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s��-�eo-oo2o City af Zephyrhills Permit Applica#ion Fax 813-780-0021
<br /> Buliding Department
<br /> Dats Rec�lyed _ ph ne-Coritact for:Perm[ttin —
<br /> Ownsr's Narne �^�- " Owner Phone Number I
<br /> f � � �
<br /> Owner's Address • � Owner Phone Number
<br /> Fee Simple Tltleholder Name �� � Oweer Phone Number r ` � I�
<br /> • �
<br /> Fee 3lmple Titleholder Address �
<br />'i JOB ADDRESS � 1 �I J I � �' � ( �L 1:.� LOT# �_�^�
<br />' � . � � P.ARCELID# I ( ,� Z�6 zr — Q�ro .� o �o� � � c�
<br /> sueoiv�sio� ���' �' 2�-��-�rG.�l. � ,. I �
<br /> - . (OBTAINED FROM.PROPER7Y.TAX NOTICE)
<br /> WQRK PRBFOSEQ : NEw'CONS'TR ADDIAI:T � S1GP1 Q [� t7EMOLiSH
<br />, -e, INSTAI:L. 8� , REPAIR •
<br />, PRQPOSED=USE Q� S�R � CQMM , , � OTHER
<br /> TYPE OF CONSTRUC"PION � Q ` 'BL.00K � Q FRAME �] STEEL Q
<br /> DESCRIPTION OF WORK A ^�~�b�`��� 5��� �2 X� �-
<br />( BUiLD1NG'StZE `� � SQ FOOTAGE C� . �HE1G1iT,#��^�
<br /> OB1111.DtNG $ t� � �� .�: .
<br /> ff '��j� • `JO�. VRLUATiON''ta�-T01'ALCOttiS't`Rt1CTiON .
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<br /> Q ,,� � AMP SERVICE Q 'PROGF�SS ENEFiGY Q W.R.E,C.
<br /> E�ECTRICA� $
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<br />' QPLUMBING �f � � ' �" 4__
<br /> � Q No � ��,�
<br /> QMECHANtCAL $ _ VALUATIQN OF MECHANICA�tNSTALLATKaN ' �Q� �,psb'�'���;4�`y
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<br /> o�s o ao����G e� SPEClAl.TY �� OTHEFt ��er��
<br /> FINISHED FLOOR ELEVATIOPIS FLOOD ZQNE AREA �]YE$ NO �
<br /> '� P. , . - - "-��3
<br /> �au��a�R ��� � � co�nPi►�r: . � -
<br /> SIGNATURE REGI3TERED Y/ N FEE CURRE� Y/N
<br /> Address Ltcense# � I
<br /> E�ECTRICiAt�t: . ,'G'OMPAtiY`�.
<br /> SIGNATURE m' REGISTERED Y/ N� FEE CURRE�`' " �Y/N' . �
<br /> Address • - . � . � ,. _ License.#,i , �
<br /> _ ., . .
<br /> PLUMBER -, , COAI9PANY ; .- .
<br /> � SIGNATURE'� � � �_REGI8,7ERED Y_/a.N..+ .�FEE�CUFtREN , �. Y�/N �
<br /> l�ddr688 ,"' f � LICSTI&e,.# �' � - ff u,�.
<br /> � �MECHANICAt: � � , , - ,. , . . COMPAt�lY , . � .�
<br /> SIGNATURE• r�Gi`,s7�Reo,, Y,.;/ N � ' FEE CuwtEn� Y./N
<br /> � Addre�s`• . � ,.4, =` , - - , , License# r t I
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<br /> OTHER `. ° ' ` _ ' �CO{UlPAtitY ;
<br /> d?nt^ h
<br /> SIGNATURE' .. '�" '= ' � ' ` ' ` �REGISTERED ' Y/ N_.; 'FEE CURRE� Y/N ,
<br /> Addrs�s� -:�r:� � - ��� � � � • � � ' Ctcense#��� �
<br /> . ,�{.;. ... .,; . . . . ;_. _
<br /> E2ESlDEN'fiAt:ra,. �Ait�di'{2};P..[ot�Pla'ris;,{2}seti"s"�:o'f.;Bullctingi�P..lans;`(1}'set of,Energy�Foims;:R=f3=W Perr�iit for'new consitucttan,
<br /> . .. :..,. , .. . ,
<br /> v. Minimum,.ten�(1,0).working;days�atter;submittal"date.�:Requlred onsite ConstrucUan Plans;Stormwate�'Plans w%SiltFence installed,
<br /> .....�:-.....•�.,. . - ,
<br /> ' SanitaryFaclllUes.;&:1�,dumpster�Site•Worlc;Permitfor_su6diyisionsllarge.proJecks';-�..::,<` .: � ., � , � � �
<br /> COMNIERCiAI. A#tach{9)•cbmplete sets:af Bui[cltiig Plans.ptus a��ife Safety Page;(1}set of Energy Farm's.R-t1rW Perri�it far new canstructian."
<br /> Minimum ten(10)working days'after submithal�d`ate��Requl�ed onsite,CansUucNan Pians,Stormwater.Plans w%�SUt'Fence installed,
<br /> Sanitary Facilitles 8 1 dumpster.Site Wor1c Permit for all'new-proJects..All commerclal requlrements.must meet compllance'�
<br /> SIGN PERMIT AttacFi{2)sets of Englnerer,ed,P(a�is.; .;,,;' ,--:.,: � ..._ ' < `
<br /> """PROPERTY SURVEY reguiredYfor aII.NEW,canstructlan.. -
<br /> Dlrectlons: � ,:. • , •` _ ,
<br /> FUI out applicatlon compl�tely. ''�*.++ , . ,+'. '� � ��; '�
<br /> Owner&Canhactor slgn back of apgitcatlon,rsotarized' ``' ;' �,a �1t ` __ .�_.a, . ,''i ^�.
<br /> If over��504.a Nattce±af Commencemenf is�reqi?�rad,�,<tAlGrupgiatle�-•aver 3T500) :Y:, �--, ,..�.`"'��}z`''."",`:�••'."�~�''��'='�;3 A
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<br /> ,'r�N�i'":: y ..r...�� �.',I��_. -� ... .� �',S:n":':i';, r,
<br /> " Agent(far tFie contractor)'ar Powe�of�Attomey�(b�t�ie�owneF)`wo',uld,b�`someo�ie with notarized letter from owner authorizirig:;samet;;�;;��•, "� :'b=
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<br /> k ,.. ,: -s ��: • ;�<.�.si��t�c� � : ��:.�;- . '', � :: ,.;,_; �: -
<br /> DVERTHECOUMi`ER,FERMITTiNG-. ..y..(Fmnt•of�ApRllcation�Oniy}f-;�,,. .�;.,.�`�• `,r�'; :;:�`:��`` `' " - �
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<br /> Reroofs if shingles Sewers Service,Upgradg,s„rA/C.,7�r����ence's%i��',IodSu�lrey/Foatage) , ' �..-_`"�r' `4;�'_ '`��•"' ';`;;v,�-,,, .... •- -
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<br /> . ..._. ... >�Y,�.�,..n,;..;N-..r,...e.-_.�v,+..w.v u.w'.a„ • .. " . -. .s-.. �
<br /> Qrivsways-Not aver Counter if on pubiia roaduvays..need"s ROW' �
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