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' � s�s=��o-ooza City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Bullding Qepartmen#
<br /> DfltB R9G@IVA{� ��0118=Cantactfor Per�ntttln � L5�„ —
<br /> Owner's Nam �/�G Q a'lcJtr°� Owner Phone Nurrtber /c'�r / �C1'" -Tf�
<br /> Owner's Add ss ��� l��Cf.�!/�/. L�.S� Owner Phone:Numher, � �
<br /> Fee Simple TlCleholder Name ( � � Owner Phane Number �� �
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<br /> Fee Simple TI leholde�r Addre�s °
<br /> JOBADQRES ��8't7�I /"`R/�l� a�G LOT# �_�,_�
<br /> sugo�v�stow lit�A-�N ei��2av e�� PARCEL ID# l� o�� �/ G� 1C1 �1.,��L� D�cS�'C3
<br /> s (QBTAINED FROM PROPERTYTAX NOTICE)
<br /> WBRK PROP�SED =tv�w CONSTa ADD/A�T � SiGN� �C] � DEMO�ISH
<br /> ��e; INSTALL REPAIR
<br /> PROPOSED? SE Q SFR Q COMM � -t3THER
<br /> TYPE OF CO STRUCTION � Q � BI,OCK " Q FRAME � STEEC C]
<br /> DESCRIPTIO OF WORK } � 6 � lc�e �D �$�/Q lf !l c,�[ 10'� /�/1,,,�
<br /> BUILDtNG SI E r� �' SQ�FOOTAGE�� . .H�IGHT�-��,�
<br /> ���� ���' (' ' � VALUATiON�OF TOTAL CONSTRUC'1'ION
<br /> �J
<br /> QE� CTRiCA� � �$ ' � AMP SERVICE Q PRfOGRESS ENERGY Q W.R.E.C.
<br /> �.�
<br /> QPL MSING �� '
<br /> QME�HANtCfU. ($�� ' ��� VALUATION OF'MECHANtCAt�INS7A1.1.,9Tlt3N
<br /> " �1��0 r.� .
<br /> QGA [� RpOFif+tG .Q SPECIALTY � OTHER� -
<br /> FINISHED FL OR ELEVATIONS ��� FLOOD ZONE AREA C]YES ,NO
<br /> BUIl.DER COMPANY . , '
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address L'lcense# �� ��
<br /> . � . -,. .,. �
<br /> ELECTRlCI_ GOMPANY - �
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURREk� Y/N
<br /> Adcire$s ,. , License,#.�- . � �
<br /> PLUMB�R GOMRANY � ..
<br /> SIGNATURE , ,REGIS.7ERED Y.I.N F.EE CURREk Y�/N. �
<br /> Addsess ..License,# � �,� I
<br /> MECtfANIGA� �+ ~ e COMPANY. R qS � - '�' �
<br /> SIGNATURE ' ��� REGISTERED Y.,/ N FEE CURRE�— Y/�N
<br /> Addrss$°`> I .;7�` f�`�1 enJ-- �"�/Ll..'�`� � License# �����_� T D I
<br /> OTHER � � - . ��GQ1411PANY ,
<br /> SIGNATURE � ": `+ ' `-` ' ' "REGISTERED� ' Y/ N.,. FEE CURRE�• Y/N
<br /> Address G -" `f' ' � ' s Ciceiise#•1 1 �
<br /> RE8lDENi7 ' :.-A#taioti'{2).Rtot�Plai�s;,(2}seEs�.6�+Builiiirig`}?lans;'�(9}sef afi Enetgy�Fo'rin's;:�R-0=W`Perinit far new c�r�struction, , � �
<br /> .: „ � .. ,
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<br /> �;_Minimum;ten;_(:10)warking;days„after subr`riittal'date::,Required onsife;�ConstrucBon-Pians;Stormwate�"Plans w/Slit Fence instaped, _
<br /> � Santtary FaGltUes;&1.,dumpster5lte�Work Fermikforsubdivisionsllarge�projebts," ,_ `.<; ` ` � '
<br /> COMMERCt Aftach{3)`comptete'sets�of Bsiltding Plans plos a��ife Safefy Page;(1}set of Energy Farms.R-O W Permtt for ne�v construct3on.
<br /> Minlmum ten(10)warking days afker submittal date. Requlred onsfte,CanstrucNon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FacflfUes&1 dumpster.Site Work Permlt far all new;proJects:.All commercfai requlrements_must meet compllance
<br /> , SI�N pERtVI! At#adi"(2)sets ofEiigiiieered;Plans.: �;.$."' . � _ - � -
<br /> ""PROPERTY SURVEY reguired for all._NEW constructlon..
<br /> ' Dlrectloas: ` ,- , - - � ' �
<br /> Ff0 aut a plicatlon completely.
<br /> Owner 8�Contractor slgn back of applicaHon,notarized
<br /> If over�504.a Not3ce af Cammencement Is regairad. (A!C upgrades over 57600) ;
<br /> .. •`.;����.: �.-
<br /> � Agent(f r the�contractor)'or Power ofAtfomey'(for the owner)wauld be�someone with notarized latter from owner autharizing same .
<br /> DVER Tt1E COUAI7ER PERMi771NG._ ._-{Front-af Applicatlon Only}.
<br /> � � u'.�'i+.o '��...#,k:s
<br /> ', Reroofs if shingles Sew�na�����-Seniice'Gpgrades`�A/�"" Fences�(PIoUSurvey/Fookage) ,
<br /> �.l::'-�'t�,`:,.� i, � , ,/^ ;, ., t, ��54i1�f�s'�Sil�'ni:.Rn�k'�'`.m:'riYway."14,,�.�°asa�.cd4".%.c+u..�`
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<br /> Drivewa -Not aver Coynter�ifori publlc madways::nseds ROW` � � � '`� ¢'"� '` .. , ` ' ��
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