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<br /> �� '�-780-0020 Ci#y of Zephyrhills Permit Application Fax.a�8aea-oo2�
<br /> -' ` • 8ullding Department
<br /> o�e��x���,r a . - . " .
<br /> � � - "`-Phone Gontact�for Permlttiri ��' �
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<br /> Ownsr's Na I e t �Q f.�,,,,�- ��,.1, � �„��{,��.�,./�C.���saw�Cer Phons Numbe� � ��"" t�1 —���{? �
<br /> � � � �.e�o rc�..-��I ��"'��� -CJc�� �r�Q u�-1
<br /> Owner's Ad ress � � tlwnerPhoae Nnmber
<br /> Fee Simple INeholdee;Name �_(�,,,,�/�..,� � Owner Phone Number � �
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<br /> Fee 8imple ItIehOlde�.Add�ess . ' 'r"= , "
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<br /> �� G��''`�° � LOT# . v lT
<br /> JOB ADDRE� 3 .
<br /> SUBDIVISION �� �t `�.� ,1�� �.:� ��PARCEL':ID#,'�✓�"'Z -'�L�-' ��O"-' �
<br /> �-�, ,{.,p� ' �(08TAINED FitOM=PROPE1tTY TAX NOTICH}
<br /> 'tJ tiu_(�"'+3, ,
<br /> WORK PRO OSEq � ` NEW CONSTR � - ADD/ALT � SIGN [� Q`, DEMOLISH •
<br /> .- � � � INSTAkL ���-., :REPAIR� ,
<br /> PROA03ED�tlSE.. Q�� SFR �] -.- COMM'` � OTF{EFt` ..
<br /> TYPE OF C E NSTRUCTION., �]'' �BLOCK�' _'�Q� ., � FRAME � STEEL, Q:
<br /> DESCRIPTI� N OF WORK � 1 C..�-=C�-- . l,.S�_ `'� rC.�„�...�,.. V�� '
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<br /> BUILDINIG�3 ZE`� � $Q,FOOTAGE��, , . <,HEIGHT,.� �.r
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<br /> OB lLDING $ - 'VALUATION`a�'TtOTANCCIWS'i'RtJCTION �
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<br /> J ! 111�'��'TRtCAI. $ %�j��� i e j,,,�2 AMP SERViCE l U� � PROGEtESS ENERG �[� 'W.R.E.C.
<br /> ��.�r � � `7 /�
<br /> QPE.UMBING $ ���""'L- .
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<br /> QM CHAiSFIGAt. $ � �V111.i1ATtQ�t-OF M�Cli}iNICAL INSTAILA,Ti0�1 °�
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<br /> Q � S Q ROQFtNG ;Q SP.ECIALTY � 4TMER-
<br /> FINI$HED F�OOR ELEVATIONS FLOOp ZONE AREA , �YES. NO
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<br /> �Y
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<br /> BtlI4DER � CQMP7lNY �
<br /> SIGNATUR REGISTERED , Y/ N FEE CURRE� Y/N �
<br /> Addre� r� , � - Llcense#�l � �
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<br /> E�ECTitIC � � -_ � , '' CCIMPAWY ,' . �� �.i J�...LJ ,�C�4.A •��
<br /> SIGNP►TUR � . C. ..7" EGISTERED Y/ N F�cuR�n Y/N :
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<br /> �►ddres ���0 �� VJ ��� Llcense#ri��� �����Q�t,�"I_I
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<br /> PLilMBER j , COMPANY� , ' � .
<br /> SIGNATUR � � REc3IS7ErtEo. �,-:•.Y./�N � •FEE�.CURRE�� `Y PN: •'"'
<br /> Addre . _ , , � .. Llcense#=� ' ' �� ,
<br /> MECH�i�lIG�� `- � ;" '.` , � , � ;.GGlMP1�NY� . , ... � ., .�. � . , � � -- � - ,
<br /> SIGNATU� ' M " — REGI�S7ERED:; ,• , ;.Y/ N- ;FEE.CURREP Y.I N:�- -
<br /> Address`. _ . , - - . ..License#- � ,
<br /> OTNER �) .. �.,= .. . , ... . " .. , . , .. �:�CO�JtPANY , , : _ „ ; . � � .. ,
<br /> . . .. .-.: ,.. ��...r .
<br /> SIGNATUR -=.: .,�.,.. .. '. �. -� �"� .
<br /> ,..REGISTEREp Y/�N... ' �.FE�;CURRE� ,.Y✓,N�r..-,
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<br /> Addre � _,. ,:L;x _.} i,..;�,.. . . , - ._�Uc@nse#•� �,
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<br /> RES{pENTI� ;�`Aittadi.:2�;;P1otPlaits,��2,sets.ofzBWtiliri`�'Plans`��1,"sek'ofrEne�''�Fornis:'R-O=W�Perrriif:fgr'nevir'.constructton;; - ,
<br /> ,.. . { } , t..) . . . 9 , t ) . �+ , , ..., . .: •- ,..,,;. �.
<br /> _....
<br /> :::�MlnimumGterr(1Q)�woritin,g�:days;afte'r,;"sutijEiilttalftlafe:i Requf'ted bnstte;-ConstiucBon�Plans;�Stoimwater Plans w/.`Stlt Fenqe fnstelled, .
<br /> ���anttary�acj44tles 8��'�tluimpster,S{teFWorlc�Permtt;�onsutiiiivislQtis!large'projects�{:;:�'ti;4';Y::'i=.�::`,'
<br /> COMMERCIAL Attach(8)'"isbmplete sefs of Bultifing`Plans ptus a Life Safety Page;('!)set of Etiergy Forms.R-O-W Pemrit for new canstcuctlon.
<br /> Mlnimum ten(1Q)working days after submittal d�te. Required onslte,.;Construadon Plans,Stormwater Plans wl Sllt Fence instelled,
<br /> Sanitary,Facllttles.&1 dumpster.Slte�Work.Permft tor a1l�new=proj�ct"si A!1'commerciat.requirements�must meet compitance
<br /> SI{iN:P�RM T Attach(2j sets clf`Eogineiiared;pians:r;r.,�;rr�`� -- •-� , .
<br /> .««. ..._.,._._._.� �1,,.. _ struction..._ ...;; -- .
<br /> i PROP..ERTY,SURVEY..r ulreciforal(NEWcon , ,.
<br /> Dtte:ctlona: '�. . , _' -.. , .. .._ � � _ .
<br /> Ffll out �,pplicadon completely.
<br /> Qwnec Caatractar s[gn badc:of.appitca�ar�,notarized
<br /> If'over�2600,�:Notice.cf Commencement ia raqulred. (WG upgradsa over 57500)__. , � ..
<br /> �O f .:Z'�y.'.'�.�'�4""�:iky.J,r'
<br /> Agent(tor the ccintractb�)or:Power of Attoiiiey(for�the.owner)would be someane with notarized letter from owrner authorizing same
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<br /> 'OVER'?17iE CQUNTER.FERMiT11NG�=�-- '-{Ficnttof Application Onty)
<br /> Reroofs If shingles Sewers Service Upgrad'es NC_ _ Eences:(Plot/Suryey/Footage) : ; . -,_, _ 4 •
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<br /> Drlvewe�ys-Not over Caunter if an pubiic roadwa'ys.:needs ROW . , � `i �$
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