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<br /> 813-�eo-oozo City af Zephyrhills Permit Application Fax 813-780-0021
<br /> , Buitding Department
<br /> Date Recetved : :Phane�Contact for��e��n �a t��a"'�'—��� {
<br /> Owner's Nam I 0�'�C�L Owner Phaoe Number
<br /> Owner's Addr ss �� D� � "'e V�-�� Ownar Phone Number � �
<br /> Fee Simple TI leholder Name � � � Owner Phone Number � �
<br /> � .
<br /> Fee Stmple Ti leholder Address '
<br /> J08 AbDRES �� � � � � �CI Y��LR.��i � 3� LOT# ��
<br /> suao�vrs�or� �- � " PARCEL!p� 1 �'2�Ce-a.t---�r�-�y 5�c� —c�o�S
<br /> _ - , . � (QBTAINED F,ROM PROPER7YTAX NOTICE)
<br /> WORK PROP� ED -,NEW C4NSTR AD�lALT � SIGN' 'Q �Q DEMO�ISH
<br /> � .�. INSTALL �� - REPAIR "
<br /> PROPQSED� SE Q SFR Q -COMM � OTHEF2 .
<br /> TYPE OF CO STRUCTION Q ' BI.00K " [� FRAME � STEEL. Q
<br /> DESCRiPT10 8F WORK �t/i�..� Ct,�-� �•
<br /> BUElDING St �� � SQ FOOTAGE���� ; . HEIGHT����_�
<br /> .:, �,
<br /> ��U� �»C' � C" VAIlfAT10N�G1F TOTAL CONSI'F2UG1'ION `
<br /> �;�� '-
<br /> QEl CTRICAL `� ' � AMP BERViCE Q PROt"aFtESS EI�tERGY Q W.R.E.C.
<br /> QPL MSING $�'�� ��� ' � / ,
<br /> L ��,
<br /> Q ME�NANICAI. $ ` � VALUATtON OF'MECHANtCA�lNSTRLLATit?N
<br /> � (�
<br /> C]GA Q ROOFING Q _ SPECIAL'tY �] OTHER� �� 't�� i
<br /> ./ ;
<br /> FINISHED FL�OR ELEVATIONS ��� FLOOD 20NE AREA QYES NO
<br /> BUttDER ,� � �j� , f��� .��-,�, COMAJ0.NY� �G. U�--�-�. `��-�7����� ��"
<br /> SIGNATURE �M� (� ��"' � REGISTERED Y/ N . FeE cuaREn Y/N'
<br /> Address Cicense# � � �
<br /> EtECTRlC ._ : , 'COMPAlZY' _ , -
<br /> SIGNATURE �" REGISTERED Y/ N FEE'CURRE�`' � Y/N
<br /> Acidress . .. License# �� ' �
<br /> PLUMBER � GOMP.ANY � : �
<br /> SIGNA7URE' `�' REGISTERED Y-/,�N,; . FEE CURRE� ' Y/N.
<br /> Address ` � License,# �� . �.
<br /> MEGHANIG'._ ' � r GOMPANY.
<br /> SIGNATURE ' � ' '" � `� REGIS7ERED ^',. Y,/ N , � FEE CURRE� Y/�N :
<br /> Addre�s - • , ,- . ` ' _ � � � ' license# C _ I
<br /> OTHER ,:' r {.�., ��-h��'l �,GQN'IPAkY ��...� ���-t 'E'�.1�tZ.t�c..E`1CS�2 c�
<br /> �,.,.r, ,.r,. ,,
<br /> $tGNA1URE �. '' ` ` ' REG1STERED ' Y J Nk.. FEE CUR E�•_ Y/N
<br /> Address �a' { � - � ,J' � - � �lcense#'1 �
<br /> �::: �
<br /> R�3lREN'i'IAt�. -°AttactiW(2)tRlotP..fan"s;.:{2}sets•of;Biitiiling�Ptari's;{1}seFof'Eriergy=Foims;��F2;0=W�Permttfarnewconstrttction,
<br /> _;_;Mini,mum�ten�(1.0}•wworicing;tSays,sftet;subm�titai date:.Reqi,tlred onsite;:Go`n'siruc8c►i�Rlans;'Stortnwater'Pians w''/Silt Fence instailed,
<br /> �Senitery�Faciltdess&,,1;;dumpste,r;�Site°Wo,r,k,Permit tor subdivislo�s/large pro)ects:.__r.` -� ' ' �
<br /> COMMERCi Attac�{3)coiesplets sets'iif Bultill'og Plaris plu`s a E..ife Safety!'agei;{1}set of Energy Fomts.R-O W Perm(##or new canstructton,
<br /> Mintmum ten(10)woricing days afker submittal date. Required onsite,CansUuctian Pians,Stortnwater Plans w/Siit Fence installed,
<br /> Sanitary Faailides&1 dumpster.Site Work Permik for all new project's.All commerGal requirements.must meek complience
<br /> SIGN PERM! Attacti"(2)se�s of�Englnesr.ed=Pians. _ "�; � �.- -
<br /> "'"PROPERTY SURVEY required for ail_NEW_canstruction.,
<br /> Dtrecttans: . . �- -
<br /> Fiil out ap�pUcadon compietely. z�` ' ; '
<br /> Owner 8 ntractor sign back of appltcaUon,notarized
<br /> If over Q0.a Notice of Commencerttent Es required. {A/G upgrades aver 57540}
<br /> "* Agent(fot the contraotor)'"or Power of Attorimey(for tFie owner)�would be sameone with notarized letter from owner authorizing same
<br /> t�VER'TFiE Ct1UNTER PSRMi7'tlNG... {Front of-ApPltcatton On1y)— , `
<br /> Reroofs if shingIles Sewens Servlce Upgrades A/C Fences(PlodSurvey/Footage)
<br /> Drivsway�s-Not aver CouMer if on pubilc roadways..rieads ROW � '
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