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<br /> a�s-�eaaozo City af Zephyrhills Permit Application Fax-813-780-il021 �
<br /> ;; ���, . Building Department
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<br /> Date Received 4 . � phone-Contactfor�Perrrilttin - � !
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<br /> Owner's Name;I e �- vv l/�. �° � t3wner Phone Number
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<br /> Owner's Address �� �U O�3�� J '� � � Qwner PFione Number �� M1� '
<br /> Fee Simple Titl�h'older Name � ,���3J���' �� Owri�r Phone Number �� —1
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<br /> Fee Stmpte TI�holder Address � �
<br /> JQB AbDRESS !:' � �'`� LOT# �_„�,� �
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<br /> SUBDIViS10N � , � PARCEi.ld# ��� 4 "-���.�t-��� �� '
<br /> , „ �. . , . (OBTAlNED FRQM PROPERTY TAX NOTfGE) �
<br /> WOEtK PR�4P��O t s��w�coNsfa . ADDtA�T � S1GId'� [�- � DEMOLfSH ,
<br /> •e_ INSTALL 8� ;;>.REPi41R "
<br /> PROPOSED;U58 . � Q SFR• � "COMM �OTWER �
<br /> TYPE QF CONS7'RUCTION - Q� ` BLOCK ' Q FRAME ` S7EEC Q
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<br /> DESCRIP110 OF WORK C�� t/ �/�%J l (�j' � ��
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<br /> Bt1tLDINt3 SlZi � ' �� S4�FC30TAGE ' . . ..HEIGFIT� - ��
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<br /> QBUIl�DlNG $ ' VALUATION�t�F�'f01'ALCONS'fi2t1CTIQiN ' a
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<br /> �ELE�TRIGAl: $ " � : AMP SERVICE. Q �PROGRESS ENERGY C] W.R.E.C, i
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<br /> [�PLUMBING $ ' �
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<br /> ECHi4NICAL $ VALUATIqfd OF'MECHANICAL INSTAUATION: " �� � '
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<br /> [�cAs , Q ROOFWG [� 3PECIAI.TY..� OTHER� � • ' V� � �
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<br /> FINISHED FLOOR EI.EVATIQNS FLOOD ZONE AREA [�YES ;NO _
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<br /> BUILDER COMPANY'
<br /> SIGNATURE REGISTERED Y/ N FEE CURREh Y/N i
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<br /> i4ddress ; Cicense# � ��
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<br /> E�.ECTltiCiAtV.- • 'COMPANY� � .
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURRE�a "Y/•N
<br /> Add�es � , , � . lEC8DS8# � + �
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<br /> P�UNIBER ' , � C.OMP,APIY-; ~ . � '
<br /> SIGNATURE" ' ` _ ,REGISTERED. � Y�I�-N.; ��. .;FEECURREN ' Y/N. �
<br /> Adtires� _ Licerzse.# 1:-. - . --�
<br /> MECl�IAANlC'N!.` � COMPANY /�'"7. (/G.ir.r / '
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<br /> SIGNATURE � ' RE(iISTERED �� , Y_! N F�E CuwtE�. Y/N
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<br /> AddPe���' � ` , . . ,. .
<br /> `' Ltcense# �-. `�/�s�� � 2' ,
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<br /> OTHER „, ;` _ . . . . � . ;COMPAt!IY � � � � i
<br /> SIGNATUR�� .::- "?_' " •r'' � ` ' " � �'REGISTERED ` Y/ N.., 'FEE CURREI�• Y Y/N
<br /> Address �,� . . � _ � ��� , - '- • ,� Udense#`� ��
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<br /> „h,.. .,:.-y=' " R,�,r,.;s�,..:. �* .
<br /> RESIDENTIAL;_'-�Atfacfi'(2)Plot�Plari5;..(2)'sets.of;Building'Plans;(1)�'sef af<EnergytFoims;^R=O-VV�Pemilt for new construcUon,
<br /> ,. Mintmumaten�(10):uva,rking;days.�afte�„submitEai dater.�Required onsite,:Consfiucdon'Plans`rStartnwate�`Pians�ni!Silt_Fence�instalted,_ __
<br /> ..� ::`:.��;���,=M�.N n... ,,.-. . , • - -�____- -
<br /> � Sanitary Faciifties;&�'I,;dumpster,Slte°Work�Permit;ipr"subtl�vlslonstlarge prc5jects;;;:.;,:�`` � -. ,� ,
<br /> CONlMERCIAL Attach{3)'e6mplete'sets`of 8uildirig Plan"s plus a Life$'afefy Page;�(1)set of Energy'Forms.R-O-W Permit for new construction.
<br /> � Minimum ten(10)waticing days after submtttal date. Required onsite,Constructlon Plans,Stortnwater Pians w/Sil#Fance instailed,
<br /> Sanitary Factii#es&1 dumpster.Site Work Permit for ali nevu pmjects:,,0.11 cammerciaf requtrements.must meet compltance �
<br /> SlGN PERM�T AttsrrFii'(2)'sats of`Engi►ieereii:l?lans:.;-,.a>�=.,, ,.:.�.. x ..�,, . ` ;
<br /> "•`•PROPERTY SURVEY r�qulred far.aU NEW consWction._
<br /> M����Qn�.4 r: -I...>-.1,4i...�. ; ,
<br /> Fill aut�application completely.
<br /> Owner�&Contractor sign back af applicatlo�,natarized
<br /> If ovsr�2500.a Notice af Cammencement is required. (AfC apgrades over i750Qa
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<br /> '• Agent{for the�i�ntractor)or Powe�6f Attariiey(for tti�r owner}wouCd be somaone with notarized lelter from owner suthortzing same j
<br /> pVER THE;COUNTER PERMfTfiNG- �- (Front of�RppiicaBan Onfy)- - ' � i
<br /> Rera6fs!f shingles 8ewers Servlce Upgrades A/C Fences(PIot/SurveylFaotage) ;
<br /> Drivew�ys•Nat over Counter if an pubiic roadudays:.�eed's RC11N � i
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