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- 813-7 0-0020 City of Z�phyrhills Permit Applica#ion Fax-813-780-0021
<br /> 4• Bufiding Department
<br /> Date Recetved -f j� 1�p Phane Coatect for Permi�ting '' �) �f Z _ �t 2 C�.,
<br /> Qwner's Mam � ��a i ��2 r Owrner Phame Number ,
<br /> Owner's�Addr ss. �g p � �1'�cV e 2�'"��S;� Owrner Phane Number �/ Yf/ � �7'�J��J �
<br /> Fee Simple Ti lehoider tdame �� � Ovuner Phane fdumber �^ �
<br /> Fee Simple Ti leholder Address
<br /> JOB AUDREB 3�7 O�J ���f�1v z.��`� L 3�S"�`�Z_ L�T# [��
<br /> SUBDIVIStOPI � � PARCEL ID# 1'Z���'-2'�" �4 y0 �t����► .- �y `�
<br /> � (OBTAIIdED FROM PROPERTY TAX NOTICE)
<br /> WORK PRQP SED � IVEW CONS�R ADDIALT � SIGN Q Q DEMp1.ISH
<br /> e INSTALL 8 REPAIR
<br /> '' Pf20P.t}SED SE'- 0 SFR Q C4MM' �� OTHER�
<br /> - TYPE�OF CONSTRUGTIOiV - � BLOCK • Q FRAME � STEEL -Q .-
<br /> I � /�► �1 �t
<br /> DESCRIPTIOIV"OF WORK ` ��C7t7't" � `�L F-47�L'1 c L bes � �e� . �- S-����
<br /> � " - t c-�J�73z t C
<br /> BUIL`DIPIG`Si E �� �_ SQ FOOTAGE �_�D �.IiE1GHT
<br /> � OSU{ DING � ' �-J� � � VALUATION�OF'TOTAL CC7NSTRUCTiON
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<br /> [�EL C'FRIGAL r> � AMP BEFtVICE 'Q PROGRESS ENERGY Q W.R.E.C.
<br /> L
<br /> �PL �IBING � �_
<br /> QME FtANlCAC � � VALUATtON OF MECHANICAL.tNSTALiATtORt
<br /> QGA � � FtOOFl�I�S Q SPEClAE.TY �� OTHER
<br /> FINISHED.FL�JOR EGEVATIONS ��---�^� FLOOD ZONE AREA QYES , NO
<br /> BUILDER CO�liPAFiY
<br /> SIGN�4TURE REGI5TEREp Y/'N FEE GURRE� Y/N
<br /> Addres License# �� I
<br /> EL�c;tRic� ca�i�,�Y
<br /> SIGNATURE � ` REGISTERED Y/ N FEE CURRE� Y%N
<br /> �� ,, s
<br /> Addres Cicense.#.��__ � �
<br /> . PCUMBER,:; COMP�►tYY -
<br /> SIGNATURE r %REGISTERED- Y:•/ N- . �FEE GURRE� Y`/N
<br /> � :; :
<br /> �ddres , Liaense# � �
<br /> . � � �
<br /> N{ECHANIC x - CQMPANY
<br /> � .�SIGNATURE ' - REGISTERED Y/ iV FEE GURRE� Y/N
<br /> , , f, .- , .. ,
<br /> '�' - . .
<br /> Ad'dres - � ' " � � License# � �
<br /> �;",sa�r �
<br /> .�o�r����� _,:;��� �.,� .. .- �� co�n�aiu�r ���iE=c.�.e.it ���_ S . e�� ��.�.
<br /> � : ., �'
<br /> � -SIGNATURE:� : ' '� REGISTEREp Y�/ N FEE GURRE� Y/N ,
<br /> �,,<<;.,�,,
<br /> �►ddres - ;�.I�.� c ., e .� .,� L��1E 3.�� �License# ��� i32 9�/� �.
<br /> :,':RESIDENTI � `.� Attacfi..(2):Plot�=P}ans;�(2}'sefs-�of Building�P(ans;{1}set�of Eneigy,Forrris;'R,O-W Perrrrit foE new conshuctian, �
<br /> . �:.._, ' .. . , :
<br /> �� •Minimum';ten°,(1U)wo,rking;day,s aft`e'r.:subinittal-date. 'Required`bnsite;"ConsVuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> _,.. .. .. :, :
<br /> . ., - �;����;t.. .� :-::,.t.�....
<br /> ,.. .. � .
<br /> - .. 8ariftary;,F,a�til9ties»8��1adumpster,SEte:Wotk�Petmi#for,sutidi'visions/large pro�ects � .' . '� _ :_ '
<br /> �,,C�M�IERCI Attachw(2)''coriiptefe"sets�of Buitiiing`Ptans pius a Life Safety Page;(1)set of Energy Farms.R-O-W Permit far new constniction.
<br /> . Minimum ten(10),working days after submittal date. Required ansite,Cnnstruction Plans,Stormwater Plans w/Silt.Fence installed,:
<br /> r• ' Sari(tary FaaiEities 8�1 du'rnpstec.Site,Work Permlt for�all�new projects.All commercial reguirements must meet.comp]iance _
<br /> ,:�SIGN°PERM 1' Atfacli`(2)sets a,fi:Engineer�d Rlans:�-�. �� ."- � '
<br /> .^- ***"FROPERTY BURVEY.,required for aII.NEW canstruction.
<br /> :'=Ditections: �_> , , . ,
<br /> � Fill':out pplication complstely.
<br /> Owner Gontractor s9gn back of appitcaUon,notacized
<br /> If o"ver 2500,a�iotice of Commenc�ment is required. (A/C upgcac9es over$7500)
<br /> -"-_,P.�n^:���lY:�
<br /> • *" Agent(�`r�ttie°cbntractoc)�or Pawer`of Attomsy{fbr�ttie�owner)woutd-be sameone with notarized Istter from owner authorizing same
<br /> ::OVE�'t'HE. OUNTER�.PERMITtING._, (copy-of-contract-required)
<br /> = Reroofs if sh ngles Sewers Servlce Upgrades A/C Fences(P,lot/Survey/Faotage)
<br /> 'drlveways-Not over Counter if an public r6adways..needs ROW
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