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e�3-�so-oo2o City of Zephyrhills Permit Application Fax-8�i3-780-0021 <br /> Bullding QepaClment <br /> Date Recelved phoee Contaet for Permtttin � <br /> �.. ��� �,:_..�.���. _ ... <br /> Owner's Name � •�. �� ��.��6+1�4 �a�� Owner Phona�Nu�n6e� �.�.�c,��-�G7�� <br /> . . .._.,,, , �• r:�•: �• <br /> Owner`s Address � ���� .���•�,��-�� ��� �'�'aa Owner Phane,Number-;�== ` '� <br /> `' .' 't o t' ��" y�.. M +.4 t.'/"� � _ ' <br /> Fee Simple Tltleholder Name ^� P,,h� 1.,,l�iN� (�°1.�.��!t�� Owrner Rhane Number � � <br /> Fee Slmple Tltleholder Address ��a�'`� _ S 4� " � 2� � \� �l ���-]'^y� <br /> dOB ADDRESS d- �f�SS�..t� �12�1 � h �(1�S LOT# C�?S� <br /> susoEvis�or� 1�1�"t�ar.�� � ��xc��.ro# Oz� Z� n2.t--� oC� �t��3--t�.3��i <br /> (OBTAINED FROM PROP.ERTYTAX'NOTICE) <br /> WQRK PROPOSED NEw tONSTR AODIAi.T � StGN � Q DE11+t01.lSN <br /> INSTALL 8 REPAIR <br /> PROPQSED USE �SFR Q COMM: �' QTHER <br /> 'iYPE OF CONSTRUCTiON ��BLOCK Q FRAME � STEEL. [� <br /> DESCRIPTI{}N OF WORK � `�'6� �t� � j� <br /> BUIE.DING SlZE °c�`1 •�`7X '�`7 rI sa�oo�r E t'S_} HEIt3HT ��,� <br /> Q BUlI.RiNG $ `� �/ pF T{.1TAL COisISTRUCT10tV�` I� <br /> �a� C5D O_.—I <br /> C]ELECTRICAL $ ���� AMP SERVICE I+S� ��p�pG12ESS ENERGY Q W.Ft.E.C. <br /> OPLUMBING $ ���1 ����_ / <br /> �..� ��� <br /> [�MECHANICAL $ ��� VALUA710fV OF MECHANlCAC INSTALLA7IQN�+ � <br /> QGAS �� ROOFING Q SPECIALTY � OTHER <br /> FINiSHEd fLt30R ELEVATIONS, �� FLOOD ZONE AREA QYES NO <br /> �BUILDElZ COMPANY � N�i�� �t���c� ��� ��� <br /> 3tGNATUR REGISTEREd � N FEE CURREA Y N <br /> ; /�f�t88$ �� . a �� �`�� � R�� �C$t1SL'# L.17�� 1�i� l.��_� <br /> I <br /> ElECTRICtAN COMPANY � <br /> S{GhtATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre�s l.lcease# �r�.�f L��jj}fp��' ! <br /> PLUMBER COMPAldY <br /> SIGI�IATURE C��� ���� REGISTERED Y/ IV FEE CURRE� Y J N <br /> Address �[r.ettSe# <br /> �-" <br /> MECMANICAL ��_-_������,�h�/�,ll ,n� COMPANY <br /> SIGNATURE ac�C�'� `�'lr <br /> REGlSTERED Y J IV FEE CURREh Y J W <br /> S`� <br /> Ad Elcense# �— � <br /> OTHER � ' � COM�ANIf MX�►A� ��tiV p� <br /> SIGHATURE REGISTEREB J �I:. FEE CURREh Y W <br /> Address 3c�y t 3 � �y � '�� ,{� d � Ucense# ���.. ���,5���y� <br /> RESIbENTIAI: Attach(2)RlotPlans;.(2)sets of.8uilding"Plans;(1)sat of Energy�Forms;R-O W Pertnitfor new constcuaUon, <br /> Minimum:ten{10)�warking,days aftec.submittal date: Requlred.onsite,Construc�on Plans,Stormwater Pians wt Sltt Penca lnstailed. <br /> Sanitary Facilldes,&�,1.:dumpster Site�Wark:P.ermit for subd(vislqnsAarge projects <br /> COMMERCIAL. Attach(3)complete sets of Buildtng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minirnum ten{1d}working days after submlt�l date. Reqaired anslte,Canstruction Plans,Stormwater Plans wJ Silt Fence iristaNed, <br /> Sanitary FaclliGes&1 dumpster.Slte Work Permlt for all new projects.All commercial requlrements must meet cempllance <br /> SIGN PERMIT Attach(2)�ets of Eng)neered Plans. <br /> "*'PRQPERTY SUR1tEY�equired far alt I�IEW c�resUucHon. <br /> Dlrectlons: <br /> Ftl!out appllcat�on mmpletaly. <br /> Qwner&Contractor slgn back of appltcatlon,notadzed <br /> If aver b2500.a Natice of Commencement Is requlred. (AIC upgrades over 3750Q) <br /> " Agent(for the cantractor}or Power af Attemey(for ttre awner)would be someone with notarized letter irom owner authorizing same <br /> OVER 7HE COUNT.ER PERMI'iTING (Front of Appllcation Only) <br /> Reroofs if shinglas Sewers Servic:e ltpgrades AtC Fences{PtoUSurveylFoatage} <br /> prlvewaya-Not aver Counter If an publlc roadways..needs ROW <br /> I <br /> � _._ -- ....___---- .--`_.__- - <br />