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<br /> 813-780-0020 City of Zephyrhills Permit Applicatian FaX-813-780-0021
<br /> ,-� 7. . Bullding Departrnent
<br /> Dale Rscalved , . ., ��� � ,
<br /> '��Fh'oneCorit�ctrfar`Fermttttn `�: `. ;.j`lj `?�o'� `�
<br /> Ownee's Mame 17" �� G � Owner P.hone Number I�D ���a�� � "
<br /> Owner's AI dress �7 � I3'7Y)* �'� QwnerPho�e-Number � �
<br /> FeeSlmplqT(tlehalder:Name ��� ' � ` ..'. ^C..
<br /> _ .,_�,,,�„ Uwner Phone.Number �
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<br /> Fee Stmple TltlehalderA,ddress � " �:�: . , , _ � - .
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<br /> J08 ADDR( SS � !(,�✓o�� e � /�� LOT# �
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<br /> SUSD�v�S1UN ������.. i~r��� P�c��iu# � �5'�2/ .db�� .�5 1� .
<br /> - �' - � � ` � `(OBTAINED FRaM PROPERTYTAX`NOTICEl. � �
<br /> WC}RK PR AQSED ° NEwGpNSTs ` .�. ADDlAt:T C�` SiGtV " [� - '[�� DEMOLISH �
<br /> '� �'e INSTAGL �8 :-,; .REFAIR' - - . ,
<br /> PROF4SECl:.USE Q�� `'SFR: '� COMM` �� � O'CFI�Ft'-- :' .
<br /> TYPE OF C�NSTFtUCT10N; �] ` 'BLOCK�' '�Q . FRAME . �� STEEL �Q� . ._
<br /> DESCRIPTi(ON OF WORK j` /"'SES � � (.... . —GLG,,�� � '� � Q -.�/G �CO�2
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<br /> BUI�DING S ZE:;� � St�FQtJ7'AGE . - .,HEIGH�=,�. , �
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<br /> QB l�D1PIG $ �a..:t.. r,,r ,, . .. .
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<br /> - VAt»UATIC'1td"O�OTA�CCINSTRiJCTION
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<br /> QEI. CTRICAL � � AMP SERVECE ` Q' � PR�GFiESS ENERGY [� W.R.E.C. , , I
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<br /> [�Pi: MBtlVG .$ . . - - . . .
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<br /> QMECHANlGAL ' $ VAl.UAT'[4N OF MEGHANtCAI 1NSTAELAZION _
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<br /> QGA� ; ROQFlNG..,..; �..1 SPECIAi.lY.° OTFIEtt. " .
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<br /> FINIBHED FL.00R ELEVATIONS FLOOD ZONE AREA �YES. � NO , '�
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<br /> BUiE.DER COMPANY " j T'' - . .
<br /> SIGNA►TUI2E � REGISTERED , Y/ N ' FEE CURRE�' .,,_ .Y/.N. _: , .
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<br /> Address I ..'. � `- •�' '
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<br /> -' '�' License#'`
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<br /> E�ECTRICIt;�i+t:- � 5, ' COMP1�tNY `- , . ' _ �
<br /> SIGNATURE I �' RECi13TERED Y/ N FEE GURRE� Y/N .
<br /> Address I � . .. _;.License.#�,��� ���
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<br /> P�t1MB�t� �� , . �GOMP.ANY= : , . . .<
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<br /> SIGNATURE '� � � �REt3IS7eREP:- : -:, -�:,Y./r:N�..� �' FEEiCURREf�' .. •y�N,
<br /> Addre�s � , _ � _ �� � , , ..Ucense#;I� . �.=�° . � - �' I
<br /> M�c��ca�:' - . .�.. . . .. � _...c,aMP�nr�° _ f��I�S � ttN� �'-. �,,�� � :� ,
<br /> SIGNATURE ���"rrn�� BEGIS7ERED:� Y/�N .:FEE CURREt�. _ ''Y./rN•.:,�>
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<br /> Address�' n',J � � ._v . - t � 4lcense#,I '�3-/��� ` = .I` -. -
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<br /> SIC3NATURE.;. i' , ° , - . . . . � . �..REGIS7EFtEp �Y k N...' :FEE CURF3E�., :Y/�N�:. - _
<br /> Addre�s . . ; ?�:,� :,;.,;�' .. . .~.p_ .. ., , .- •- . . . •_`ltsense#�� � (
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<br /> RE810E�iTIJ0.�=,.��"A,ttach{2}P1otAPlaii§;(�)sets af Bnit�ltig'Ptans;{1.);setiof-Eriergy�Fainis�;R-0-W Rermit.for��y co�s�buc�on,..,: -
<br /> ;.:r�Mlnimum�tens(�10)�working�;d�y',s;aft'e�;'suti�iiittal�date�RequiFetl ci'nsite;<,Constiu'odon�Plans Stis"iniwater`�Plans�w/Silt F$nqe fnsfalled, ,
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<br /> ..�4�..�^..�. '.ev.: �wus _ y .. .
<br /> Sanitary�Fa�41tl�sT,$t1�c�u�r�pster,�Site>Wcr,k3Per,m�t.(or;siitidi�IslC�isllarge'prqJec'ts;;.>;:',y��;:_`��� -- ._ .
<br /> ���LA.' ..- ..� .` '' , : .
<br /> '- COMiYiERC1Ai.' At#adi(3j''comptete�'set�:'of Sultdl�g`Plans plus a'Ufe Safety Page;('!)set of Energy Forms.R-O W Fermit far nevV eoristruction.
<br /> Minimum ten(10)working days'after submittal date. Requlred.onsite,Construcdon Plans,StormwaterPlans w/Sllt Fence installed, ,
<br /> i Sanihary,vFadlittes 8,1,.dumpstar..Site•Wark�Bermit for�II_new�project's:�i4l1`commerdaGcequlremenls�must meet compllance . . ,,
<br /> StGN PERM1'T Aita�i(2}"se`ts o`t'Engii%eer,e��Plat�s,:;;;:�%M�='.. . . . ,,, . ' - ' ,
<br /> � """PROPERTY 8UR1/,EY-regulrecl fnr aJI�NEW�.copstrucdo�i:...,,. - „ - - =-- , ._ - �.
<br /> Dlrections: ; . . , ,:F �... ....�_ �_ _ -_- -- - .
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<br /> Fill out appll�adan oompletely.
<br /> Owaer 8�Co�tractac stg»back�of appBcatlon,noWrized
<br /> tf'over.$�SO��Df,,a�Nottee of.Commencemsnt is required._,tac u�gra�as.o�+�e�s��oo� .� �� _
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<br /> /�qent(for th�.cCntractor)"pr:Pbwer of Attoiney`(forttie.awner)would be someone.with,nota�ized letter from awner authorizing same
<br /> Reraafs if shingle��'ER:PERMITTiN�:_..=::.;��(Front ofeAPPitaa�un On{y) =;. �- ��: ,:j-•-., .:t J� _ _ - -�- ._
<br /> .OVER 7`tiE'COU
<br /> s Sewers � Servtce Upgrades�A/C ,Fences.(PIoUSuryey/Foatage) _ _, .�_ . - , � --
<br /> _.�:..;�, - - �. t- ,
<br /> Drtveways-�ok over Ccunter if on public roadweys 1n`e�s RC1VV , . �
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