|
i` — 1.
<br /> a�3-��eaoo2o Cit�+of Zephyrhills Permit Application Fax-813-780-0021
<br /> '� 8ullding Department
<br /> I —
<br /> Da#e Receivedl
<br /> �l . . - : Phane-Cantaet for Permlitin -
<br /> t3wner's Nam�! 'L��� .C�.y t b �A C��t� owner Phone Humbe� I
<br /> . I
<br /> Owner's Addross ���� G- � �p S . Owne�Phone Number j
<br /> Fee Simple Tl t l�eholder Nam� rL AC{�Y � R��� ��� �I�CGI���� � Ovirner Phane�Number ' !
<br /> �;�
<br /> Fee Slmple Titleholder Asldress 5 .�2, G � R� J Z�G p/►'��R��(/�JJ�' , FG+
<br /> JOB ACIDRESS ���� �, c� �A T. [/G+ �YI��I Gv� �V• LOT# ��
<br /> i
<br /> S�Ba�V�S�oN� ��Plf Y�. �f�l��r� p,��E��a# 1,�,��. -�l=d D D- 118� — �Z �
<br /> I , . (OBTAINEDFROM,PROPERTYTAXNOTICE) j
<br /> WORK PROPASED t.NEW CONSTR ADD/ALT � StGN '� � Q DEMOLtSH i
<br /> { �_e.. INSTALL 8, � REPAIR �
<br /> PROAOSEDa SE Q SFR [� `COMM Q �t?THER '
<br /> TYPE M�F CONBTRUGTION [� " �� BLOCK " [] FRAME `.��]' STEEL Q
<br /> DESCFtIPTlO�OF WORK� } I"��/•►OV� � E'i P J,+r�G� G�/1jG��j�'G ��j V C,VV�� ,�..fD� J
<br /> BUILDtNG SI�E �� � � SQ FOOTAGE�� - ,,HEIGHT�,C� .
<br /> �
<br /> BUI�DiNG $ .����. -� � .� �
<br /> � �` '��L�1� d,�-' VALUATION�OF TOTAL CONSTRUCTION • '
<br /> I
<br /> [�ELECTRIGAL $ ' AMP SERVICE Q PRtiGRESS ENERGY Q 'W:i2.E.C.
<br /> OP!�MBtNG $ `
<br /> � , ,, qC�� v/
<br /> QMECHi4N1CAl. $ VALCIA7lON OF`MECHANiCAL INSTALLATIE?N � ' �,�1:.�
<br /> i � _
<br /> �� �
<br /> Q� , Q R{�4FlNG .Q SPEGIAl.TY � � OTHER�; -
<br /> FINISHED FI.00R ELBVATIONS FLOOD ZONE AREA QYES NO �
<br /> � � -
<br /> �
<br /> � - � ,
<br /> -- --�:d6�€3��: - - _-- __—__-- _--- - ------- Ctalliip�tFlY_._ _ _..._____ ----- --___ :__�_.�_
<br /> SIGNATURE� REGISTERED Y/ N FEE CURREP Y/N
<br /> ` Address Llcense# �� �
<br /> Y
<br /> ElECT�IClAtV; t� - `COMPANY� � � .
<br /> SIGNATURE� � REGISTEREb Y/ N FEE'CURRE�� 'Y/N " �
<br /> Acidres ' * , . , .. Ltcense#.�` ' �
<br /> PLUMB�R°'� . ,. . . COMPANY . . ,
<br /> SIGNATURE t „REGIS7ERED Y./,-N FEE CURRE� -,' Y.•/N.
<br /> Address� License,# �.-- � ,,�.,
<br /> , !I
<br /> MECHANICA�:' �. ' COMPANY �
<br /> SIGNA7URE�I � � � ' ` REGI$TERED., Y.,/ N _ � FEE CURRE� Y./tN
<br /> ,�� _ . ,
<br /> Address� ` ''�r � " �- � � . Cicense#� -
<br /> fJTHER ;�) , , - " ' - ' �CQMPANY }
<br /> SIGNATURE� "•=> . `"" • §� �'- "� �'REGISTERED' '' "'Y/ N... FEE cURitEn• Y/N
<br /> Addre�ssx. � ,, � ,�:� «. - � . _ .,,' . ,_ �. . , _ Ci+�nse# `
<br /> P � �
<br /> �
<br /> � ?' .Y''�i�;��, �
<br /> ..ya.a . '{�i": ,... ,
<br /> RESli?EN'F1�:;:•;�Attac�i"(2),.Plof Plans;(2}sets:of;Bt'iildin�rtPlans;(�1}�sef of.Energy`Forii�s:F2�W'Feniiit far new cons#fucttari, �
<br /> �: ,�. ,Minimum ten�:1A;wo, in ,d@: ;after"„"submitital-date::R�°"ulred ansite;ConetiiicUon=Plans;3tonnwate�'Plans w7 SilYFence ins#alled,
<br /> ,.,_ . ,�,:._,. _>._� E, .) �.�4 .9 Ys e4
<br /> �� �Sanitary Facl�llties;&�,1.;dumpster^Slte�Wp►icPPermit;#or;subtlivisipns/large:proJe,cts,�:._�`,.::� "' ' ' ' �
<br /> COMMERCIht. Attach{3)`"ridmptate sets of Buitdti�g Plans plus a'�I:ite'Safeity Page:(1}set of Energy Farms.R-O-W Permit tor nev+r c�nstrui�lon.
<br /> � Minimum ten(10)worlcing days after submittal date. Requlred ansite,Construc#lon Plans,Stormwater Plans w/Silt Fence ins#alled,
<br /> _ - � j SaniQary Facilltles&1 dumpster.Site Work Perinit for all new.projects:Al{cammercEal re�uirements.must meet compllance � �
<br /> � . SlGN PERM II Attacti'(2)"sets of Engin�ierr,ed:�i�ns.,:� ,.".�-� ... .. �;u- . - - -
<br /> """PROP�RTY SURVEY reguired for�II.IVEW_r,onstructian,
<br /> �
<br /> Direa#bns: �� _ � ._. � �. _
<br /> Fill out applicatlan completely. �
<br /> . Owiter "Cantractar slgn back of appl[caflon,notarized �
<br /> If over�2500,a Notice,of Commeocement is requirad. (A!C upgeades over�75a0)
<br /> _.: -. ,
<br /> ,.. -,�.<.;;���. ,
<br /> _. .. . .,-. .., __ _.,,,.,,,..:_...._- ..
<br /> .. ._. , .,_
<br /> ,;. ..,..,:
<br /> " Agent(for ttie cii�ntractcir�'o�Power of�ttorr`mey(fo�the owner)vrould be someone with notarized letter from owner authorizing same � , :.,� -.
<br /> �VER THE GOUNTER:PERMITPfNG�;,� -;;(Front o,f-ApPlication Oniy}- , • � � - '" ` ` ` ',��f ` '
<br /> Reroofs if shingles Sewers , ; Servlcei Upgradas.:�lG,� .- ;Fences(Plot/Survey/Foatage) � " ' ' � � ' �
<br /> Drlvew�lya-Not over Counter if,an.pubiic�roadwayis.�:neecls ROW , - . � . ^ , -��` , � .� ; .��. . ; - .'
<br />
|