|
813-7�o-oozo T City of Zephyrhills Permit Application Fax 813-78p-0021
<br /> Bultding Department
<br /> DateFieceived . ' Phone-Coc�tactfarParnittEin �t � 7r�2 _ JrDIJ�
<br /> Owner'�Name� �}�}� �C�°I ' Owner Phone Number �1�" t3 Q"' �.
<br /> I . ` � �
<br /> Owner's Addr ss ��� 3� C� � � -Owner phone Numbsr �
<br /> Fee Simple Tit ehalder Name �� ' � Owner Phone Number � �
<br /> j �;? .
<br /> i
<br /> Fea Simple TI I eholder Addre$s ^
<br /> JOB ADDRES �/�LP�.:.! � B UG..- G N/LL /'/� 4714 Vi/�Q LOT# ��
<br /> SUBDIViSION� - �� � PARCEL ID# ��� �� �� ���� �QD�D ��,�
<br /> � (OBTAINED FRQM PR4PERTX TAX NOTICE)
<br /> WORK PROP i SED ° NEW:CONSTR ADDlALT Q StGN �Q Q DEMpLISH
<br /> e, INSTALL �-�REPAIR .
<br /> PRQPOSED� ISE Q SFR Q COMM Q OTHER .
<br /> TYPE OF CO�STRUCTION - C.] ' BLOCK ' �C,] FRAME �� STEEL Q
<br /> DESCRIPTIO OFWORK F �l� ��C ��A`/V L"DLe-�:• p[ `C� rJ7VF'/U�S � �/�,0
<br /> I
<br /> BUILDING S1ZE �� ' � SQ�FQOTAGE - . . HEIf3HT �� �
<br /> ,
<br /> �$��� �N�' � , y '. VALUATION'.OFTQTAL'CONS7'RUCl'ION � �
<br /> � , • .,
<br /> QEi. CTRICA! � - � AM3'SE#2VICE Q PFtOGRESS ENERGY Q W.R.E.C.
<br /> QPL�MSING _ � -
<br /> � . ..
<br /> QMEI�HANIGAI $ ;�" p���� VRi.UATlOIV OF MECHANICAI tNST1�tilATtON ,
<br /> l
<br /> [�GA� Q RQOfitNG .� SPECIA�TY � OTHER
<br /> FINISHED FL OR ELEVATIONS � � FLOOD ZONE AREA QYES NO
<br /> BUtE.DER I �
<br /> CtlMPANY� .;
<br /> SIGNATURE i REGISTERED Y/ N FeE CUtttt�n Y/N .
<br /> I :
<br /> Address, �Clcense# '� �
<br /> , � _ _.
<br /> ��.�c��c�a�. coM�,a�air � - �
<br /> SIGWATURE, '� REGISTERED Y/ N FEE CURRE�=' ��Y/N'
<br /> I
<br /> Addre�s� - - ' . License�# � �
<br /> PCUMSER � COMPANY , _ '
<br /> SIGNATURE'I ' _REGI3TERED Y/�N '.FEE CURREk- � Y,/N. �' '
<br /> Address �- - • License,# ��, - �
<br /> � .
<br /> „I , . T
<br /> MECNANIG ' � ' c. ` COMP�tNY � l�1�/�� !'l�pfi�/iJe��qS?�-�U' ��UGG
<br /> SIGNATUFlE� '' ��� ���t.Ph... " REGISTEREO Y./ N . FEE CURRE� Y/rN
<br /> Addre�` � "7��"�� f��i1) " . - - • � License# ��� ����'��
<br /> :i , . . _ � ' .
<br /> OTNER ,' - , ' {;GOMPANY �� `
<br /> SIGNATURE, -'. '_, "'� - ' � ' ' �� �` REGISTERED ' Y/ N;._ FEE CURRE� Y/N
<br /> Addre�( . ' . ' � � � ,� UCense# i �
<br /> ,.t�.;.
<br /> RE$lDEN'it ;Attacti'{2}.;Ptof P,Isiis,�.{2}sets�.ofiBiiil�lrig Plans;{1}'s'et af-'Eiiergy�Faiitts;;R-O�W'Pemilt far new cons#rvction,
<br /> - '�j_i•;::Minimum.ten;_(�1.Q)4working;day�,aiter,;submlHal tlete.��Requlr'etl onsite;Constiucdon�Plans;-Stortnwate'r`Plans w%Stlt Fence installed,
<br /> - �Sanitary Facflttles-8�::1:;dumpst@r,^Slta Wor1c�P:.errnit for subdiyislohs!large�proJe,cts_,,,:. .:: ' ' " • �
<br /> ,.-<�.,. , ._ .�.,.,_ _.. .,,
<br /> 'CORttMERCI i4ttach(3)�cbmplete�seats'Eif-Butliliiig Plaris plas a Life Safe#y�F'age;{'1}set cf Energy Forms.R O-W Permit#o�nerri canstrucUon:
<br /> Minimum ten(10)working days�fter submtttal date. Required onsite,Construction Plans,Starmwater Plans w/Silt Fence installed,
<br /> Santtary Facilitles�1 dumpster.Site Wark Permit for atl new`projects..All commercla!requlrements must meet compltance
<br /> SlGN AERMIT Attach{2)"sets of Eng'irieiered;Plans., ..:,=;== ,.v ., �;... • .
<br /> •'••PROPERTY SURVEY reyuired for all NEW constructlon.
<br /> Directlon�: � _ .., -� ,
<br /> ' Fill out a plicadan completely.
<br /> Qwner Contraa#ar slgn back of appitca@an,notarized
<br /> {f over 2500,a Notice of Coanmencement is required. (A/C upgradea avsr 37500)
<br /> " Agent(fpr the�i�nfractor)or P"wer o�'" tk rth�, �vouid be someone w[th notariaed letter from owner authorizing same
<br /> ���ta�.�.�,a��a���'+_., �.
<br /> OVER THE�OtiN lR RERMi�1'tNG-,�:�`,tU�F"ront af-Appatcatiqn�n1yj_ , " .�� " , �`�`''� ,,,,,,�,r„
<br /> Reradfs if shi gles ;,Sewers�ss���-Setvfce�Glpgrade�i�.'�Uts', ences(PlodSurvey/Foo 'ge) a!���"f'�'� '''"„�'��'�2 •�y9'•�r�"'J%�
<br /> � -� �iJ;_tr}:.tifc;;4Ztlj"'7 itlfiiC:�_4�r�_ t+'.� ��.^, . - 'l ��� {t 7 °IF;i$t;r+"�£ifiSi ' pi��';`�'
<br /> � �,°t�^.;� f :9��ii:, � s �,'t;�yJ„a a
<br /> Drivew�a -iVot'bverCaunter;�lf`on, ublic�roadwa' t`p�'. 's,Ef ��` +=t Y!t'..'""j;�c� �;";r,` `ft� ° ��r..:'
<br /> Ya +„� l P Y�,, ,�� � _ ' ✓� ��
<br /> t ��`•�i,�"i ei� � • _` i.: ��:7ti�.u!iP�(i7,iJ % ''
<br /> i htt��r�ttP.fO�'!G���l��Gl't Ri;:'G5!�T::ST.�i1Q � � (,t•,s,e:�' ,., .. � ,a'����;,•
<br /> � �y�et�m.�s''r�sx�;s'y�itn��'�y �a::.`,��;�`.n�',ifiB'�t'paTtte<G:'�k>83-�f=C'F�yqGy��ti� � �
<br /> � dT' �{p��`'�.�.-'�'.`¢.�,��'�r"�
<br /> „�;.,..�yy ,y,1i�'!�'* r
<br />
|