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a�3aso-oo20 � City of Zephyrhills Permit Application Fax 813-780-0021 �,
<br /> Building Depafinent
<br /> D�te Recelved. �� �-- ..� � � — _ � `� 6 '
<br /> r�° Phone�Contaat•forPermlttin `� �= L 3 ' � � ;
<br /> Owner'a Name �J O h''(� I_2� Owner Phon�Number �- a.
<br /> ��- y1�7-(� 07
<br /> Ownar's Address � I I�-O� �`Do �G�d (��,�cr �lvtl�, (y�i. �.�c�.��ll+�, �3�I,6 f 3 �
<br /> OYvn�r Phori�Number
<br /> Fee Simple TlNeholder Name Owner Phone`Numtier '
<br /> Fee Simple Titl�holder Addresa - . f- .
<br /> JOBADDRESS �3�� C, ��-� �blvp Ze � �h� � ls �(- 335`�a � �mr# �
<br /> SUBDIV/ISION ` ` . - PARCEL ID# (� `�b �a` � �- ��1 (� '� 13�b 0'— b b�p ,
<br /> • ' ' (OBjAINED FROM�.P.ROPERT1f TAX NOTICE) �
<br /> WORK PROPOSED � • � ��NEW CONST ` • . Q' SIGN 0 � -Q DEMOLISH ,
<br /> B
<br /> INSTALL. REPAIR - � , - ' -
<br /> PROPOSED�USE ' - Q ' SFR. Q 'COMM,:= ` Q � �OTHER � ' � - "
<br /> TYPE OF CONSTRU�TION � ,� ' 'BLOCK' ` Q FRAME . , '-�� , "STEEC �''Q�'
<br /> DESCRIPTION OF WORK'' ^~ ���/"�lJ �"�O j,/��[-20':C�.r 1 aa.� �OeG./'i ,,,�c�,1�S '� i/�-S'�,�� L��--�5'
<br /> BUILDING SIZE' � ' SQ.FOOTAGE.' ���� . � '�` � � ��
<br /> ,C�: .,_FIEIGHT�� '. � � ,
<br /> Q'�UILDING $, � 5- va , _. :, . , ,
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<br /> DU_-. VALUATION�OF"f0'i'ALrCO1�S'•i'RUCTION
<br /> QELECTRICAL• $ � � , AMP SERVICE " '`:PROGRESS ENERGY W:R:E:C.
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<br /> QPLUMBING `=$ _ ' '
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<br /> OMECHANICAC $ � ; VALOATIONAF;MECMANICAL INSTALLATION.
<br /> Q GAS ; �Q ROOFING ;Q SPECIALTY...Q �-",,.,OTHER�- =.
<br />' FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �]YES. � -
<br /> BUILDER � COMPANY='= ��� � �a✓�; �+.S�tiLG`ri��`� .��`^-�-�-
<br /> 31GNATURE REGISTEREO Y/ N �""FEE'CURREK� ' ` `;Y`/N- �
<br />� Address 3 �`i13 S2 5`'1 Z2 f'�, ��;��5 �L.3.3 5,!f;(. , ,:, ., - .License#� ` CG:C l5l —11�11
<br /> ELECTRICIAN; ., . . . , "COMPANY'` , : . .- �- , i
<br /> SIGNATURE "` �' REGISTERED Y/ N FEE:GURaeN�' ` -°�-Y�/N"•: ` '
<br /> Addre"ss � . . � . � , _.. .. . , • , . � _ , .Lipense: ` u - - �
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<br /> _ � ' � .. ' " -" . � _ . .,. l�Y� �� '
<br /> PL•UM�ER _ . , COFNPANY =•„ ��.: .- :;..;,,: :-.-. �.
<br /> SIGNATURE'�"� , . ""�' .
<br /> REGI3TERED,` Y./...N•.... .,�FEE.CURRER. , YI:N:�
<br /> - - , . .. . _ �`,:
<br /> Addreas . - . - .UcenseN# : ,_ . . -
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<br /> NAECHAPIIC�IL` f . , _ _ .. ;COMPANY - _ -
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<br /> SIGNATUMZE� � .'. ., � " ' ,.. �� . REGIS7ERED _ Y.:/ N� FEE CURRE�;_ YA��N�-_ ,
<br /> Addrea"s-'''� �:�,;: , -. ,. , . • � , �. , ;License.#: .
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<br /> �:; � � � - . - ' ' . '
<br /> OTHER _ , _ � , � , , , , �OINPANX ; ,_. .,
<br /> SIGN�►TURE::..�.� , , :;:', , .- _; , i� _ v:. . ,
<br /> �` 'REGISTERED Y . '' ' Y/ N,.,.: FEE.CURRE� Y/N
<br /> Address - .S; ,u,. .,: , . . � . � _ License#` ' - , - . '
<br /> � ; - • � .. ::. :, ., _;.,; ._ .� .,,,, : .{.:.>-_-...;�. . . . . .. :. � • ' ,. - --
<br /> RESIDENTIAL;�:�,��Attacti�'(2),PlotfP;lans;�(2)§ets`of+9ullding�•Flans;`,(7).seE;of�Energy=Foims;�R=O=W'Perm,itfor.new,consf�uction;
<br /> .�--:�'Mlnlmumeten=(r1A�'Eworiiing�days;after;submlttal'dete:Y Requlreii�onslte;?Con'stru�ctlo'n�Rlans;'Stormwa4er'Plans w/Sllt`Fence lnsfalled,
<br /> �" �Sanlfery Facllldes,8;lF;dump��er;Slka•;Worli�Permltfor`subdlvislon§/large<pro]ects:��9 ,� _ - _ ' • • , -
<br /> COMMERCIAL Y Attach(3)�cample'te'sets"'ofBullding'Plans plus a Llfe Sefe�!Page;(1)set of Energy Forms.R-O-W'Permit for neW,construcdon. �'
<br /> Minlmum ten(70)warking days'after submlttal date. Requlred onsite,Constructlon Plans,Stormwater Plans w/Sllt Fence Installed,
<br /> Sanitary Fadlides 8..1 dumpster._Slte Work Permlt for all new�project's:�'All commerclal requlrements must meet oompllance ' � ��
<br /> SIGNPERMIT Attacfi(2)"setsof"Engineere.d�Pla�s:;,...,:;��r;=�..;�,;.E:�.;' _ . _ .,_
<br /> ••••PROPERTI!.SURVEY required for:all,NEW:constructlon. � -- •
<br /> Dlrectlons• , �,:,,.:.._;::<.::- _ . ,
<br /> Fill out applicatlon completely.
<br /> Owner 8 Contrector slgn back of applfcatlon,notadzed
<br /> If over g2500,•a:NoUce:of.Commencement Is requlred. (A!C upgrades over 57500) ,.�. -
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<br /> a::::::. �ry=��•`-::y�',_ .
<br /> " Agent(for the conVactor)orPower of`Attomey`(fo�ttie owner)would be someone with nota�ized letter from owrner authodzing same
<br /> . - a a� � :.-�:.SL.t
<br /> DVER-THE COUNTER�PERMITfING�•- �-�- �(Fronfof=Appllcatlon-Only�;���-� " "�`:"'`���.3
<br /> Reroofs If shingles Sewers Seroice Upgredas A/C Fences(PlodSurvey/Footage) ' � `
<br /> _ • � ' , i.�. -..� �. � ,.� h�.•�- �.: -n� a " � _ - ��'�t�
<br /> Drlvewaya-Not over Counter if on publfc roaduvays:�.�eeds ROW - � . �
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