.R-O-W Permit for new cbn"strucl�on:
<br /> Mtnimum ten(10)working days'after submltkal date. Required,onsite,!ConstnuoUon P'lans,Starmwater Plans w/Sllt Fence installed;
<br /> Santtary Facllities:8t;l..dum�tster...S1te Work Perm[#.for ai!'new;project's:Aii commerciaGrequtrementa�must meet compilance ,
<br /> SIGi�1�PERMiT Attadi(2}set`s of��ngiii�er',ed"Rlans;;;�*-;r:�r=- --.. .-� ,":. - ., . ,` : ' , ,
<br /> ""'PROP.,ERTY..SURVEY:requUed,fior��II��NEW construction:; � �- �
<br /> Dlr�ctions: � ..,:7'r�; < , . . _. .. .
<br /> Ftll out appflcadon completely.
<br /> Owner&Contra+�or sign.back of applScatton.nota�Jzed
<br /> If over S�g00,�a Notice of.,Commencement la required. (WG upgrades oyer 57500)_.. �
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<br /> Agent,(for ttCe'contractorj"4r:Poviier of Attomey(fof ltie.owner)woutd be someoae writh notarized tettee frotn ouvnerauthorizfng same
<br /> 'OVER'THECOUNT�R�.PERMITTINt3:�-�:�(Front;of•.i4�ipliceBon�Only)""�".. .. ,l_ .^. , .....,. , -
<br /> Reroofs if shingles Sewers Service Upgredes��/C Fences(PIoUSurvey/Footage) , - •- - ;
<br /> .,` __.,. _.. ___ __ . _3_. _ _.. , - ' .. ,. . _ ., - � � ' - •
<br /> f�riveways-Not over Caunter if on pubUc roadways:�needs ROW - �- ' .
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