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a a, 81�-780-0020 City of Zephyrhills Permit Applicatian F�c 813-7$0-0�2�
<br /> � Building Department
<br /> Date Recelxed � .. . . .:; :Rt`tone Coiitac#�for`Psrmttfln'�' 4 � � � `
<br /> �Ownar's Name ��f�r� y� Owner Phone Number I s,� `���2 `Y�`"
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<br /> �,,,Owner'sAddress � .t:,�'� /7, ^ ' OwnerPhons-Nuri�ber C ,.
<br /> Fee Simpla TltleholderNam�� ��� •`�.�, - '�'��.� . �J' Owner phone Number" " f
<br /> - ' .:,"�i'ti•. � ; - ' � .�
<br /> Fee 3tmple Titleholder Addresa •- - �� ��. �
<br /> x JOB ADDRESS �/l.! � �! / �� . 1 J���Iz�r�d `�W G�� (,"✓/'=1� LOl'# ��,
<br /> SUBDIVISION � ��,� ^ �,,� PARCEL ID# ' ' - . � . - .
<br /> , , . , � ' ' (08TAIHED'FRORI=PROPERiY TAX NOTICE) _ - „
<br /> WORK PRCIPOSED NEW CONS7R ^-' :� ADD/ALT [� �SIGN `Q � � Q'^` DEMOLISH ,•
<br /> . e . .'INS.TALL', , ,8.�r � :REFAIR' ' .. - ' .`
<br /> PROPQSED•ttSS -� °SFR ' [� COMM�` :� OT'FiER:
<br /> TYPE OF CONSTRUCTION�,�` �Q", °BLOCK ' "Q" .` FRAME, L"� STEHL. Q-. ::� � _
<br /> DESCRIPTION OF WORK�' � s� ��I �'r .
<br /> BUtLD1NG51ZE'.F�����'gQ:FppTAGE . -- ;.HEIGHT`�^���� , ' .
<br /> QSUILQitVG ($' •� � "��;�:_��.. � . :s�;,,t.. _--• '. _. . . . : '
<br /> - �I ,>� �� •VA4:UATION`��TtJTAL CQNSTRl1CTION `
<br /> L�.�,L.. �
<br /> Q�LECTRICAI $ AMP SERVIGE Q' - PROGRESS ENERGY; Q, W.R.E.C.
<br /> r � : ., � - ` � � -
<br />� [�PI:UMBiNG L... ,,, ,,, . � • ., � '
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<br /> - . .: _ � ��,�
<br /> QMECHANIGAL ' $ ; .'1IAL.Ui4T10i�f�.OF.MECHANlGAE.,iNSTALlATiON ��' � r ,
<br /> QGAS , ,Q. ;- ROOFiNG.:.,,.,C] . SPECIA�TY-� -��.'.� OTMER` „ . -
<br /> FINISHED F1.00R ELEVATIONS FLOOD ZONE AREA �YES. _iV0 -
<br /> � � - , ,. - . , • � _
<br /> BUtLpER � � � COMPANY ' _ .
<br /> 31GNATURE / REGISTERED / N.. FEE CURREh' .' '`.Y l N .-, ,: ,
<br /> , Addreas � , l:icense# 1 ' ` � I
<br /> _ - 7..,:
<br /> ELECTR1CiAHi�:;.:' ;; • � „ ` . COMPANY� . � � . . . _ - ,
<br /> SIGNATURE M RE�,ISTERED Y/ N FEe CURi��; 'Y°!N : _ �
<br /> �Addre$s . . , , .,#, , . �:. -.Ucense#��I °= ' '� �
<br /> , „ < : . .
<br /> �, .
<br /> PlUMBER - , COMPANY` ; . . .
