: e��aeo-oozo Ci#y of Zephyrhills Permit Applicatipn Fax-s�s-�eaoo2�
<br /> • Building Department
<br /> Date Receiv�d .. ; A . �Phone=Contact=for'Permi#tlri?°`.` V �1 3 '7�.� _ � � ��
<br /> Owne�'s Na I e �L.Jt�1.� C�..� .,,�,�131tI1.vL�.+ Owner Phoae Number �f 3 ""' ��P��o7p .
<br /> Owner's Adelress ��„� a'��' �.�_ �/��G�LS� '�� 'OwnerPhone Number C' � �.,
<br /> Fee Slmpla�Itleholder:Name ��— �� qwner:phone Number � _ �
<br /> ' - -- '.'_"�'y'&t._' _ _ - . . _ . . . �..
<br /> � ,.
<br /> Fee Stmple Itleholdec�Address ' • "
<br /> JQBADDR SS � �l� '�"�� ��— �`H/�C.S LOT#, ��
<br /> SUBDIVISI N �� � � �PARCEL ID�' �J'_ ��,-—���'� �1Q1� ���..�J� �O��
<br /> � ' � " �(OBTAlNED FROM"PROPERTY TAX NOTlGE} �
<br /> WORK ARO OS�D �`= NEW CaNSTR -' ADDlALT � SICiN .�� ' 'Q" DEMOLISH _
<br /> ( . , 'T� ' , INSTAL•C REPAIR'' ' -�
<br /> PROFOSED+�USE. 0:;= . 8FR� ' Q COM{VI'��', [,� `OTF{Ei2 "_ -
<br /> TYPE OF CON3TRUCTION�; Q� '�BCOCFC�' '�C] �' F.RAME [ � STEEL Q� . { . .
<br /> DESCRIPTt NOFWORK � /7,C Jf"AN �'=` . LP.� � .�G�/V Pb7Y] 0l1.l.�N.�� q/�I ��07N7Ja
<br /> BUiLDtNG IZE.����� SQ FQOTAGE�� �_ , ;�HEIGHT�.��'=
<br /> . �8 ILDING $ -.�;.::::�._ �.�r:.�r.,. _... �.. . . .,
<br /> , ,. ,VALUATICIN��F`TOTALCONS'1'Rl'JCTION ,
<br /> � �; � .. . � ,
<br /> [�E ECTRICAL $ 'AIV1P SERVlCE Q` PROGF2ESS ENERGY Q W.R.E.C,: .
<br /> ., � -
<br /> QP tlMSIl�EG � . . _ . , : �
<br /> ����„ �� - � � . . � /�f � �
<br /> OM CFtAN�GA� ' $ ,,�, Y VA4;ilATtflN�OF MECHANEGAL��NSTAL�ATaON -. ��.1 t��
<br /> ( ��95, da:�
<br /> p " s Q. �oo�i��, �:_: s�Ecia�.rr� a�ri�R� n
<br /> . C� C� �, ��j
<br /> FINISHED LOOR ELEVATIONS r FLOOp ZONE AREA , �YES. NO 2,� . ,
<br /> BUii.DER CpMPANY ` � � � � '
<br /> SIGNATUR R6GISTEftED Y/ N ' FEE CURRE�°' s Y l,N;•.;;
<br /> .. , . r . - < -. ;. ,
<br /> �ddre s , "�- � - � C:Icense#'1 ' � I
<br /> ELEC7RICt ,,. _. ,. ,�GOMP/1PIY , --` , .`. , . . .
<br /> SIGNATUR �' REt31STERED Y/ N FEE GURREA �"'Y7 N
<br /> Addr s � , . . . � , , `.Llcense.#�'�` i� �
<br /> PLUMBER - • � , COMP<ANY, , �- � • : ,, -
<br /> SIGNATUR ' _ „ ����i�TeFtEt��: .�y;,: -�Y/mN� :F,EE!CURREH't ., `^Y/N:,.
<br /> �►ddre ::� � , � - ..4Jcense#�.I' = . . �
<br /> MEGHANtG� . - ;CQMPANY ��-�/t/.f1�S f2'1 .!9l{IG�i�f�5 r���.-��L�.
<br /> SICiNATURE� �"�"� ��'' � REGISTEf3ED= , :Y.I N. �.FEE CURREA' _ �Y./-N� '
<br /> x
<br /> Add ��F�J' �Tjl�1J' �!�11.1� �.�. � . . _ I:Icens.e#-I`-�i'�-.�'��.Z-C�-"., . -1 .
<br /> {3TNER " � .._., .. . . .. ..._: . . �`GQIy1PAFIX', � ,. - . � . • � : � . ,�
<br /> -,,, ,. �, -..,::; -. :.
