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<br /> ; 813-780-0020 City of Zephyrhills Permit Application Fauc 913-780-0021
<br /> ��' .` * Bu{lding Dapartment
<br /> Date Recetv d . -n , �
<br /> � . 'PhoneGbeit�cttfar'Permittin °i' ', . -
<br /> Owner's Na I e �'�,..C� �� • " Owner Phoae Number �� ��'�CJ� � �t31.� /
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<br />�i Owner's Acldress liJ���' .���� �� • Ctlwne, r�h ne N bsr ����--�n
<br /> Fee Sim le�. Itleholder:Name� � ^� �, , r Qwner Phone Numb�r
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<br /> p , ` ,��a ��„7t°""_" �� •� _ .. .. _ . ..
<br /> FeeSimpl� itleholiler,�4cldre�a � �' °'� � .
<br />� JOB ADDR SS '�V1 �C/ I �-Q,, K�. • � LOT# CJJ_`�''�
<br /> SUBpIVIS10 �=-��1�.�/t7~��I�irl��� `PARCEL ID#'Q�Z��" L 1''-�t.J� � - lJ�J lJ�'"' � �O
<br /> � ' � ' ', �(O$TAINED'FROM'PttppERTYTAXNOTiGE)
<br /> WORK FRt11�OSE0 , NEW CONS7R �'�' � ADD/Ai,T � SIGN [`,� ' Q�; DEMOLISH
<br /> � •� Y e � ' INST'AI:L 8 =�� ,REPAIR
<br /> PROPOSEDitJSf- Q� SPR Q 'COMM'� � OTtiEFt� .
<br /> TYPE OF C NSTRUCTION,, �`�] �BLOCK�' [� �� FRAME � STEEL. [� � •
<br /> DESCRIPTI N'OF WORK 1�.� l_.,JL.S� ��
<br /> � .
<br /> BU1�DING SIZE � S.Q FC90TAGE�. ,��, HEIGHT T_. -
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<br /> _.._ QB,!LDlNCa $ �TM:�;:���_... ,:r.,�,�„ ..._t..., .
<br /> , �. VALUATION`'a�F"TQTAL'COMS7RtJCTION
<br /> ,,,�,_f ��
<br />` ,��f EI.EG('Ft1GAt. i�"�� � �"''']� ,�:
<br /> $ AMp SERVICE j�V ��- PROGRESS ENERGY/ [� W.R.E.C.
<br /> [,� ` . ,
<br /> QPi; MSING $ �� �—""' ,
<br /> QMEGHAiVIGAt. $ ; ' VAk.tJt4T10N,OF MECHANlCA�INSTAIlATION � �
<br /> QGAS Q ROOF.IiVG� Q SPECIA4.TY �" OTMER� `
<br /> FINISHED F IOOR ELEVATIONS FLOOD ZONE AREA �YES. NO
<br /> BUIi.DER , , i
<br /> Ct��flPANY '
<br /> SIGNATUItE REf31STERED Y/ N. , FEe CUR�A: : 'Y LN. ,:, ,
<br /> Addre '' Llcense# I ��
<br /> • �:
<br /> ���cr�c . . :_.. .� .' ,, c con��a�iY ' �S�"��:SC C3 �%�.52.��1� . -
<br /> SIGNATURE ` ��IsrER�o Y/ N F�cUR�n Y 1'N .
<br /> Addre$ V�4l� � `�,� .'.Lfcense#- C-��.,. ����
<br /> PtUMBER ' - , COMP.AWY=" .' . .., � ., - . ; ,.
