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<br /> � e�saao-oo2o City of Zephyrhills Permit Application Fa�c-813-78p•oo2�
<br /> �� Bu{Iding DeFtartment �
<br /> Date Ftec�rlvad p� �_�t ' �
<br /> y ' G'"L � _,:=Phone Coatactafor P�irmittln :.: . $t�3 2.�g _ 3?J� �
<br /> Owaer'sNa�a ���e«k toaGs��r� , Owner.PboneNumber 813T Z�}p^:3'?i� ,
<br /> Ow�er'sAddress SpY.� /!�N ,S�iC�T'� '- � CiwnerPhone•Number (�'t3� �&'Z�- 7OYS �
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<br /> Fee Simpte TlBehalder Name �� � ' � Own�r Phone Namber l
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<br /> Fee5tmple�TltiehalderAsldress - d "
<br /> J09 ADDRESS �'�Y3 /q ;r� sT�tEET' ZEP�YR.N,tttiS FL� 33Sy Z. �or# c.—�—�
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<br /> SUBDIVISI N � ,` •`-' ' I PARCEL_ID# ' .
<br /> � ,„ � • , ' '(OBTAINED FROM PROPERTY T/UCNOTICE} °
<br /> WORK PRt3pOSED ; :, " ^- NEw CONSTR '� � ADD/AI:T =� S1GN [� [� DEMOL(SH
<br /> � IIVSTALL 8= REPAIR .
<br /> PEtOAOSEp:USE. � SFR ' � � ,COMM'_ � flTFiEFt'
<br /> TYPE OF C�ONSTRWCTION.; ', `BLOCIC�'_ Q FRAME �_� 8TEEL ,Q.. �
<br /> DESCRIP710EN OF WORK .}- pS�yE C��W��►0 Peo4. iNs�re.��T�o,o' � _
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<br /> BU�LDIFIG'SIZE.,=' 2� RauN�A " � gQtF..00TAGE•��� ; HEIG,HT� . SZ ��+cWrtS . ., . , ,
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<br /> � ,3jo$,�, . 1.$— VALUATION O�OTAL'CQNSTRUCTION ,
<br /> QE�ECTRtCAL $ -AMP SERVICE - ' PROGFtESS ENEf2GY W.R.E.C.
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<br /> QPl:tlMBlNG $ �
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<br /> [�MEGHAi+lICAC $ VA�lJA1'ION;OF,MEGFiANlCA�.INSTALLATlON ti:✓ �j��
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<br /> Qc�s , ,�,.�] - RooFac��,tVp - s�ECEAt.�r=�(� o�rH�+� � � �
<br /> FINISHED F1.00R ELEVATIONS FLOOD ZONE AREA YES. NO /'�Q t'���Cr�Y����
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<br /> Bu��p�� o nf�e,�l� �.o�a�srx�� tJ o��Ar�,r � , , 4•
<br /> SIGNATURE � REf31STERED Y/ N.. FEE CURREA°. , .Y/.N � �
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<br /> ELECTRIC,UiN::-.,. ., „ COGIAPANY `
<br /> S�GN/iTURE �' REGISTERED Y/ N �CURRen ' `Y 1 N -
<br /> �4ddre�a . ' �, . , � � Llcense'#��� - �
<br /> PLUMBER� : . . COMPANY; ` r ' .
<br /> SIGNATUR� sREGISTERED Y/�.N. , �e:cuw�e��i :�Y/N: :.• '
<br /> Addre� , Wrsnse# - _
<br /> MECHANIC'AL`. � - . � :_ - ;.CqMPANY ..;, - ,�;. . �:� -
<br /> SIGNATURE ' , i' � "�
<br /> a , RE�ISTERED.,, ,,. Y;/'N�,_�. ;.�e_CuwtEn� �=Y/wN�-��
<br /> �ddre�s: . . { .>. .. .' ,.t _ � - z : .. : .,l,icense# �. ,t.:� , :.... . -��• 1 �
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<br /> .RESIt}ENi'fAl�..-.-<Attact�•,{2),Plok°Plans;�(2);sets�af>Suijdirtg-Plans;:(1};set"ofiEiietgy°Fo"'miiS;'R=0=1lN'.Perriit#:fcrnev;r:canshuctton,:. -
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<br /> _„ '.t;;;Mlnimum,�tem(1rQ�)�worltin.g;days�after,;�sutirtiitFaliilafe:��Requlted anslte;-Cons'truc8on?P,Ians;;Stoimwater Flans'w/Sllt Fenqe,tnstalled, • ,
<br /> _' l _.. 'Sanifary�ac�lttles&n1�clur�►pste_r,yS{te�i(Uoric�Perrriit�oc".siititllr"rl'stonslfa�ge'pcojeats��,:=��ti:},�A�;,�"n:°°�'' �' _-._ � ; ��.. , ..
<br /> COMNlERClAL Attach(3j'oomptete`"sets of Bu`itilitig Plans ptus a'L`lfe Safety Page;(1}set of Energy Forms.ft•f3-W Permit for new conatructlon.
<br /> - Mt�imum ten(10)waricing dayg eftar submlttsl date. Requlred onsite,�t�onsUucUon Plans,Stormwater Plans w/Silt Fence instelled, . .
<br /> Sanitary Fadtt�es_�1,dumpster.SIte.Work.Fermtt for ali.nerv;proJBcts:-Ap commerciat requlrements must�meef�compliance
<br /> SiGN PERMIT A#acti(2)seLg of`�ngi"r�"eei,ed'r,Plat�s:�:;,�:~s=`-•P; .. . � ,. . < . _ _ ,
<br /> 'i •"""PROPER7'1I_SURVEY requirec!forTall;NEW�cons.tniction..._., -__ ' . � -
<br /> DtrecNon�:,� ���.;:�^. �- . .;,: . ... __ ._ _. _ _ - •
<br /> Flil out applicadan completely.
<br /> Owner,�Contraotor sign bac�c of appllcatton,notac�ed
<br /> If.over'$2500,�►Notice of Commancement is required. (AIC upgrades over t7500)__ _ � � . '_ . _
<br /> � ,,:�,�...�:(t.^.a:�s:.;;: . '
<br /> '• Agent(far ttie ciinti�actorj`or=Ro`we�"of-Attoiney'(fo��#tie oiwrnec).wauld be someone with notarizec!tetter from owmer autho�izing same� ;,�,;
<br /> ;D..V:ER7HE:eCOUNTER�PERM1TTiNt3�= _ :{Front;af-ApPllcation Only)•_..� � �^. Y�:Y , ' � � .
<br /> Reroofs If s�ingles . Sewers S�rvice Upgrades�A/C_'•, Fences(PIoUSunrey/Footage) ., ' _~ ..` ' ;^' - . , -
<br /> .. N� _ -. . ,_.,..,-- '.":r'�-,`'.-:-.
<br /> Driveways-Not aver Counter if on publia roadways::need§;R01N:..,. ry�. •� -
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