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a�s-�'ao-oo2o City of Zephyrhills Permit Application FaX s�a-7eaoa2�
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<br /> � Buliding Depattmen#
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<br /> Date Recelv�d �/� j�, � t'� tL '�'�— t�1:
<br /> f � . _� Phone-Gontact far-Pe�rilt#in
<br /> Owne�'s Namd ��1- 1 Owner Phane Numbar ���J "7��" 1 �3�
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<br /> Owner's Addr�s �� Owner Phone Number
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<br /> Fee Slmpl�Tikleholder Plame s�"�'�'t-�"" Owner Phone Number
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<br /> Fee Simple TI leholder Address °
<br /> JOBAGDRES ���-� LOT# ��°77 � f �
<br /> SUBDIVISION �_ �� PARCEL ID# �l '�'� �"! b�16 C�.�� �� G���
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROP ED � e NS.TALI.�R 8 REPAIR • � StGN' Q �C] DEMOt,tSH
<br /> PROPOSED?IISE Q 5Fit. Q �COMM C� OTH�Ft —�N
<br /> TYPE OF COM�STRUC710W Q�' BLOCK ` [] FRAME [_� STEEG 'Q
<br /> � DESCRIPTIO OF WORK ' I �M.O✓£. 7�J t Wl�v4'J �,/C£. ,�MS�-t,{� � �G� � G`�''�C'�'�-7/�/ Lf W
<br /> BUILDiNG SI�E' �^ �`SQ FOOTAGE ' � � : . HEIGHT�E__�_�
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<br /> QBUt DlNG $ ` "'j�r�� VALUATION�fJF T01'AL CONSl Ftt1CTiO1V l`���'��
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<br /> QEL CTRICAL $ - AMP�SERVICE Q PRt�GRESS E[+tEF2GY Q W.R.E.C.
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<br /> QPL�MBIN{3 �� � _. �
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<br /> QME HANtCA� $ VALUATION OF'MECHANtGA1.INSTALIATIQN ���
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<br /> Q� � ROOFING Q SPECIAI.TY � t7THER • ��'"7�
<br /> FINI$HED FL OR ELEVATIONS FLOOD ZONE AREA [�]YES NO
<br /> BUFLDER COMPi4NY` � '
<br /> 31GNATURE REOISTERED Y/ N FEE CURRE� Y/N _
<br /> �ddres LiCense# � �
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<br /> ELECTRtCt. ; � COMPANY
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' 'Y/N
<br /> Addres � - License#.�� * �
<br /> PLtlMBER ' GOMPANY '
<br /> SIGNATURE " � , REGISTERED Y./..N FEE CURRE� ' Y/N.
<br /> Addre � � , ;License# ��� , .��
<br /> . NIECHANIC `� � . ` COMP_�N1C
<br /> SIGNATUitE ' '" � ' REGISTEREp Y/ N „ FEE CURRE� Y/-N
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<br /> Addres '' ' . - ' � , . .
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<br /> ., _ -. Gcense#
<br /> as�ER � `,co�P,ar�Y t1 S � �'v��CEi C.�� -�-�G'
<br /> SIGNATUR -� ` ' �� REGISTEREO' Y/ N:,.. FEE CURRE�' Y/N
<br /> Addre� * .`,z,G�,I=^lf�i �{U�'S� t/tr�►l�l�= YC- 1�3��5 `` ' ' ticense# ��� t?�� t 7`7i
<br /> RESID�AIT1 �AL:;; Aitacti;{2),Plat�.Rlae`s;.(2•}sef�:oftBull�Ing4Flans;'(1}sefoF�Ener�y�Faims;:R=O=W=Peiiciitfo�newc;oasbucfion, � �
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<br /> g� .Mlnimum;tern(.1,0)�working;days:aftec„submittal dat'e.r Required onsite„�Const"ruc8on:Rlans;�Stomnwater Plans w/Silt'Fence installed,
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<br /> �:�`"Santtary Facllittes:&,;I;,du�^npste,r,,Slte Worlc�P.,errnit for�subdiVlslonsAarge projects _ �.:°.<,- ' , �� '
<br /> GOMMERCIl41. Attach{3)�comptete sets of 8uitdirig Plans plus a INe�Safefy Page;(1}set of Enerc,}y Forms.ft-O�W Permtt for new constructton.
<br /> Minimum ten(10)working days after submtttal date. Required anslte,Construallon Plans,Stormwater Plans w/Sflt Fence installed,
<br /> Sanitary Factlitles&7 dumpster.8ite Work Persntt for a8 new;prcJec�:.All cammerclal requlrements.must meet compliance
<br /> 81Gt�PERMIT Attacfi(2)sets of`Eng,i`neored=Pians:,,,. :�- � -
<br /> """"PROPERTY SURVEY requit�ed for_all_NEW consVuction.
<br /> Directtons: • -� ;- '
<br /> Fill out�pplicaUon completely.
<br /> Uwner Contcactor stgn back of apptication,natartzed
<br /> If over I 500,a Notic�of Commencement is requlred. (A/C upgrades over�7500j .
<br /> '" Agent(�) r the cantractor}`or Power of Attoiney"(for Uie awner)would be someane with notarized letter from owner authorizing same
<br /> OV�R THE CQU�ITER.PERMITfiNG - - •(Front of-Appiication Oniy)
<br /> Reroafs if shi�ngles Sewers Service Upgrades A/C Fences(F'IodSurvey/Faotage)
<br /> Drivew ya-Not over Caunter if on pubiic roadvirays..need"s RQW
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