<br /> SIGNATURE�' � w :;REClI$TERED� i� :-•.:YI��N.�� � •Fee:cuw�n ,� .Y/°N.�- '
<br /> ; � , (�� , (
<br /> Address .t - ' ' ' .Ucense# I. � :
<br /> MECiiAi�11G� _ . .' ` �_ ,.CQMPANY ` ' �, . '
<br /> ; ,,,,. .. ; , .,
<br /> SIGNATURE � . ' , > . RE�i�Te�o: Y,-/°N- , :�e Curtr�n Y./�l•.;-. I
<br /> Address - , - ., � , 4 � ' ` , � Wcense# (. - , `�
<br /> BTHEit , = � __ ... : . . . , - ' ._GOIy1P1WY . � . , : .;
<br /> SIGNAYUFtE.I' � _ - ' ` `- : , - _ �REGISTERED _.- ,Y/. N-. �� �uR�n Y.J.N��.: � .
<br /> �:
<br /> �ddre8s ' -i. _ r.t,�u�;:;;�; •�.� ;',.:, "a', . ., �-,;. `: ;< < . ��
<br /> s:, Llcense#��
<br /> � ~ _
<br /> � ` i ._ - - , _ • � _ .; ' - ._ , .,,.:.. �..a�,...,;.,,... .-,,�:...:'��.�5',;:�w �+-cz::,..r.. . . .- -
<br /> RESIDEN'i1�1i:,.,__.-A.ttarti.(2}i,P1o�Alans;:{2):"s'ets:of.8uildlrigs'Plans;.,(#.):setof,�Energy�Forms.::R=O=W;Per,r`.t%Iffoineyi►,.coris#;uc#Con;.,.r•
<br /> ;`Mlnlmum�ten�(1kQ);worktng days,:aiter„submlftal-dafe:�Requlred onslte Constniodon;Plans,Stoiinwater Plans w/Sllt Fenc,e tnstelled,
<br /> 8anttary�,Fac�4ldesa:8�alhdu�pster,SltefWcrlc:aPera�iit�or;stibdi'v"Islqris!lar+�e:praJects_;=�;,�,_ ;�:.:: - " __ . ' - � - � �
<br /> , COM�'JlERClI�iL Attach(3j�cbmptete sefs of'"Bu`Itrltng"Platis plus.���e Si�fe#y Pege;(1)set a�Energy Fom'ts.R-0-W Pemtit tor new cbtistructian.
<br /> Mlnimum ten(10)working days after submlttal date. Required onslte,,ConswoNon Plans,Starmwater Plans w/Sllt Fence Installed;, �
<br /> Sartltary Facltitie�,t�1 dumpster_.SIte,Work.Petmlt�for alf.neiw�praJects:All`commerdat.requlrements-must meet complkance
<br /> SlGN.PERM!'� Attach(2j sets of'Engin�+ereiliFJ.at�s:i;;ry���=��' �:.. ... ; . - . - • - .
<br /> '""PROPERTY.ySURVEY required,for aJI:NE.W constcucUon.. _ - , . Y- � , -
<br /> Dlrections: . .,��a.:.. < r..... _, .. _. _ m _ • �
<br /> Ffll out a�pllcadon ccmpletely.
<br /> fJwner&CantraaMr.stgn bacic�of appltcatlon,notarized
<br /> If over��500,a�Notice af,.Commencement ts requlred. (A!C upgrades over i75pqj_ �
<br /> /J:l�:w'w.�111..;1#!'�,�i"!!+� '�_: ..r ......,. ✓.�..�, • _.:.i�.���Pu.. _ �
<br /> '" Agent(fQ�ttie contracto�)pr:Fo�iiie�of Attomey(for#he owmer)�would-be someone with notarized letter from owner authorizing same
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<br /> ; _.�;r,:,�
<br /> 'aVER THE COUNI�R:,P.ERMITTING�= --:•=�(FionE-of-}lpP�lcation Onlyj+'
<br /> Reroofs lf shtngles Sewers Service Upgrades A!C Fences{Plot/Survey/Foatage) ° ��.,-�;� ; , , y ._ , _
<br /> . ..- -o,yt,l ._�: .+.. t:, er. M1�,.. ;
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<br /> Dirlvewra�s-Not,over Counter If on publlc roadways.:needs RO1NF� ' ,�,;,s � 4 - • ,:;.�.,. � . • �
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