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e�3aeo-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> ` ' Building Deparqnent
<br /> Date Received : Phone�Contact�for=Pemiit#in �O� 5 -Q�-��
<br /> Owner's Mame ��`t ;Z[7!-� W t ('`Q..��` 'S Owner Phane Number
<br /> Owner's Address "1 �� �„ �u�1ti � �yZ Owner Phone Number �� �
<br /> �L � , �
<br /> Fee Simple Titleholder Name �" l� � ��'c' �T e�►""►� ""� Owner Phane Number
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<br /> Fee Slmple Tltleholder Address '7 01� �..�GS�i n c�t�^..� � 'U'"�t �u..("'�� � [S.� �
<br /> JOB ADDRESS 3 c�-�- 1 1• �V'''�1� � `,� � v"'��II S t-- 3� a LOT# ���
<br /> SiJBDIWSION , �� � PARCEL tD# ��'{' -a�-a�'��1(������0���
<br /> , . , (OBTAINED FROM PROPERTN TAX NOTICE)
<br /> W4RK PROPOSED • NEW tONSTR ADDtALT C,� StGN Q � DEMOI.ISH �
<br /> .e. INSTALL 8 R�PAIR
<br /> PROPOSED-USE Q SFR C] GOMM � t?THEF2
<br /> TYPE OF CON3TRUGTION � Q � BLOGK ` [� FRAME C] STEEI; Q .
<br /> DESCRIPTIQN OF WORK '1 C%L � �"�, v�, ' W b.}pJ c��.l �- " (
<br /> h� '�'�a �y u�`� o�-�.
<br /> BUlLD1NG SlZE �� �' SQ F001'AGE�__�. HEIGHT����� �`�f?.;� Y�tv�'C`��•�,,rr�`�
<br /> QBUC�QIN� $ .. !+'ti c�G��.tf,�`��ii� '�Y1S'1�"Q, �ll�t�. . i
<br /> �� �� VALUATiOi�i::CiF`'t'01'AL COt�S1'RUCTiO1V �
<br /> �t101..� i�n5`�c��e„ �lt.��. S`-.2I�.
<br /> QELEC'ii21CAi. r$ .��... AMP SEI2VICE Q PRO�RESS ENEFtGY Q W.R.�.C.
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<br /> QPLUMBING •� � ��'��
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<br /> QMECHANIGAL $ " Vi4�llATION OF MECHANI�AI.INSTALlAT10N
<br /> QGA3 , Q RG?OFING .Q SPECIAI.TY, �] OTNER �
<br /> FINISHED FLOOR ELEVATIQNS � � ��� FI.pOD zONE AREA QYEB NO
<br /> C_� - .
<br /> ac���.a�R � .��� �S t coM�i�r�� =- `,�.�e �,�,}.���r �S '�-�. t'�C 1�C,
<br /> SIGNA7URE ..,G--- REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address , Liciense# L.%���`,�c�� '1 4a��
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<br /> ELfCTRtC1Ah! C'OMP/WY� -. . ,_ -
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE��f '�° �"Y/M `
<br /> Address " . . .- License# �• �
<br /> PLUMBER � COMPANY t:
<br /> SIGNATURE' ` , ., ,REGIBTERED Y/,N�. . , FEE CURRE�„ =.'. Y/N . ,
<br /> � Address , License.# � - - I
<br /> MECHANFCAE: � " CdMPANY
<br /> SIGNATURE� ' }� REGIS7ERED .., Y../ N FEE CURRE� Y 6 N - �
<br /> Add�888'� � ' . • � • � . LiCeflSe# � �
<br /> GTFIER `� _ . ' ' ';COi111PANY` �
<br /> SIGNATURE '" � ' � " ' REGISTEFiED Y/ N � FEE CURRE� � Y/N
<br /> ' Address . ' ' ' License#��� � �
<br /> ,.. _ ,.. .. . . ..... .... ... . .
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<br /> RESIDENTIAI:; �Aitaich'2„i?Itsf�Plaris;.2 "sets�of:Buildln`'•`Plans; 't `set of Ene Foim§�R=O=W'Fertriit far new canstcuc#tbn,
<br /> { } � } .,.� 9 { ) t9Y'.: _
<br /> � .;Minimum�ten(�1.0);workingtdays;:after,:submlfEal date.'.:Requlred onslte,:Constiuodon=Plans;'StormwaterPlans w/Silt'Fence installed,
<br /> `��f�`Sanitary'Facilfyes&�1,;dumpste,r,•°Site°Work�PermitforsubdiVislonsllaig"e:projects,- • ,�' � . � - -
<br /> COMMERCtAJ. --Attach{3j complete'sefs of Bul[dliig Plaifs plus a lJfe Safeity Page;{1)set af Eaergy Farms.R-0-W Permit#oc nev�construction.
<br /> Minfmum ten(10)working days'after submlttal date. Required onsite,CansUucdan Plans,Stomnwater Ptans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Wark Permit for all new�proJecfs:All commercia!requlrements_must meet aompilance
<br /> S1GN PERMlT Attacti'{2}�sets of'Eiiglneeredr.Ptans.a, -.-� :. � - . "
<br /> •`"•PROPERTY SURVEY regulred for all,NEW canstructlan..
<br /> Directians: � . �� � < .
<br /> FIII out appllcatlan completely.
<br /> ( Owner&Contractor sign back of appiicatton,natarized , Y -
<br /> tf over�,2500,a Nattce af Cammsncement ia requirad. {AIC epgrades over 37500)
<br /> "' Agent(for the contractor)'ar Power of Attomey-(fo�tFie owner)would be someone with natarized letter tram owner autho�izing same _
<br /> � DVER 7HE C{3UNTER.PERMITTFNG- ,-{Front of-Appticatlon Only)- � ,
<br /> Reroafsifshingles Sewers Sg�ric�,llpgrades.•A/C�•r YFences;(PIot/Survey/Footage) .,. . � .,.-.,.�. . .,._ . .�_,�. - _�-
<br /> I " _ � :\ '`' w !`r ,`}. `' t . " , ,. ,.� ,, .., _ �„' .t;, " � . .,,
<br /> Drlvewaya-Not over Counter if on�3ublia:roadwajfs..needs'ROVt/� ' �.` ,i ���� k
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