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813aeo-ooao City of Zephyrhills Permit Application Fax 813-780-0021
<br /> .. Butiding Department
<br /> Date Recetved • Phoae�Contact for P�rmlttM f� t� _ [� Z,
<br /> Owner'a Name * E' � �S d� Owner Phone Nur�nber
<br /> Owner`s Address / � r'� •��' � !' Owner Phone Number � �
<br /> Fee Slmple Tltleholder:Name C�� /�'��'fo� Owner Phone Number '� �
<br /> Fee Simple Tltleholder Address J � �2 �� .� il r•//'"' �' �%�
<br /> JOB AQDRESS '2 � � '�'"" [ +j//�'��-�' � � 2 LOT# C��
<br />(� SUBDIViSiQN � � PARCEL ID#
<br />� W�RK PROPOSED , ' NEW"CQNSTR ` AS3D/ALT � SIGN NED FR�d-M PROPERTYT�7�ce)�EMOt.lSH
<br /> e. INSTALL. 8 REPAIR
<br /> FROP05E0=tlSE Q SFR Q COMM [� -QTIiER
<br /> TYPE OF CONSTRUCTION ^ � BLOCK ` [� FRAME 'C� � STEEL , C]
<br /> DESCRIPTION OF WORK E'Z�� t �Z t/ G��G� �
<br /> BUILDING SIZE �� � �w� $Q FOOTAGE . ;HEIGHT��� �
<br /> QBUt�DING $ .. a. '—J ..�.- ......_-. . ..,3•�. ._... ,. �. -
<br /> �/y'�1 I VALUA710Ai::G>F TOTAL COAlSTRUCTION '
<br /> ��LL_..J -
<br /> `���LECTRICAL ���ce � AMP SERVICE r�� � PROGFtESS ENEFiGY Q W.R.E.C.
<br /> \
<br /> QPLUMSlNG � � g,$�`1
<br /> OMECHANtCA! $ VALUATIQN OF�MECFiANlCA�INSTJ�ILLAT101+1.
<br /> ���
<br /> QGAS Q f200FiNG ,Q SPECIAI.TY �] OTHER �
<br /> FINISHED FLOOR ELEVATIONS �� FI.00D ZQNE AREA QYES NO
<br /> BUtLDER COMPANY , -
<br /> SIGNATURE REGISTERED Y/ N FeE cu�t�n Y/N
<br /> Address . , . License# � �
<br /> SIGNA UR� �f . `CbMPANY 1 �{�J� G'I G�C.. ���C�i��
<br /> � � REGISTERED Y/ N FEE CURRE� �N`
<br /> Addresa - .. � 1 License#.��.�3� � ����
<br /> FUJM�ER ' COMPANY - - � ,. - _ �
<br /> SIGNATURE' REGISTERED , X/.N, FEE CURRE�-•� �- " Y:/N.
<br /> Address - . , Ucense# � , . ��
<br /> MECHANtCAt:' . . - • COMPAFlY
<br /> SiGNATURE " � '� REGISTERED � Y/.N _ ,;,�eE cuw�En Y./:M
<br /> Address r • - � - . � " License# r . �
<br /> OTNEft : � � `{COMPANY
<br /> SIGNATURE � � ' ` ' RecisTEii�� � Y/ N.._ FeE cuRi�n Y/N
<br /> Address - ' � ` � ` license# �i �
<br /> RESlDENTIAi:,:,: Attach`(2),Ptot�Platis;�.{2)sets.ofBullifing�E?tans,{1}setof`Energy�Fo`rans;,F2=0-WPerrriltfor'newcansWct�on,;
<br /> ,,,, , ,
<br /> � Mtnlmum;keny•10;workingxdays after"submlttal`date.�:Requlred onslte;;Construodon�Plans;Stortnwater"P1ens w/SIIt Fence lnstalletl,
<br /> ..,. �..)
<br /> ` �� Sanilary'FaclltUest&{1�dumpste_r,°51te•Wotic:Permitfor.subd(vislons�/large-pro)ects.... ".- : � �
<br /> COMMERCIAt. Attach(3}cbmplete sets'of Bu11�Sliig'Plaiis ptas a t.IfetSaftify Page;(1}si�t of Energy Fotms.R�O W Petmit for nev�+construction.
<br /> Minlmum ten(10)working deys'after submlttal date. Requlred onslte,Canstructlan Plans,Stormwater Plans w/SIIt Fence lnstalled,
<br /> Sanitary Facllidas&1 dumpster.Slte Wbrk Permlt for all new.proJects..All commerclal requfrements.must meet compllan+ce
<br /> S1GN PERMIT Attat�(2)sets otEngl.'neered=Flaiis.;, -.^ �. , _ .
<br /> '•""PROPERTY SURVEY regulred for all,NEW construcUon.
<br /> Dlreatlons: � . • . ,
<br /> Ffll out applicatlon completely.
<br /> Owner&Contractor stgn back of appltca@qn,nota�izad
<br /> If aver�2500,a Flotice af Commencemen#is requirsd. {A!C�Psgradea ov�p:67500)
<br /> '" Agent(for the contractor)or Power of Atkamey�(for tFie�owner)would be someone wlth�notarized letter from owner authodzing same
<br /> OVER TNE CC1UN'i'ER-FERMI'iTfNG� ---(Ftont-of�APPIlcatiomOniy};: ;-.,,w.....� � _ .. >
<br /> Reroof�ifshingles Sewers Ser,vice.Upgrades A'/C'", "`Fences:(,,P•,IoUSurvey/Foatage) ,�, � � � .�~ ,!;a .
<br /> . " ._-. ._ : r. ��' �,,: � ., . ,. . _ - t.,l't}' _ •�_ e�e '3': — • 'S+S. _ . -r- .,e
<br /> Drivewaya-Nat over Counter if on pubtic roadways:.ne"ecls'ROW ���; � ,,„, s;�,�;+. . ;,., _ '.,:,`,'
<br /> ���i �.t .,: 'u ''��',��' ;Y ....r:. ,-.. ' ..'��.�-':,. _, . '- --. a - ;_ _ v
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