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<br /> e�aaeaao2o City of Zephyrhills Permit Applicatian Fax 813-78Q-0021
<br /> � • '� Bullding Department
<br /> Qate Recelved. . , � '-Phone�;Coratac#�for`Perritittiri� ' � .
<br /> Owner•s Hame � yct SD . . . . Owaer Phone Nu�nber `'7.� '�`� - = 3 . .
<br /> + , . �a j� .
<br /> Owner's/lddress `� A �L;z e u L Owner�PhoneNumber '� (�'��'� ^ aa-lb �:
<br /> � �„ 3
<br /> Fee Simple Tltlehalder Name Qwner Phone'Number x �� • ".���- '����
<br /> � ����--r� . _. � . _ . . , .. ,—,�_
<br /> Fee Simpl�Titlehalder�lddress . � °� � � . • -
<br /> � �
<br /> Jp6 ADDRESS � l�1�o v'c C �T, LOT# �+� .
<br /> SU80iVIS�ON1 �_ ` + ` � PARCEL ID# � ' ` p
<br /> `� (OBTAINEDFROIN`PROE+ERTYTIIX`NCTICE}
<br /> WORiCPRQPOSED NEvuCONSTR � ADD/AI,:T Q SIGN Q Q��� DEMOLISH , � ,
<br /> j ._ � e INS7'ALC '.8 •�• REPAIR �
<br /> PROPQSEp:USE. Q Y SFR � _ �GOMM' 'Q {?THER;` , � : ..
<br /> TYPE OF�ONSTRUCTIQN,, - '�] ' BLOCK�' '��]� .. FRAME, . � ST�EL .�], . . •
<br /> DEBCRIPTION'OF WORIC �~ .h 4 c -
<br /> �� , e �.' ��� �
<br /> BUiLD1AtG;SIZE� � � Stl.FQOTAGE��. , ;, HEIGNT`.��.:- � . . ' .
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<br /> .. �AV��V�I`{�7 . . � -7z';,.2�jtY;i�:.�...,.r . �..;lr.•��.�.-..'., ,. ., � � . .
<br /> - . , � VAI:UAT�ON`aF'TOTAL`CONSTRUCTION
<br /> �ELECTRICAL ���'� AMP SERVICE O� PROGRESB ENERGY Q W.R.E.C, ,
<br /> 5� o 0 0
<br /> [����:un�Btr�� �,$.
<br /> � �� � „ . . , � � �3
<br /> Q ECHANtCAC $ , � 1tAl.t)ATtON;OF MECHANlCA�1NSTALLATIOEV t.M �
<br /> � � . .
<br /> QC,AS _ Q ROOFlI+►G> Q SPECIALTY 'Q OTHER - `
<br /> FINISHED�l.00R ELEVA710NS � FLOOD ZONE AREA ,��YES. NO ,
<br /> r�, -
<br /> BUli.DER � V . COMPAt�1Y '
<br /> SIGNATURE R6C31STEREp Y/ N �E CUttttEn' Y/.N,.
<br /> Addre�s � ,'"r ' `L'Icense#� �
<br /> EtECTRtC1AN,, • . . . - ,�COMPANY ' �.�. � � �
<br /> SIGNATURE ��' RE131STERED Y/ N F�Gurtit�n ' Y/N -�
<br /> �4ddre�s . , �Icense.#=;� �
<br /> PlUMBER� . . , . , COMP.ANY° ' „ ' . .. . .
<br /> SIGNATUR I . ,, �.rtEGIS7ERED. ,...:.Y.�h>N.., . .�e:cuwten� . Y/�N: ' , �
<br /> �1ddre� ' - . . Wcense# " _
<br /> � ,. •
<br /> ME£M�lICAL`. ,YGOMPANY _ ' .
<br /> E :�.o,_� .
<br /> SIGNATURE ' .. _ . . • � � ` ' REG�S7EttE�� ._ ..Y;/�N ;,FEECURREN �Y/:N.-,� -
<br /> lY�dd�`;.-,..�' , , - ,_ � .ic . .,. . � - ..Y `ul,`,r�_,[IS@ri'`'�^ ' ' . - .�.,..
