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<br /> �'13-780-0020
<br /> ,, � Ci#y of Zephyrhills Permit Application FaX-s�3aeaoo2�
<br /> T'` 'r ' Building Dapartrnent
<br /> �at�R$�Ys� , , �'13 � � _ d;d�� - .
<br /> ' • °"�Phone�Contact'for`P`ermtttin`�` �
<br /> Own�r`s N me f� p � . . . . _ Owner Phane Nutnber �! �"' O.�O �d
<br /> Owner's Address ��o�---� �,l�G$ /��/��- - �,'�� "�'�- OwnerPhone=lVumber � � �.
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<br /> Fee Simple TlHeholder:Name ' Owner:Phone Number .C�
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<br /> Fee Simpl�71tleholderAddreaa :• � � °' ��:., _ , .
<br /> JOB ADDR SS 5�'85 ORc�S AI1/�'_. G'-�//L l.5� �or# ��
<br /> suaaivisi N �� , ��. ��PaRc��:iu# /l>- � � G�l �G1dDD �/�'L�
<br /> � , � ' � ` �(QBTAINED"FROM PRORERTY TAX•NQTtCE} •
<br /> WORK PRO„OSEO �` NEw CONSTR � ' ADD/ALT [�'� SIGN �Q ' �Q`;� DEMO'LISH �
<br /> _ ,� � � ,, ,� INSTA�L � ._. -:REPAIR' � . . .�
<br /> PROADSEO USE. . Qf° � SFR � � COMM � ` OTHEF2� .: . .
<br /> TYPE OF C N3TRUCTION,•. ;[� ` ��BLOCK�' `Q ' `,FRAMEy '�] ;STEEL- ;C]�' `. � .
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<br /> I, DESCRIPTI N OF WORK f' �C 4f/�A�N ���/,�1.�% � T�'N CO�'Y3 Q7V�NTS �
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<br /> HUI4p1NGS ZE.=�� _ � ;, ., � ,
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<br /> SQ,,FOOTAGE��, _ _ „HEIGH�_�.�,. �:
<br /> . QBt}�LE}itVCa $ -'�,r.�4� �v. -r`�,� ;. , _ •
<br /> � . , ,VAl:UATION�B�TCOTAC'CONSTRUGTION
<br /> QEL CTR1CAl $ • �AMP SfRViGE Q` PROGRESS ENERGY � � W.R.E.C. ,
<br /> QPi: MBlNG -��µ ,, - ,
<br /> �ME MAi�lICA� " , $ ,;j�jt.gJr"'. d�, ,, VAt,UATIflP}.QE.MECNANICACINSTALLATlON _ - r. �
<br /> QGA Q RflOFiNG-,�Q SPECIAI.lY '� •OTHER� •" ,
<br /> FINISHED FL OR ELEVATIONS � � FLOOD ZONE AREA ��YES. NQ . ,
<br /> �i_`5 .
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<br /> ', BUILDER CQMPANY � `" . �
<br /> SIGNATURE RE(31STERED Y/ N �e CuwzE�' ,, Y./.N:..::, ,
<br /> Addreas . . . �lJcense# �- ..,..=..:..�
<br /> E�ECTRiC1AN:.� � • .- - ` � , i . . , '
<br /> L� ., CQMPANY' ''=- .�. ,. , ,.
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURREP ' '.Y'/N
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<br /> Address � a _;�.License#;�. '`.t� " .. .�
<br /> ' PLUMBER , , ,. . COMP.ANY� _ .+ . � { `. . .,
<br /> � SIGNATURE � -� .�REGIS.TertED� _ , �<:,Y/�.N,-. .._:�e�cuwten�` .� Y/N:-
<br /> Address ;.� ` ' ..Ucense#� �
<br /> MECti�ttGN:`' Gg�,�,„ � �,, _ . ,,COM_P.ANY, . _�1��S ,A1t� S�'G"� .-=hl�i '.
