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813-780-0020 City af Zephyrhills Permit Applica#ion Fax 813-780-0021
<br /> Buflding Department -
<br /> Rale Received "Z -- P.hane=Cantact far=FermittEn � 2 I �c� � �` !�
<br /> sOwner's Name r�-L'lcJ 1 S QGG ' Owner Phone Namber � '„Z����
<br /> '�Owner's Address 3� Owner Phone Number
<br /> Fe�Simple TItleFiolder Name �i�--�vJ�S ,['S�`G�-c�Y� Owner Phone Number �_ �
<br /> Fee Simple Tltleholder Addres� 3 � ,� �
<br /> JOB ADDRESS 3 12 • LOT# l� �
<br /> St7BDiVtS10N .�,i'Y)�1�G2.4� ,/`�/.1.•?T� PARCELID# y �
<br /> (OBTAINED FROM.PROPERTYTAX NOTICE)
<br /> WORK PF�OPOSED a NEw CONSTR ADDtA1.T �� SIG{Y Q [� DEMQ�ISH
<br /> e, INSTALI, � REPAIR
<br />' PROPQSED=USE � SFR � COMM Q OTiiER
<br />, TYPE OF�ONSTRUCTION � C] - BLOCK " FRAME [� STEEL' Q
<br /> DESCRIPTION OF WORK G/l(_,. . �� "� �'�'�
<br /> !�L � J�
<br /> BUlLDING S1ZE � j � � SQ FOOTAGE HEIGHT ���_..._.L_
<br /> ��U«����' � � VAlUAT10N''C'1F TOl'AL CO(�S'i'RtJGI`ION
<br /> Jl'"' ���
<br /> f QELECTRICA� ' `$,,� " �� AMP SERVICE 0 _PR{JGRESS ENERGY Q W.R.E.C,
<br /> �__.. �._p' �,,
<br />�I �PLUMBlNG S ^� !�x��
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<br /> i QMEGHANtGA� $ YALt7ATlON OF'MECNANICAI tNSTALlAT10lV � �
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<br /> i QGAS Q RQQFING Q SPECIA�TY �� OTHER �j
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<br /> FINISHED FLOOR ELEVATIQNS � FLOOD 2QNE AREA QYES. NO
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<br /> BU1LDEit . � COMlPANY �-���
<br /> SIGNATURE
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<br /> REGIS7ERED / N FEE CURREP Y/N
<br /> Address -Ltcense# � �
<br /> A
<br /> ECECTEtlCI. � �I�!/!S �31�''g 1�Y � �'CflMPAl�tY " /�� -
<br /> ', SIGNATURE ' REGI3TERED Y/ N FEE'CURRE�'.�' =�Y/N�
<br /> Aaa�e` � . . - , , � �ioense#� - � �
<br /> FLUMBER ` COMP,At+FY , , • , ^ , - �
<br /> SIGNA7�lRE` REGI$.TERED, Y,/.N. -.FEE CURREA Y-/N
<br /> Address , License# � � ••.� �
<br /> ' MEG1fANICAI:` = COMPAt�lY , ` -
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<br /> SIGNATURE- � ' ' ` RE�is,7�Reo . Y/ N. . . ;� Fee Cur�ten Y-/:N
<br /> Address � . ` .- . . ' License# � 1
<br /> OTNER ' . , . ;CONI.PANX,
<br /> SIGNA7URE � � ' ' ^ � REGISTERED Y/ Na.': FEE CURRE� Y/N
<br /> ' Address � . ,��� 1 . ticense# � �
<br /> ,,. ,,,... . �.,: ::..:� .�_� � � � y . , ,. ,_ s.�.,,:. .. ,�. , .
<br /> E2ES[DEN'ilAt;::� ;�Attacfi'{2}<Plot Platis;u(2}sets.ofsBiattdl'.�;Pl�ns; 9 set df�Erie
<br /> r�g �a .(�) rg}rFaims;°FZ-O-W Peri►iltfor'newconstntctton,
<br /> ; Minlmum;ten�T{�1.0);,woridng�days:after,.,sut�miEtal`date:�Requ�red o"nslte,�Constiuotlon:Rlans;`Stormwater'Plans w/SiltFence installed,
<br /> , "��'��-Sanitary_Facllitles�&:,1}dumpste_r,-,Stte Work=Permltt�orsubd(vislonsllerge-proJects .. '.' � `-` -
<br /> GOMMERCIAi: Attach{3}-coiaplete sets"'qfi Balt�irig Ptaiis plus a�Ufe Safaty Page;{1)set af Energy Forms.R-0 W Permlt far new ccnstnsctian.
<br /> Minimum ten(10)working days after submittal date. Requfred onsite,Canstrucdan Plans,Stormwater Plans w/SUt Fence fnstalled,
<br /> Sanitary Facilitles&1 dumpster.Site_Work Permit for all new:proJects.All commercial requlrements.must meet comppance
<br /> S1GN PERl4fIT Attacli{2)set`s of�nglneer.ed�Plansl: ,,� z'�-�-: . '
<br /> •"'•PROPERTY SURVEY requtred for aII�,NEW_canstructlon.
<br /> Directlans: - .. , . • , ,
<br /> , Fill out appiicaUon completely.
<br /> � Clwner&Conhactor sign back of appllcaUon,notatized
<br /> If over�i!500.a Nottce of Commencsment Is nequired. (�4tC upgrades over S7s00)
<br /> ,.�rr,;�;,,;..
<br /> '" Agent(for ttie contracto'r)o�'Powei ofAttomey`(foi^tFie�owner)would.be.someone with notarized letter trom owner authorizing same
<br /> OVERTHECL3UN'f'ER•RERMI'fFING .-:,(Front-of�APpllca�omOniy}-;. <;:.•_"�� '; , � _ ., ,_ .�. ,� ,. . , .. ..
<br /> Reroofs if shingles Sewers Service Upgrades A/C �, Fences(RlodSurvey/Footage) `� ; -�- < , � � , ; _
<br /> Drivewaya-fJot aver Counter if on publEc rosdway5:.iieeds ROW� i , . ` � , - ..� , . � ' �� .:�
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