<br /> OTHER � , ,4 _ : : ,�. , . . _� _GOMPANY ' � ' . .. . . -
<br /> SIC3NATURE. � - - ` • � ,REGtSTERED_ Y , .
<br /> �' ' ' .. , �; � , , _ ., /..'N:� FE�GURF3E�,' Y'/,N-:�. � , - .
<br /> � �, �... .
<br /> Address ;x - .:�..;;,�.;�.;E.; _ �. ,;,; .��' . � , _ `Llcense#^
<br /> 1 _ r ' �;4-,.:. :��.:�, ,.Y�...:s.� :t''_ . _ :,�:�.. �t-1"g:'..J�'y'.n��x.- '.,��c• .i.f?`•.,,., . , - , ". '
<br /> RESlI?ENTiAL.. _-Attach,(2};,R1otP.,latis=(2):sets.of�Builtllrtg�'Plans;,(1.)`set:offEiiergy��Forrris;'R-t3=W",Pemnit;for;nauit,;cbnshric�ttcn;". .
<br /> - - 1 - S . -.i.. �:�..�-•-. );f
<br /> , -��Mlnlr�ium,tens(:1�Q:hworltingi;days:af�e�;subintttel�:aai8:,-Rs��irea�o�sice;co��aucd'o�;Plans,�Sfor'mwater"Plansw%�SIItFenc,e.lnstalled, .
<br /> _ ��Sanitary-Fec1ltU�ss,&>1�s�i��?Pster�,•SIte�Work�Pem:tit'.tor,•_su6dfv_i'stonstlarge�pioeicts� - :.i°�Y`� � ._ � _ - ; _ ,. - - �--- -
<br /> - -- —# _ ,,s� - .� ..:r .,.c. - � �^ -
<br /> COMt1�ERC1At Attac�►►(3j'complete"sets"af Sult1iing P1ans ptus apL-1ie 8afefy Pag�;(1)set of Energy Forrns.FtA W Permit far nsw oonstiucUon.
<br /> MiMmum ten(10)worlcing days'after submlttal date. Requlred,anslte,�ConsUuaUon Plans,Starmwater Plans w!Stlt Fence Installed,,,,
<br /> Sanitary Fadlttles 8c 1;�dumpste'r..Site_Wark.Petmtt;foc aA`new�praj8cfs:AIl;comr►zerdat requlrements-must meet.campSlance
<br /> SlGN.PERMlT Attacti(2)'sets af`E'ngliieier,ed,F!lans;�;a:�;:r::-�-,::�.._ : ... ' , , ; , ` . ;' " -_ .
<br /> ""'•PROPERTI!.SURVEY rsqulred•for all_NEW-consWCtion...
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<br /> Dlre,cttons: ' -�'��a h ,. _ _ .. __. _.�. �
<br /> Ffll out appllcaUan completely.
<br /> Oirvner�Cantcactor stgn back�of appltcaSon,notarized
<br /> If`over$2500,a Notice.of.Commenc�ment ts requlred. (AJC upgrades over S75dq)__ �- - "
<br /> { 1;,t;�„�yn�t';.,i�,Yrr�'.. � ..- . ...._ _. .._ .......... ...._.,f . ...... ,
<br /> " Agent(for the contractbr)`'orfowe�`of Attoiiiey(foc tFie�owner)would-be someone,with notarized letter frnm ovtimer authorizing same
<br /> O.V,ER`THE COUNTER�.P.ERMiT�IPIG"=-- ':{Front:6f�ApPllcai8on On�y)�� `. �. _ '� _ - --.
<br /> Reroofs If sh[ngles Sewers Servlce Upgrades A/C _ Fences(Plot/Survey/Foohage) »�- -_- .
<br /> __.._ _....�..__ .._._..,-: �-_ - _ .,. . ....t ,:;�`:�, '�; ., - ... � �. ._. . ... ., � .
<br /> Drlveways-Not over Caunter tf on•publlc roadways.:needs RC1W
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