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<br /> a� �-7eo-oo2J City of Zephyrhills Permit Application �j��y tb Fax 813-780-0021
<br /> � Building Departrnent l� !
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<br /> Date R�celv�d gG�, "9�773 - �`� f
<br /> ;i - � Phon�-Contact forPeririltlin ` L �1 L
<br /> Owner'�Na�I e L �/�! Owner Phone Number U`�7 � �O O `` .�
<br /> Owner's Ad I�ress ,/ / �B J» v� Owner Phone'Rlumber
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<br /> Fee Slmple FlHeholder Name Owner Phone Number
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<br /> Fee Slmple 1'Itleholder Address >
<br /> JOB ADDRESS ��` e�D/1'� � LOT# �]
<br /> SUBDIi/ISION ��ND O/"LZD PARCEL ID# �� �� ''o�� �� (� Q�� `�
<br /> � _ . (OBTAINED F,ROM PROPERTX TAX NOTICE)
<br /> WORK PRO I OSED :,�,NEW CONSTR ADD/ALT Q SIGN �Q Q DEMOLISH
<br /> � .B, INSTALL � REPAIR �
<br /> PROPOSED:I SE Q SFR- Q °COMM Q OTHER �
<br /> TYPE OF CO STRUCTION - Q ` BLOCK ' Q FR�fUIE Q 'STEEC Q _
<br /> DESCRIPTION OF WORK - ��i� C� ���-�,f � s^ O(,,C�'�' � � d
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<br /> BUILDING Si� E ' SQ FOOTAGE � ^ ; „HEIGHT . _. , . _
<br /> Q B i LDING $ VALUATIONwOF TOTAL CONSTRUCTION '� , '
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<br /> QELI CTRIGAL $ � � AMP SERVICE Q PRO'GRESS ENERGY Q W.R.E.C.
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<br /> OPLI MBING $ - ' ' , ,,;'� f � ^���
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<br /> QM ICHANICAL $ �q j_�, vo VACUATION OF'MECHANICAL INSTALLATION ��
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<br /> Q IS Q ROOFING Q SPECIALTY Q OTHER�. �-�- j��
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<br />� FINISHED F IOOR ELEVATIONS FLOOD�ONE AREA QYES NO
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<br />' BUILDER
<br /> COMP'
<br /> ANY�`'
<br /> SIGNATURE REGISTERED Y/ fV FEE CURRE� Y/`N
<br /> Addres - Gcense# ' I
<br /> ELECTRICI I COMPANY� �
<br /> SIGNATURE� � REGISTERED Y/ N FEE'GURREk'�' Y/.N ` '
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<br /> ' r4ddress � - , , _- Llcense#. - - _ � '
<br /> PLUMBER ` I COMPANY ; �.
<br /> SIGNATURE° ' �REGI3TERED. � Y/-N ' FEE CURREA " Y/N.
<br /> Addres i Llcense,# �
<br /> MECHANIC I' ,r���,,!,,, � C.OMPANY 1eS.� �4l11��j7�9F'�La �t�iL,
<br /> SIGNATURE� ' �d�� �� _ REGI'STERED , Y,/ N . FEE CURREA- Y/�N
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<br /> Addre�� �'.��7,�'������D�L 2= �ILLS 3�5� _ " �icense# C����''-�' . .
<br /> OTHER ``�I' � - . . � • ; ° • `tCOMPANYy ' • .
<br /> SIGNATUItE{ •• - � "�- ' � �� � k ° � p REGISTERED Y/ N._ FEE CURRE�• Y/N
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<br /> Address ,, • :,� ., u_ � .. . . ' Clcense# � " �
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<br /> RESIDENTIAE::; :AttacFi'(2)„Plot�Plans;,,(2)sets�.of<BuIlding Plans;(1)set of'Energy=Po'rins;�R='aW:Pemilt for new construcUon, '
<br /> `� ��.:Min(mum:ten°:1,0�worliln "da. :after,;submlttal clate.�:R'"ulred on§Ife;:Constiucdon Plans;Stortnwate'r'Plans wr%Sllt'Fence Insfalled,
<br /> �:.,�, ,�.•: .,,,. ,...�..r)a._. , 9s Yg. �
<br /> ---- __, Sani�ery Faclllyes�8.,1:,dumpster,�Slte�Work;Permit for sub.tliyislons/large.proJects,� ° :�:- • � , , "- _ _ - - __ ,_ _ __
<br /> COMMERCI �—Attach(3)complete sets'of Bullding`Plan�plus a I.,ffejSafet���?�g�;�;�)=se4 0�@�ercy'rorms.-R=C'i-W-Permlt for new construction:--
<br />- : -- --- -- ti�ir�ie�r�urei tan(10)working days`after submittal date. Requlred onsite,ConstrucNon Plans,Stortnwater Plans w/Silt Fence insta{led, -
<br /> Sanitary FaGliBes 8 1 d'umpster.Site Work Pertnit for all new�projects:.All commercial requlremsnts.must meat compllance ' �
<br /> � SIGN PERMI� Attacfi"(2)sets of-Englneered;Plans:. :.:�;-�= - �. .�- . `
<br /> "'•PROPERTY SURVEY requlred for,all NEW construction.
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<br /> D'�eVIIDA�� '1 ' ._„_�.`�._`�_ .. i . ' . '
<br /> FIII out applicatlon completely.-`-� -- � "-
<br /> Owner&�IContractor slgn back of appllcaUon,notarized - -
<br /> If over�¢500,a Notfce of Comm�nc�meait 1�required. (AIC upgrade�over 57500) _ .
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<br /> '• Agent(f�r tlie contractor)�or P vvvcyr"of Attomey(for tFie�owner)would be someone with notarized letter fram owner authorizing same
<br /> OVE�THE COUNTER P,ERMI��NG�a:�StQc�&of�Ap�Uc�Yioi�O�ly}�'�x %' ' � "�"�` -
<br /> Reroofs If shi �@S / 5 a e r a ii, 1 f�'f�'�`es.N�� �i����.#yy ���'e�yT�r _
<br /> � Sewe�� -Se�2se�l'Jpgrade's A/C ,.�er.�,c�s.(P'dSurvey/Footage) ,�,��. _
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<br /> Drlvewal -Not ovar Counter�if(On publtc roadvaays7:need's R01N�' *' _ i�''.�'t',��,``�4{�a� �'"'�is`��`''� 7�54� as�= �
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