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s�s-�eo-ao�o � �City af Zephyrhills Permit Application Fax 813-T80-QQ21
<br /> � . SuHding Department .
<br /> Dats Race4ve ' . . � F?hane•Cantact for.Permiftin �� �r� — �� L�
<br /> Owner'a Namd� Q-!Y1 E Owner Phone Number o��-� ���Z.'�/��
<br /> Owner's Add�sss �o�J'r/ f�� ��. - /L �S Ow�er Phone Number �� �
<br /> Fee Slmple Tltleholder Name � � � Owner Phone Number �� -
<br /> .;� '
<br /> Fee Slmpte TI leholder Address °
<br /> JOB ADDREB� � / �� � �•t ~ L r�.
<br /> r�� .,,, � /L �" /�"'� LOT# ��
<br /> SUBDIVISIO � � PARCEI.tD# �l � �I �C3I� l�?j}r �
<br /> , , (OBTAINED F.RdM PROPBRTYTAX NOTICE)
<br /> WORK PFtOP SEQ �NEw CONSTR' ADDlA[.T C� S1Gt+f Q- C] pEMO1:iSH
<br /> �_e. INSTALL � • REPAIR �
<br /> PRQPOSED: SE Q SFR � `COMM � OTHER .
<br /> TYPE OF CO STRUCTION - Q"` `BLOCK ' [� FRAME �] 'STEEL Q
<br /> DESGRIPTIQ OFWORK' „ �Cd �1.�77'7E.. �lYl�l.�e � e ZQL"�ZyC1G5?Z. fI/I' LE/'1 L •f—'
<br /> BUtlDING S! E �� ` � SQ FOOTAGE�� . „HEIGHT����
<br /> QBUt1.dING �� Vp��ATtON:{3F 7'OTA4.CONSTRUGTIi�N.., ,
<br /> QEL. CTRiGAl. �$ �~ , ' � AMP SERVECE Q Pf20GRESS ENERGY Q W.E2.E.C.
<br /> �_�...
<br /> QPL�MBING �6� ,
<br /> QME NANIGAL $ �,���.. �� VALUATIQNQF=MEGHANICAtlN$TALLATipN-
<br /> QGA Q RQOFlNG Q SPEGtALTY ['� OTHER= `
<br /> FINISHED FL OR ELEVATIONS �� FLOOD 2pNE AREA [,�]YES NO
<br /> BUIl.DER COMPANY'
<br /> SiGNATURE REGI3TERED Y/ N FEE CURREP Y/N
<br /> Addre�s � � - - Llcense# �� �
<br /> ElEC7'RIC . : ..'COMPANY� " • _
<br /> StGNqTURE "' REGISTERED Y/ N FEE'CURRE��•� 'Y/N
<br /> Address ;. - . .- . LEcense#.( -. . .�
<br /> PLUMB£R' CONIPANY �
<br /> StGNATURE , ; ,REGIS.TERED Y./,.N•. ` FEECURREn " Y•/N • '
<br /> ���� � ..Cicanse# �� 4�
<br /> StG ATURE• �'����{1��h-' , GOMPA�IY R�/�R.S. ._ {'� f�;/t�L�T�fi"''lC�(,�
<br /> REGISTERED Y./ N . , .FEE CURREA Y/�N
<br /> t;
<br /> �a�« � �y��! �-tl���E��- �-���,cs e�,��'S l � � ����Ss#� ���3�� ^�
<br /> :� . . -
<br /> OTHER ' � � � � ` ';COMPRNY
<br /> SiGNATURE �_ � '��� ' � • ` ' ' ' ' REGISTERED Y/ N,,. FEE CURRE� Y/N
<br /> Addf6• ,' � , .. °a . . t . ClCetf56#'� �
<br /> RESIDENTI,. ', � -Altacti;{2},�Ploti P;laiis;,(2)sets�_of Bu�lding�Fians;(1)seE of-Eeergy�Faims;�R=O�W'Peririit tor new c;bnstructiari, -
<br /> �_.Minimum.ten;{1,0);woricing;,deys aiter"�submifEai`date.�:Requlred onsite;<Constiuc8on Piens;Stortnwater Plans w!Stit Fence�instailed,
<br /> Santtary Faclllties�.&1;dumpster;SlXe;W.,o,r1c,,Permit[or subdivisionsAarge;pro)ect�i. ' -
<br /> COMM�RG Attach(3)ciiinpiete'sets''of BuHdfng`Pians`piiis a l.ife Safetjr Page;{'f}set of Energy Forms.R-t)-W Permtt#or nevii cans#nsctlon.
<br /> � Minimum ten(10}working days'afker submitta�.date. Required onsite,CansUucUan Plans,Stormwater Plans w/Silt Fence installed, _
<br /> � SentMary Facflitles&1 dumpster.Site Work Pertnit for all new'projecfs.All commerclal requlrements_must meet compllanbe�"=`� �
<br /> Sl�N.PERMI Attacti"(2)sets�of�Engliseereci;Rlans.;,:�.�:K e, �, _ . . • .
<br /> "•"PROPERTY SURVEY required_for aii_WEW construc.t�on.,_ . � ,
<br /> Dlresttons: � . - '
<br /> F(Ii out a piicatlon completely.
<br /> Owner 8 Contractor sign back of applicatlon,nota�ized ,
<br /> tf aver 500,a Noticc�of Commencament 1�requ�red. {A!C apgrade�over S75fl0}
<br /> �, ��'�.�.�.-.�,< . .. . �
<br /> MY� �s.� .
<br /> Agent(f r the contractor)or Powe�of74ttor►iey(far tiie�owner)would be someone with notarized letter irom owner autha�izing same
<br /> dVER THE C UNTEtt:PEEtMiT-"iiEiG� ��,�;�Ri��a#�n,r�t1Y�,�.���s,r
<br /> k' ��=r��s#�"�nc�4`�as�il�;rs4��
<br /> Reroofs if shi les Sewers rvice ra '.v? � ; w cr, � +:sw^ ,,;:���•:,
<br /> 9 .sUpj d8� �C3,i � Fences.(PIoUSurv�y/Foota9e) ..�'(3. tA:. ��`1f,. G .� :,.
<br /> M 'i'•�.,�.,`,�r,� .�
<br /> :........ ...... libt'•.ti�i 4C`?il�el�}` _;i,+lU!��l;';F.i�l�i 'rL�,`,��=:i� '�,1�,j ��iilriE�t�.l qtsiC- .u'=;;�5 }�S61C�:� far"-w �. .
<br /> Drlvewa -Not aver Coun#er tf an 'ubi�roadwa .;needs ROW�,^. --;+{,�, _ � t• �,t; C � y; . �. ,t*,f',;.">'�`
<br /> � �. �� ,�,���j` s i i_� . �.i<2 2i1; �`:4ii�.. %r� �+rc A�
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<br /> 3.d.. .4a"1Gv �i�'137}0�,1�•SJ.�i��+� � fti,
<br /> . �p6i+�$��^�`�`�.�°'w��� �$^.��td�
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