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<br /> 813-�saoo2o City af Zephyrhills Permit Application Fax-813-780-OQ21 ,
<br /> Buitding Department '
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<br /> Date Receiveti ' ���-��"� �j Phone Contact far Pem►ittin � �•�� �� � _ c�C D %�J
<br />` Owner's Nam1 i��h n� 1�f.�e/f Owner Phane Number ya3' �(c� ' 07��f��
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<br /> Qwner'sAddee�s �.SD '�'�/r�a�,LN� 1�}'� r/{,.'//S�/ OwnerPhcneNumber �` �3�- 7��� � I
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<br /> Fee Slmple Titleholder Name C �� Owner Phone Number �— � ',
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<br /> Fee Simple T�tleholder Address ' �
<br /> JOB ADQRES$ 3 S�o'� f'�r%do/ ��r ,c'E��ry"/�i/!S /z f LOT# � �� �
<br /> sueowisio� �m R�"�"� �°t�'��'U � d�PARCELID# - .��- d- �v0� � �� �
<br /> � (Q87AlNED FROM PROPERTY 7AX NQTICE) �
<br /> WORK PROP�SED � NEW'CONSTR � ADD/ALT [� �IGN' Q Q DEMOLISH i
<br /> '! � INSTALL 8 REPAIR �
<br /> PROPOSED'USE Q SFR [� COMM � OTHER '
<br /> TYPE OF CONSTRUC'170N Q BLOCK � [�"' FRAME [�� STEEL Q !'
<br /> pE3CRIPTlO� OF WORK ��°� /°2'"�°�0 ^�Jr' �"� �d �U/��/ti !
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<br /> BUILDING SIZE /`2'�`�O � S4 FOOTAGE "��� , HEIGHT �'� � � i
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<br /> QBUIi DING $ ��/�� pG'+j� VALUATIOfV OF TOTAC CONSl''RUCTION �.� 7t,1 . �� _ �
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<br /> [�EL ICTRICAL $ �6�-;�.tl � AMP SERVICE [� PRQGRESS ENERGY Q W.R.E.C. ;
<br /> QPIt}MBINt3 $ ��p, z90 ��I�J� �
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<br /> QMEGHANICA� $ VAItfAT10N OF MECNANICAI.thfSTALLATION ��. ���5�...�� /,{�,p-�
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<br /> D�As � �aaFi�G Q BPEClA�TY � o-r�eR
<br /> FINISHED FLOOR ELEVATI4NS F1.00D ZONE AREA QYES iV0
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<br /> BUiLDER � �/ i COMPANY
<br /> SIGNHTURE ! ���� � REGISTERED / N FEE CUR C N
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<br /> Address� Ci�ense# �
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<br /> ELECTRtC1AN ��N �, yr- � �;�; COMPANY
<br /> SIGNATURE � REGISTERED FEE CU n Y/N i
<br /> Address. `License# �
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<br /> PLUMBER (,��,i N� � ,� ff't1�"� v COMAANY � �
<br /> SIGNATURE i \�� REGISTERED FEE CURRE� Y/N �
<br /> Address{ License# '
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<br /> MECHANIC COMpAFiY
<br /> SIGNATURE , REGISTERED Y/ N . , FEE CURRE� Y/N
<br /> Addres$� License# � �
<br /> OTHER COMPANY
<br /> SIGNdATURE REGI$TERED , Y/ N FEE CURRE� Y/N
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<br /> Address � " License# � � �
<br /> REStD�NttAt:` Attach{2}.Piat Rlans;.{2)sets•of=Building`Plans;{1}sef of-Eriergy�arm`s;R-0-W Pemilt far new construction,
<br /> Minimum.ten,(10).working days after,subriiittal date. Requfred onsite,Constructlon�Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Fact{ities&:1-clumpster S9te�Wortc_Permit for subdtvistonstEarge pro]ects-
<br /> COYttINlERC1A4. Attacti{3}compf'e#e'se4s of Saitditig`Plans ptus a Life Safety Page;(1}set of Energy Forms.R-Q-W Permit far new construction. '
<br /> � Minimum ten(10)working days after submlttal date. Required onsite,Constructian Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary Facilitles&1 dumpster..8ite Wark Pemttt for ai1 new prolects.Ail commercEal requirerstents must meet compltance
<br /> S1GN PERMITi Attach(2)sets of Enginesred Plans.:., ��
<br /> � ••'"PROPERTY SURVEY required for all NEW'canstruction. '
<br /> Directions: � 3
<br /> FIII out applicadon completely. ; ,
<br /> Owner&��nEractoe s{gn back of appltcatlon,notarized �
<br /> if over$a500,a Natice of Commencement is required. (AIC upgrades over�7500)
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<br /> " Agent(for the conkractor)ar Power ot Attor`riey(for tfhe Ytiwne`rj;v`iiould tie spmeon�with no'tarized tetter from owner auth6rizing.same�� , 4 't
<br /> ,4...'_ . �-x.�! .:a, •�
<br /> DVER'THE COUNTER RERMITTING � (Frorit`:of A'pplicaUon Only)�� ` ;.'`�, ``: � , - Y' . "� ' _ � • r; �
<br /> Reroofs if shingles Sewens SeMce:Upg�ades A/G�° `Fenbes:(Rlot/,Survey/Footage) , � �' � � � •� �� � � � + ` �;
<br /> � .> .>> .. . ,, ,,,,,,; ,,,,, .. ; '�,,,,, $ , . „ , .,.'., :
<br /> Drtveway�-Not aver Counter if on public roadway's:."n`eeds Rb`iA1"""�"""`"°'"�""' - � �'`-� � • � s.�. - „ .`.._ �, `
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