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<br /> a�aaeo•ao2o City of Zephyrhills Permit Applicatian Fax-a�aaaa-oo21
<br /> - ' r Building Department
<br /> Dat�Itecetve�d
<br /> ;f , Phons�Gantaet'for Permittin '�J`�r�' J�c�
<br /> Ownar's�tarne 17 : . . . G� g �
<br /> tiwrner Phone Ntumber t�f� 7�' T� r' '�t1 �
<br /> Owner'a l�:sldress �O�%� o r�/L �'�wrnerPhone Number � �
<br /> Fee Slmpi�Titlehalder Name•• � � i3wner phone Number _ �
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<br /> Fee Simpl�Titleholder Addresa ��� � -
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<br /> JOB�DRESS � �'�- LO'T#
<br /> sus�ivis�or� �i/it.�'o���z,d�u.� � P�c��.i�# 0_ � ��, , - . U�UQ• QCaI D
<br /> �(OBTAINED FRQM'PROPERTY TAX`NOTICE}
<br />` WORK PR��POS�D � , " � NEw CONSTR '` �' ADDJAI�T � S1GN 'Q Q DEMOLISH
<br /> ' ,. e INSTAI:L 8 � REPAIR `
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<br /> PROPOSE I( USE � SFi3 �] `COMM ` �� O'Cl1EF2
<br /> TYPE OF C,�N�TRWCTION., [,�` BLOCK�' 'Q FRAME � STEEL Q�
<br /> DESCRIPTION OF WORK V� r �,r" _ . �/
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<br /> BUiLDING$IZE-� �� $Q.FOO'TAGE�� , HEI�HT . ..
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<br /> QBUILDIFIC� � --�.�sYw:;w�v. �.�r',in. '' i
<br /> •VALUATION�F1TQ1'AL CONSTRUCTION
<br /> QE��ECTRICAI $ AMP SERVICE PROGRESS ENERGY W.F2.E.C.
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<br /> o�i�,��t�� �
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<br /> ; IUI��CHAht1EA� $ VA�UATtON OF M�GHJ�NlCAI INSTALlAT10N ��
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<br /> QGR�S Q ftOOFlNG-.,Q SPECIAITY�•�� OTHE#2� �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO � `K � �
<br /> � �� . . . �
<br /> �UiL.DEit � COE1i1Pi4t�1Y - -- - - - - - - - ._ - - - —-
<br /> SIGNNTUR� REGISTERED Y/ N �e CuttRen' , Y/.N - ,
<br /> Addre�� _ L:It�ense'#��-�_._ , I
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<br /> �t�CTF2tC1 „ CCiM�ANY
<br /> SIGPI�ATUIt��, ' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Ad¢Pe��� �_ '.License#�<l - I
<br /> PU1tV98E� I� tAWlP.ANY� . . ,
<br /> SIGPMATURE��' REGIS7EREpt ' -:,Y/�,�N � :FEE:CURRE� � Y/N:- '`
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<br /> I�1ddTe88 _ ' , , ..UC6�S6#'� �
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<br /> EWECF{�11+IICAia' _ � ,CQiV�P�4FtY _ ;,fi��
<br /> SIGN�0.TURE ' �C/C%���G�Z%��2�L''Z+C�/ REGIS7ERED` . .,-.:/ N . �,FEE'CURREtc tN�` � ,
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<br /> A�ddres�`' ' G-�`�' ' �� �" ,.License#�(, . ,
<br /> O'�NER : � : . . ' � GOi�lPANY .. . � ,
<br /> SIGWAYURE " - ' ' ` ' ' � REGIS7ERED Y/ N:., , ,.;FEE C.rURRE�" :,Y.�/,N-'_:; � -
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<br /> �ddre�s ,- �.-�: Y %,s; . . ... .� _ > . _ . . �License#��� �
<br /> - 'r�-` �:6��.,,..i 4:y�;.."r ^.t`., 6�•i5,• - '`4'2"';?_....t.. ..{.; .. , ' �
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<br /> �tE81DEF1�'.�`;=Attach�2;:P.,tot;�Ptaits�;:2��''set's=of�8uildln "Plans•: 1`.sef`of�Ene �Farms�'R-O-Vtt.�Permit:ficr.new.con"s#nictton;. .
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<br /> :.�Mi�imum.a.tens(�1Q)rworiting;days��aiter„subrrilttal�:date.�Requfred onsite;-.Constru'odon�Plans;.Stormwafer'Rlans.w/Slit Fence installed, .
<br /> Sanl4aiy�F..acjliti,es�&a9n�,umRster.,�SlteF-lNcr,Ic:�Per,mlY:fo �S �Preects�;;:�,'x;?r����:s'�^ _;�- � - , .
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<br /> COA�MERClAI. Attach(3)`t;cii�3ptete sefs'of`Bu�ililing Plans`ptus�a Life Safety Page;{1)set af Energy Farms.R t?-W Petmit far new canstructlon:
<br /> Minimum ten(1Q)wnrlcing days'after submittal date. Required onsite,Construction Pians,Stormwater Plans w/Sllt Fence installed;,
<br /> , Sar►ftary FadtfUes 8�1_dumpster.,Site Work.Permft�r aN.new�prcijeGt's:A!!commerclaGrequlrements must cneet comp8ance .
<br /> SlGN F�ERNilT� AttacFi(2j'sets of'Engi'neereci;Plat►s;,�k:;-�wr„�'- . . � � � �
<br /> i `"""PROP..ERTY.SURVEY:reguirec!_for aII,NEW;,construction.,,. , _ -
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<br /> D1(�ctlOriS: �� .:�l.r`.�,. ',T - -- - _. •
<br /> F(II out applicatlan completely.
<br /> Oinrner&Gcntractor slgn.back�of applEcatton,nota[ized
<br /> if over$2 00,a°Wottce af.Commencernent i$requlre.d. (AIC upgrades over 57500) � �
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<br /> ,>.;.,<_,�•,�i>��`.�'=: .,- „� :.. ....,...._... _ ..._.... - .
<br /> " Agent(for� e contractp�);Or.Pot�ei�of.Att6riiey(f ot�t t ie.owner)wau l d be someone wi t h no t a r i z e d le tter f rom owner au t ho�iz ing same
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<br /> 'D,Y,ER°THE"GACIN7ER.PERMiTTiNt�-- - -{Front.af•ApPllc,a�on Oniy) � .� �
<br /> Reroafs if shingles Sewars Serv(ca Upgrades A/C .Fences,(PIoUSurvey/Footage) , --
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<br /> DHveways�Not over Counter if on publlc roadways.:needs ROW �
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