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a��s-�eo-oo�o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> , � Ballding Department
<br /> Dats ltecetaed Phans Coetact'for Permlttin � .� tS c�. - S��l�
<br /> Owner's N�me �G' � IQ�l LL..S L Owner Phane Number 3��- ��� ��/
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<br /> Owner's Addrass �D � ��5c�- �-�-iKu/��,�� � ���Owrner•Phone Numb�r �' �
<br /> Fee 3lmple Yitlehold�r Name �� � Owner Phone Number � � ,
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<br /> Fee Simple Titleholde�Address "'� -
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<br /> JOB ADDRESS ��S LL. l21'f'GiL?�?.-�i�', G� /l /�'NL L.LS /�.3..�S LOT#
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<br /> S�Ba,�,s�a� ��i�ZKIf'IGL J�/�"A�'G' PARCELID# D�- - -��-�a -a33�o �-a��� � . .
<br /> WORK PR IP�}SED � " NEW CONSTR `�- ADL}lAI:T � S1G(d NED FR�4M, PROPERTY TO nc�!DEMQLiSH -
<br /> eINSTALL � .REPAIR
<br /> PR4POSE I-USE , Q S�R [� CtOMM Q OTHER �
<br /> TYPE OF C i NSTRUCTION 5` Q `BLOCK " [� FRAME � STEEI. [�, -
<br /> DESCRIPTI�N OF WORK L� GJ �-L7L�� � r�� � L°D-'!Yj D/�,{�I���
<br /> BUILDING$IZE SC!FOOTAGE�� , HEIGNT�=. � ,
<br /> QSl1{�DINCa $ .�...>;�._.._._ �,�,. , �,_ `,, .. ,..
<br />, I , , VALUATiON 4F"TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVIGE [� PRC}GRESS ENEi2GY Q W.R.E.C.
<br /> QFIkUNlSINC� $ --
<br /> QM�CMANtCRI $ VA�UATION t�F MECHANICAL tNSi'AL�Ai'ICtiV_ J��
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<br /> QG S Q ROQFl�UG _ Q SPECIAt.'T.Y-�� OTHER � �-�
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<br /> FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA �YES. NO
<br /> BU{LOER COMPANY
<br /> SIGNATUR� REGISTERED Y/ N " FEE CURREA YJ N
<br /> Address Gcense# �
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<br /> ��Ec�c��< coM��r _ `
<br /> , SIGNATURE '� RECaISTERED Y/ N FEE CURRE� Y/N
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<br /> ' Addres� , I:icen`se,#; '
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<br /> P�UMBER .. COMPANY �
<br /> SIGNA7URE RECiISTERED . ,,Y/--N • � FEE CURREN Y/'N:
<br /> � Atfdr68S , LiC9flS6# .(: . � ��
<br /> ' M�cN,a�ic�. � ° � f �coMPat�ir 1�r2 S � ��. t �
<br /> SIGNATURE ���� REGISTERED Yr/ N , FE CURRED" Y/=N-..
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<br /> � Address' `'�� ��J � �lC�.�' �: �3 _ � License# ��'t...=v�{J��� �
<br /> OTHER �� COMPANY � �
<br /> I SIGNI�►TURE, - • � REGISTERED �Y/ N:.; . �FEECURRE� Y�/:N;..
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<br /> Attdress ••�; � ` ,. '' . ';License#'� �
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<br /> RESIDENTIAl::'.3•Attacfi(2}:,PIot;Plans;:{2},s�-of'Sutl`ding�ptans;`-{1j sef of�Energy�Forms;'R-O=Vtt'.Peririi#fot n°.e"v�;,aonstruction,
<br /> � ,:� Minimumzken:(�1p)_.pyorking;d'a,ys�after�subinlftal;daEe:�Requlretlonsite,�ConstruaUon�Plans;�Sfor`mwate�'Plensw/�SiltFenceinstalled,
<br /> � �.�"'�Sa�itary�FaGl(tles.&a1�;dumpster-Slte�,Wark:,Permlfforsutidiv'islo�".sAarge°pioJects; :,`:;,�':;':'`'{.`,` ' .
<br /> COMMERCIAL Attac�{3}'cor"nplete sefs�'of B`ii3lding�Plaris�plus�a I.ife Safety Fage;`{1}set of Energy Forms.R O-W Permit far new=canstsucttfl�.
<br /> � Mlnfmum ten(10)working days after submlttal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed,
<br /> Sanitary Faclli8es&1 dumpstar.Site_Work Partnft for all new'prciJeots:All commercial requirements must.ri►ee!compllance
<br /> ' SlGN PERMIT AttacttiV(2}sets af'�`ngineer.ed;Ptans.;��:{a`<� .. ; ;•... � „ {
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<br /> """PROPERTY SURVEY reguin�d,.for;all NEW constructtan...
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<br /> Dlreations: .. _ .� - <
<br /> Fill aut applicaUon completely. � -
<br /> Uwnsr&�Contractor sign back-of apptfcaUcn,notadzed
<br /> If aver�250d,a Nottce cf Commsn�sen�nt is required. {A!C upgrades ovar 57500j , �
<br /> d '. .. ;.z»ei a;,*�.p
<br /> '" Agent(for tti�e�contractor)or`Power of`Attortiey(fb�tFie'owner)wauld be someone writh notarized letter from owner authorizing same,,,,.; ,
<br /> `QV.ERTHECtLiUNTER..PERMi71'ING.�... -- {Frontof�APPtica#ion�Onty} ,_ - - � . . .
<br /> Reroofs if shi�gles Sewers Service Upgrades 'IVC'y Fences�(PlodSurvey/Footage) � � �
<br /> _.z. .-+•,-' �
<br /> Drtvsways-Nat over Caunter if on pubflc roadways.:needs ROW � ° _ , � , ,
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