<br /> SIGNATURE " w�� f `i I�r�V`� ;RECi15TEREd� . , .Y,/'.`N.. t . '.:FEE'4URRE� ''Y./�N••`,:
<br /> Addres��a. ;,: � , . ., , .:r .-. ,. �' _ . . .Wcens_.e#-� � �'�
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<br /> OTHER . `�' � , GCII�tFANI�, .� -.; • � :�h:.:-.;. . ° ; ` ,
<br /> SI(iNATURE.�? -�' � . , _ > < , •'� , � . , REGIS7EREp Y/ N�..;, �FEE CURRE� ,,9�t.Y.�/;N� _ � .
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<br /> Addreas -,:�.;:�:,;'F � , , , , - " ', . . , •-`LlcenSe#�I`� ' I
<br /> _ .f.�� �,};• =-,��>. - ''°..r'.={�-`,'_i' *�:u,,, =:s>r,_. , �_. ._ .
<br /> . �RE810E�1TIAL;.-;�fi� 'tEach�'2 ict:Plans�.2-'=`sefs`:of�Bnit'illn �Plans;,�1�,setof�Etie �Fomis,r�R-O=VV-Permlf:for�n�yt+,con's,bvc�on;:,,,,_,,. -
<br /> ..,...._ A..,. . {. );.�'_ _ �.t :)„ , � .. ., .A.� t )... . . !'�Y_: ,..�,,..9.,;, - ,,. .., . <_.:. - = .
<br /> "'���'� S(t F'nce tnst�lled;
<br /> -Minlmuin�:ten�(10)�woriting�,days�a(te'r„"sutimiEtel�date:�Requitedo.nsife,';-CansVucNon�Plans;�Storinwete`r�Plansw% t �, .
<br /> - ��'Santtary Far�1tU�;s&���c�u�pster�,SltebVlto,r,Ic�Per,mit(or subdivistdnsllatge;Pro�ectst r:=r:��'ni:,-,, <��-` - _ . - .4 - .y�' .
<br /> COMMERCtAL Attach(3j�coinbp}ete sets'cf Builiiing`Plans ptus a'Llf�Safety P'age;{1}set of Energy Forms.R-0=W Permit far new constructlan.
<br /> Minimum ten(10)wo�lcing days'efter submfttal date. Requlred onsite,.t�onstrucUon Plans,Stormwater Plans w/SUt Fence installed;, -
<br /> Sanitary.FadtiBes,S�1.dumpster...Site.Woric-Permit for.aii`nei+vipro�ecfs:i0.11'commerc�ai.tequl�ementsmust,meet compiEance , . , ,, ,
<br /> StGN PERMiT Attacti(2)""s'ets tif'�ogin�aer,eci:Platis;�;,t:�«c=f� • .�. ,. '. � ,,- - � . . -
<br /> ""PROP..ERtY SUR1/,EY:reguired,-fios,all-NEW:canstruc8o�.,,;;. � _ - •�. .
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<br /> Dtrections: ._., . . _ .._ ._._ .. _. w _ .. _ _
<br /> Fill out appli dan completely.
<br /> Qwner 8 Co tactar sign back of appl(cattan,notacized
<br /> If over$�500,a�Notice af.,Commencement is required. (AIC upglraide�over 57500),._ x , � -
<br /> �s '�;t.:;g�yF c.:y;;5�'�;:�:.•� ;,�__, .�i.:,,:.'r. '. ...u�,.xu,-.��.,:..,....�„ .._�:v � -
<br /> Agent(for the cantractar}'qt:Po'Sni'e��of i�t(omey(for tlie;owner)would'.be someone rvlth notacized letter from owner authorizing same
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<br /> :O,VERTHECQU T�R�PERMfTTII�,ti�=:.--E:::�(Frront�of�/CpPllcaBonOn�y):- �W: ;�.
<br /> Reroafs if shingle Sewers � Servlcs'Upgredes�AIC'' ::Fences.Plot/Survey/Faatage) __ . ._.� -. :;-. , " : , `` ..
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<br /> _ w r � ,< <_ � _-=.�r.�:Y.t �.:��.: _ ,:_ � � . _
<br /> Drtveways-Not aver Counter If oi�`piitilia ioedways.`neact§ROW
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