<br /> SIGNATUR� '. - - ' ' � :REf31STEREp . , -�Y'/:•rN:-' EEE.CURRE�a �� Y hN r -
<br /> liddress , • , . . .Llcense#r l' - '�'��r--�
<br /> MEGHANICAl:�;:- � � �- - • � f ,� . -..,C,OMPqNY:•. s:. �:° .:•,^.. � , -
<br /> SIGNATUR� - h � " ... ` _ ReGisrEti�n.:� � :Y.:/ N: . ,,�Cuw�n� .Y/�N�'� -
<br /> Addras�a'� ` , . ., ., ' . ,�.. . ;, ..?... , . . . . ,.. s_ _Llcens.e,#,� • . . -�
<br /> o�r� .. , ��, . � .: = . .. � . coi�gi�x::, � ` ::;... .. ' . ., �__- ... ; � .,
<br /> SIGNATURE�� •- - '` . . �" ` � ` � _ � �ReGIST�D... ,; :Y/ N. ��e:CUR�n - �,Y:!•N:<.
<br /> � Addrass .F', a.�;:�:,�:,;.: -- - . -, - ..- .. .r. : - ' � ., �-":Liciense#���� I
<br /> ,.�.. ..� : ,- :_ : :,. : ...� ,:;.,..._:�,.. .{`,-'. i�'�,. •.,;..::�.. ,t..', . , : ,._ . . s. .
<br /> RESIDENTtlii:: ._�:=Attach�;(2).P._..lo#?Rians;(2)'sefs=ot>Building"Ptans";`(i}setiof.�Ener+gy�Forriis;`'R-0��W°Perrnit:for*newrconstr'uction,j- .
<br /> ��Mlnlmumr.ten;(�1Q),�icorkingiday,spatte�;..submittal;ifate:r=Required'a,'nsite;%ConsUucNon'Plans StormwaterPlansw/'SIIfFence�ln`stalled,- �
<br /> ... ::Santfiaiy'FacE1l�,as�c�hl,;c�u�pste�r;`Site>Vitork�Per.mlt.#or.,sutidfvislonsilarge`pnolects'_-,.:='::�.�'�:r�.": • _._ :. . . _ _ - -
<br /> COMNfERCiAL Attach(8��e6mpiete'sets bf Bu1liding`Flans plus'a Llfa Safety Page;(1)se4 of Energy Forms.R-O-W Permit for neW constniction.
<br /> Mlnimum ten(14)working days'after submittal date. Requ(red,onsite,,ConstrucUon Plans,Starmwater.Plans w/Sllt Fence installed,
<br /> Sanitary,Fac�li�e�.8.l.dumpster.,Site WarkePermlt,far-�ilmnew�projects:All`ccmmerclal:cequlremen#s�must meet comp!lance _
<br /> SIGN:PERMIT Attacti'(2)""set"s of'Eng"i�iee�ed?Pla[is:�.�;�ir��=�-,�.;=��:..:,' . . .�. � °„ . : ,
<br /> """PROPERTY�SURV�Y reguired�for:all NEVN;constructlon.:... -: ' - . �- , � �
<br /> --,,--,.. _ .
<br /> 'Directlons: :��<<<�f4=:� , , > ....._..._ _ , ,.. .._ . , ,
<br /> FIII out applicadon completely. �
<br /> trinrner&Contractor stgn bacic:af appltc^atEan,notarized , _
<br /> (f over�2500,1a;Notice.af..CoMmencemen!is required. (AIC upgrades over 37500). �r� , � ,
<br /> .�:,: a;�v:,'..r.1'.n'�`�:,v:.........a:.-.-...-_,.,,-.w ...-._..�. ..�....... .. -
<br /> .�-��..r�'11T�>.};:'.r y . ,.-.. .. . ....�.. . . .-,. . ._ _ .�. I
<br /> " Agent(fur the contractdr)4i'�Power of'leit#oine'y.(fot#he.owner)would'be someone with natacized letker from awner authodzing.same,_. _ ,
<br /> DVER THE COUN.T.E�t`:PERMIITINKi:=.:�=,,:�(FronE.:of;ApPllcation Qnly)`�.rv: � : •� ��~ . ,
<br /> Reroafs If shingles Searars 5, Seryice Upgrades AIG Fences,(Plot/Sunrey/Footage) ' � ' * �
<br /> �. �-... ��:'--- :<-:�",. ,.- - .tx,�.;r''�:;;t:'�f-:��.-�:;;��- c� _. ,. ' � {--` . _ . _ . , �
<br /> Driveways-Wot.�,ver Counter if�on_pyblic roadways..needs ROW ' � '
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