<br /> SICiP1ATUR - .. . � °- , � , , _ . . .. ;.REGISTERED - Y/ N:.� ;FEE'CeURRE� :Y.•/;N: . ,
<br /> AddP9 - _ �-ss�; ;,�... . ,� , � „ _ . , • .L1C@�59�'��I I
<br /> , . - _ " _� .:'y1,. _ _ s"`�sr'.s.y.x- _ j': i'n•�a{'€:d.K�.l�':-:.hw.k'v.. -`:tS.i�x"-..iiL�i?: _ .-> ., ,
<br /> �RE8lDEtV'E'frAL�{. ��Attadi�'2�;...P:,lot�Pians;i'2),sets:of}Bu'�ilding'�P1ans;;{1:j,sefof�Energy�Fcims;_R=Gi=1N�Permit;for.new;con�tructton� . - .
<br /> .. .t,.} t. Y .�, ,�_ ..
<br /> _ — - - - �M!!nt <er � :
<br /> _ _ �um,.ten;(��O)y�rorltfng•;daj�,�aftar,:.sutiriilfhal�d"ate.��Requlred;gn�i.e;;�'ans�'�io�or:=Pisiis;:Stoiirwa#er'Plansw/,Silt�enae'.ins3alled;'�~=-
<br /> .�.. � -.� .
<br /> ��Sanitary�Fac�j4U,ig�ss,&�1pdu��ps�,r,t31te5Work�PetXrift;fcr:'subdEvlslonstlarge projects;;=;`s`�v`�7'-�r'-`;`�= -, ;.._ - ` " -
<br /> COM�lER�IAt Attach(3j`i:oiiiptete�'sets of'Buflcitng'Pians pi`us a L{fe 5afety Page;('Ij set af Energy Farms.R-0=W Permit for neW constiuctlon.
<br /> Minlmum ten(10)working days'after subml4tal date. Required onslte,ConsUuodon Plans,Stormwater Plans w/Sllk Fence Installed;
<br /> Sa�ltary Facifi.ties&,.1.dumpstec...Site,.Work..Petmtt#ar=.�Il�newtpro�eats:=At1'ccmmerdal:requlrements musYmeeYc:gmp!lance ' , ,
<br /> BtGN P� iT Attadi(2)`s'ets ofEi►gi��ereil,Pietis;�<*:�.�'r"`.;;��;� ':>.- ''. = '�`; ��° '" ` -
<br /> I •`"•PROP..ERTY..SURVEY requlred-tura I�NEW:consWpyon...,�..---.�„ �' � . . • � ,
<br /> _ ,�..1...r.
<br /> �Dire,;cttons` �:�>v.-,-. , - .. .�....�.�. �. ._. _. �. . .
<br /> Ftll;out epp8catlo�completely,
<br /> awner&Contractor stgn back•of appticaflon.notar(zati
<br /> tf'ove �2500,�Nottc�,of:;Commencemen4la required. _(A!C upgrades over S75q0),_ �;.: . _
<br /> .. 's:<�`��3=,t:;;,.r:,,:;: . ._. . : _ . ..�_. ,, , - -
<br /> Agent for�ia contracto�)'or�Power"of Attoiriey(foFthe:owner)would be someone with notarized letter tram owner authorizing sam�e , ,g
<br /> :;; � :w �,_ .ap,���.�r.,��..s;���.,,��;�.�;�--�
<br /> 'D_.VERTHECOUNT�R.P.ERMITT1Nti:._-- Front�/�p �L. ---- � „ .,,�u�'��,;:� ,.r���.+!:�: •" , k�
<br /> Retoofs If s Ingles Sewers 8r��.��_Fer�C��PIo urvey/Faotage) ,,.,:- -. . ��'� -.. �, _ ~ _ , :s-' -
<br /> .{: l�i, .. . � �2 y�,...., r. c� k�.rl '�'��li ,i�. -y _ ._
<br /> .:;.�`.- '--- .:�..._,.... `�_1 .�.. i� �.'{y xi:.?�f6�C+`s�.!``�-��st�n�S[ , `' ._- , tq . . -. . ..., _�,.,_ � .,
<br /> r q.;• *�4.f� ^ � fj �`��^ " I.. ,, ...
<br /> Drlve ays-Not over Caunter I�on'��ib�ia roac�weys.�ieed§.�Ca4�r ,�.,,� ?� « ;; _�� . _, '
<br /> �rq: r�! .rZ z�=�i,..� c��,., ,�''��;,,.:.,, ��
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<br /> xtc'y`CG;f�t-; C4 tt:'.:g'1.1i��fT4S�. ,-:.�u��' .:ji
<br /> `���� �a,�, �,rn!r�'.s'�L•Y�^•C�ti�'1't�[,a�;::'71. '•r:,. `,y4 _�:y,a,�,��=x:`;- .
<br /> d�''�'n"�."'���'a+��n�,�m�,. �'�
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