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813-Tao-oozo City of Zephyrhills Permit Application Fax-813-780•Op21
<br /> ' sul�a�ng Department
<br /> DateReceived .P..honeACantactfor�PermttNe GO� - ��L
<br /> � �
<br /> O+++rner's Name F7 /2 l G-L.� � Owner Phone Number �aa� ✓ �J�'��3cr�'
<br /> Owner's Addeeas ��� � ��r,7�- ElQr1 �f--� Owner Phone Number �
<br /> Fee Simple Yltlefiolder Name � � � Owner Phane Number � �
<br /> � 'z ,
<br /> Fee Simple Titleholder Address ' ,
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<br /> JOB ADDRESS (.�'��� �R /!/ � t_..- LOT# C�
<br /> SUBDiViSlO� �1��lLG• /��1�• f t/✓_-_�� FARCEi,ID# p� � �1 ��'����� ade�
<br /> 1 , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORKPROPOSED ��.NEwCONSTR ADDtA1.T � SIGN �[� [� DEMOI.ISH
<br /> ' e. INSTALL � �REPAIR � '
<br /> PRQR05ED�USE Q SFR� [,� `C{)MM '[� OTHER '
<br /> TYPE OF CONSTRUCTION� - •Q' ' BLOCK " [� FRAME �� STEEI: Q
<br /> ! p �-
<br /> QESCRIPTION OF WORK � �C Cs1ff E- G�l..� , � �,/l� � l�� �� lU�
<br /> BUtLDING S!�E .�� �" SQ�FOOTAGE�_� ` ..HEIGHT` {,
<br /> QSUI�DtNG � � VALUATIONVCIF 7'OTAL COt�ST`RUC`t'ION y ` " '
<br /> QEIECTRiCAI. $ ' M AMP SERVlC� Q PROGRESS ENERGY Q W.Ft.E.C.
<br /> QPLUMBlNC, '
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<br /> � ,. , „..,, � �(�
<br /> QMECHANtCAL $ ' VALUATlOIV OF MECHfWtCAI.INSTALLATiQN !���` ��(•��✓`
<br /> � ���i � G'
<br /> QGAS Q RQOFING Q SPECIAt.7Y [;� = OTNER
<br /> FINISHED F1.00R ELEVATIONS FI.00D ZONE AREA QYES NO ���� ��
<br /> � — • � ; ,. •. _ -
<br /> Btlil.D�tt COMPAt�IY . .
<br /> SIGNA7URE REGISTERED Y/ N FeE cUR�n ,Y/N
<br /> Addre�� � � • iicanse# � I
<br /> E�ECTRiC i: , , `;COMPAR�IY �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�'- ' `Y/N
<br /> � � . - . � , ll nse# �
<br /> Address .. , ce i
<br /> PLUMBER _ COMFANY , , � °
<br /> SIGNATURE' `'` , ;REGISTERED Y/ N� � FEE CURRE� '" Y-/N
<br /> Addressi � � Licens.,e,# �...- �
<br /> MECHRNICAL ,,, � � � CCIMPAFlY S. l`O ,9- "f" Gi�-�ll�� .
<br /> SIGNATURE�j � � „ REGISTERED Y../ N . , , FEECURREP Y,/sN -
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<br /> Address�}' - � / �iil �� ;��{1LlS � _ � Ltcense# �i� �'�l'�� 1
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<br /> OTHER ::�: _. ; _ -` _ � � _ , 5_ `.'CO,NIP1iR�1Y , - ..,.
<br /> SIGNA7URE:� "<r :`-"=' '�� ��-' '`°� ` ` � ' �` `REGIS7ERED � ' ' Y/ N1.� FEE CURRE� . Y/N
<br /> Addres� , , - : ' . �, : ' �� - Gcense# � �
<br /> -..�,,. ..,;... _ � �.y.__,•; ,-: ,. .., ' � .. , . „� . .
<br /> RESlQENTFIU:,;,,-;Attacfi;{2}.Ftot�P.laiis;�:{2}sets�.of�Building7Plans;(1}'seE of'Eriergy�Faiin"s;�R=O=W`Peririit for new consttuction,
<br /> - '�• ,::.Minimumeken4(�1,0),Fworicing;days`afler;subi'ni$al'date:s:Requlred onsite,;Cbnstrucd"on'Plans;'Stormwate�'Plans w/Silt Fence instailed, -
<br /> (j�'�+��Sanitary FaGlttles;&�1�,dumpste_r,=51te;Work,,Permlt for.s,ubdiyislon's/large':.proJebts-,,-_-':.:r ,. ' .
<br /> COMMERCIAL At#ach{3)"•coinplete`sefs`of BiilEding"Plans pliis a t.lfe Safeilyr��Page;{1}set of Energy Fcrsns.R-O W Permit far nev+i canstructton:
<br /> � Mintmum ten(10)working days ai#er submfttal date. Required ansite,Construction Plans,Stormwater Plans w/Siit Fence installed,
<br /> Sanitary Facilitles&1 dumpster.51te Work Permit�for all nevu:proJecfs.All comm�rGal requlrements must meet compllance �
<br /> S1GH PERM1� Attacfi"{2}sets of�Engineei.r,ed"PEans., �:..,^-:� � ._ _ .-�
<br /> "'"PROPERTY SURVEY reyuirecl for all wNEW constructlon.
<br /> Dicacttons: ' , �i,:,s, . , • , ,
<br /> Fill out applicaUon completely. �
<br /> Owner S�Contractor sign back of applfcaHon,natarized
<br /> if over 1��500,a Notice af Camms�cemerrt is required. {AtC apgrades avar S75QQj
<br /> " Agent(for the contractor)'or Povue'r of Attamey(fur tFie�owner).woul'dtbe someone with notarized letter from owner authorizing same
<br /> it...�uz ,w'r'�.<+�«��Zr.z.-,ra�-it , .. r.
<br /> DVER THE COUN'fER,PERh�i�tT11�`� ,.t�r�(,ro�Appllcation:,Qt�ly)_�a,. _ t�
<br /> Reroofs if shingies Se`�vers. ' �;�,�,�ice,UPgrad�s,A!C`;�;��F+�c�(PlodSurvey/Footage) �_�h � .�all R •
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<br /> Drivswaya-t�tat over�un�e�(f or��Sutili�►aa�tuv�y,s..needs��t�7.,�;`� � , � r'C��-. ° " ,
<br /> (i,.^,��r I f C !l � � �..., 'S ttl� �t �I1��"':'P�•'lJ.a .t7iiT;L1J i(i�i1 `[e, �s" + y�
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