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<br /> ., s��Tao-oo�o City af Zephyrhills Permit Application Fax-813-�8o-oaz�
<br /> ' Bu[lding Department
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<br /> Date Eteau4iv�tl �� Phane•Can�ct.for�Ferrnittin � � �'. t b� _ ���� �
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<br /> Ownef'a Nanie //�J �('L� e-/�,'G/�,,'�j L Owner Pbone Number f�'- c�i 5-' I I� r
<br /> Owner's Add'ress ����� �'��'/UlneG�� �/Q Ow�er Phane Number
<br /> Fee Simple Tdklefiolder,Name � � � Owrn�r Phone'Number '�� � �
<br /> Fee Stmple Titleholder Address
<br /> JOBAbDRESS `�3�� �-Reen.lme OL� , "# LOT# �__��
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<br /> SUBDiViSiON � ' � PARCELIDO� �,J o� cX��� � !�/���. Qf
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED j�NEW CONSTR . ADA/A�T ' � SIGN Q Q DEMOLISH
<br /> �-e, INSTALL �REPAIR � ' '
<br /> PROP4SED:UjSE [� SFF2 Q `GOMM � •t?THER
<br /> TYPE QF CONSTRUCTION � Q BLOCK " �] FRAME ' [� STEE� Q '
<br /> DESCRIPTION OF WQRK � /7`C C-�`/4/1� B'"D LL7" - a �"r� � 1/'+�i � ,� ��7'7Y7 13��.'.N��
<br /> BUIlDING St2E ,� � SQ FOOi'AGE C� .,HEIGHT .��
<br /> QBUt�D1�IG � „��������.,_,. , = � i
<br /> I , VALUATiOhIMt)F`TOTA�CONS'fRG1GTiOW
<br /> QE�ECTRiGA� $ ' AMP SERVICE Q PRtJGRESS ENERGY Q W.R.E.C.
<br /> oP���B��� :C.. � _
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<br /> �MECHANICAL $ �arJ�-� �� VALUATtONQF'MECHANICAL.INSTALlAT1E}N ;
<br /> QGAS Q Rt7QFiNG .Q SPECIAI.TY � QTHER� �
<br /> FINISHED FL1QOR ELEVATIONS �� FI.00D ZONE AREA QYES NO
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<br /> BUICDER � CONlPANY�
<br /> $IGNATURE' REGISTERED Y/ N FEE CURREP Y/N" i
<br /> Address • Ctcense# � �
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<br /> ! ���cr��c�ai�4 - , , �cor��,va}r � ' ,
<br /> , SIGNATURE i � REGIS7ERED Y/ N FEE CURREk-� ' �Y/-N
<br /> Address � ' � , �- License#_ � '
<br /> P�llMBER '. ��� ' ..C,O�dtRANY .. � `�
<br /> SIGNATURE , .,REGIS.1'ERED Y./,N ,FEE CURRE� Y•/N
<br /> Addres� llcense,# �- ��
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<br /> �i MECHAN1CAi. COMPANlt ����� l� .�Jv� 5��"/� �
<br /> � L�'7t.F. `�-,a�`��it.�e�-e-C_-� .
<br /> SIGNATURE; � �EGiS7ERED .Y,./ N . . FEE CURRE� Y/�N . ,
<br /> , Aa��s� . = �t � 1 � ��'d� 2�HJtt�' � ��. License#�I �'��""� ��� T U I
<br /> ' 03FIER ;, . - ` ' . ;GOM,PANY ' .
<br /> ' SIGNATURE' •. '"�`- �'' ' `� � � ' " 'REGISTERED� '' ' Y/ N:, 'FEE CURRE� Y/N
<br /> Address{ .," �. _ �,,',,� ,,� , ` ' Ucense# �� i
<br /> ` - - ' � � -.. ,. _� $_,,.: . ,.- ,R . ..
<br /> RESIDENTlA#,�,.; _-Aftacti,-{2),Plo#�Plan's�:.{2)setsoE�Bulliling�Plaits;�(1)�setofErieigy�Fqirns;�R-O-W`Permltfttrnewconstruation,
<br /> - ' �� Mtnimum,ten�(�1,0);working;days`after�;submlEtalila#e:�:Required onsife,:ConstiuoBon�Pians;-Stortnwater Pians w/Stit Fence installed,
<br /> j�""� Santtary Facl�lldes�&�1;dumpster,SIte�Work;Permit for_subtlivislons/large;proJects..� ;;:;:�. �
<br /> COlV�MERCIAl. Attach{3)c+or�iplete sets of Biitl�iag Plaiis pliis a'1.1€e'Safetj/Page;'('f}sei af Energy Fomts.R-Q W Permtt for neuv coristructian. �
<br /> � Minfmum ten(10)working days after submitt�al date. Required onsite,Constructlan Pians,Stortnwater Plans w/SUt Fence installed, ,
<br /> Sanitary Facilitles 8�1 dumpster.Site Work Permik for ail newprojects.All commerc(al requirements.must meet campllance �
<br /> StGN PERMlT Attacti{2)"sats ofEngiiieered-Piaiis.< <.t �; F ., _ �-�„
<br /> I �� ""*PROPERTY SURVEY required for al,l NEW constructlon. � �
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<br /> DI�BCi..lOA8: i .
<br /> FIII out a�pltcaUon wmpletely. �
<br /> � Owr�er&�ContraaMr slgn back of applEcatlon,notarized ,
<br /> if over�2500,a Notics,of Comme�cement is required. (AtC apgrsdes over;7500}
<br /> I _::.�::;,>:,;y;�:<��;." . _ . �� .
<br /> '" Agent(fo�the contractor)or'PoYue�of"Attomey(°��tFie owner)`vvould be someone with�notarized letter from owner authorizing same
<br /> dVER TtiE CQUNTER:PSRMt'i�#N�'s�-'�i�.{��'of�7�ip¢tfcatibr��F3ni"y}h���:°..� � ,s�3� �'-=�
<br /> Reroofs if shingles Sewers�� SerGic:e�Upgrai�'es'A/C .Fences•.(PI¢nt/Survey/Footage) � �1'9fs� �;• ,'°-'"""`, �
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<br /> Drtvewraye-NotoverGount�tlforipub�icroadurays::nt�eds`ROVN�;;�; p; �f� t��3� t-r �,,+ ��3�ty::7 r;;,:t`�','%t?; '�.,,,��, �
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