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<br /> 813-78Q-0020 Ci#y of Zephyrhills Permit Applicatian FaX-813-7$0-0021
<br /> � Butlding Department
<br /> Date�.ece�vet� , ", 1� � ` tt3�� — . ,
<br /> � �}l �'�Phane Costact�ifor'Permtttln'�����
<br /> Own�r's Name Ownar Phone Number ` ' ��-
<br /> Owrner's Addres� . ` , � OvvnerFhoae-Niimber �! �
<br /> Fee Simpl�TlNehalder Name �_, " � . ,,.� Owner Phone Number �� - .
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<br /> Fee Simple 7ltlehaldeei4,ddresa , ��• � '
<br /> JOBADD C�ss "'7� � � i.� �i.o�J�a �� ���,1�$VL�� �.33�i �or#_ '
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<br /> SUBDIVISI�N �� � ,. � � `PARCEL;ID� ' ` ' ' _ � , �
<br /> � � . ' �� ' , , (OBTAINED FRt1M PRQPER7Y 7AX'NOTtCE}
<br /> WORK PRAPOSED . NEW CONSTR ADD/ALT � SiGIV ';[� `Q,'� DEMOLISFi �
<br /> 4 .� � D ,� INS:TAI:L 8. '� .!REPAIR� '
<br /> PROP08E0•USE:. Q�, 'SFR � -:{;OMM , �' Oi'FIEFt;:.• .�, ..
<br /> TYPE OF C�OiP137'ttUCT10N� [� 'BLOCK�' Q� r F'RAAflE � STEEL. Q �� .: a .
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<br /> DESCRIPTIQN`OF WORK ��•�• ' 'G��Ci��L �, " �,��� �2(,A�' . ' - .,
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<br /> BtJtLDIF1G 51ZE,`. ' _� 84.F,QOTAGE:. . ._ .. ,HEIGFIT .:,.. : . - ° ' ,
<br /> __ QBtiiLDiNCs $ ,,,�,�,_..., .-=-':�.��:=..-...'` - ,
<br /> J , , � • : 'VAGUATION O�TOTAL'CONSTRUC710N
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<br /> QEl,,ECTRiCAL $ AMP SERVIGE ��Q PR0t3RESS ENERGY ,[�], W.R.E.C. ,
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<br /> OPi:UMBING -$, ' , � '
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<br /> ��ECHANIGA� $ ' VP�t.l1Al'IflN;OF,MECHANlGA�,INSTP►LIATlOtV - �J'��
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<br /> Q � � , Q. ROOFING,,.:Q SPEClAIl'tl�: _ OTHER ;„
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<br /> FINISNED�LOOR ELEVATIONS FLOOD ZONE AREA , [�YE$. NO
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<br /> BUii.DER � COMPANY- _' ,
<br /> SIGNATUR� REGISTEREd , Y/ N.; FEE CURRE�` , ',"':Y/.N_: :. ; , .
<br /> �►ddre� , ` , ,. ., , ` License# + - 3
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<br /> SIGhI�►TUR� � REGISTERED Y/ N �e CURaEn � "Y/N .
<br /> Addres� - _ ', , -. -°License°#:�� - .
<br /> P�UMBER � � .� , . Y CGMPAI�tY� _ , . . . . ..., .
<br /> SIGNATUtt� ' _ , ._REC#IS7ERE0° , .� a cY/;:.N`.�. .,y�e CuwtEn", � .Y/'N=
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<br /> Addre�s .Ucense.#� • . .
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<br /> SIGNATURE � ��;� � � � . .. .
<br /> i. �� RHC�I¢TERED;. . , Y;/rN. ;;FEE:CURREt�. 'Y./,.N'._=;:•
<br /> �I Addres�� " � �� �'��✓1 c �ii� �L.� .. ' , . Lfcense# �� - ,
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<br /> SI(3NATU�Ei; _ '=. > - ,`"�" - . ' �.,REGIS7ERED, YCN.nr EE�GURRE� 7• 'Y,I:N-.: � ' _
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<br /> �ddresa '%S n�: • .. , f �j .," » , ° . . cLlc�nse#�, ��
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<br /> RE81DENi'iAtY;r:__'=A#taeti�2<,PtckP.,lat�s;�.2�ssets�oft8ulldin�'�Plans;��1.}:seY'of�Ene� '�Foiins;'R-0=1N�Permlt:foraeuv..cons�ctE�on�� ,
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<br /> >-<MIr,11;um:�ten>(,1,Q)�Worictn ;daysy�tte�;'suti�Ci`iiEtal�ilafe.; Requited,onsite;�C�on'stnicHon�Plans;�Stomnwater Plansani%:Sfit Fenqe`inatalled,> .
<br /> - - i- ° � 2San1 ary Fedll�es����aps4er�S,�s;'�:;s��i?��nte,�or:supcivisionstlar9�P�le�:y�F�>t+*^r�:.;,�a 4':'= '" � r .- - .� - . _. :
<br /> CO�lt�i[ERCIAt. Attach(3j'eainplete�"sets af Building Pians ptus a L`Ife Sataty Page:('Ij set of Energy Forms.R-0=W Permit far nein►canstruc@on.
<br /> Minimum ten(10)woricing days after submittal date. Required,onsite,,ConstrucUon Plans,�tormwater Plans w/Sllt Fence inst�lled;, . .
<br /> Sanitary Facit�les.8�1_dumRster..Site.Work.Permit•for ail7'new"piojects:All'commerdai.roqulrer»ents must meet compilance .
<br /> SIGN:F�ERM!'f Attac�i(2)setsiif'�rigii���`iair,ed�Pt.eltts�'.?:;p�s�.f,�:`::`^;.; .� ,`` - , . ,
<br /> I ••"•PROPERT.YSURVEY_required�forall•,NEW�constnuction;>, w - . . „ �
<br /> Dtrectlons: � =r u':;-;�,'.,;, .. _ � _. .__.,.... u_ .. . _ . �
<br /> , `Flll.out applicatlon completely.
<br /> tOwner&��ConEractor stgn back�of appitCBttton,notarized
<br /> , If"aver 5�500,a�Notice.of�Commancement ts requiresi. (AtC upgrad�s over 57500)_,.,_ � �-- �
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<br /> l�gent(far ttie'COtiVaCttit)"Pr Po�Arer`of Attoiiiey(for#tie�ovmer)would be someons:wifh notarized letter from owner authorizing same
<br /> OVER'THE C�OUN.T.ER;PERMiTTiNG-= =, :.(Frontof iiPPlic,e�tion Only)- t. _ , _ _, .. _ _ � . - .
<br /> Reroofs If shingles Sewers Servica Upgrades AIC Fences(Plof/$urvey"/Fpotage) � -.• -,
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<br /> �lNveways-Not over Counter if on•pubiic roadways.:needs'RClW �M1u
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