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893-I ea�ozo City of Zephyrhills Permit Application Fax 813-780-002�
<br /> . Bullding Department
<br /> Date Recelv�d 1 �— l�= 1., ,° ,,�j („� 8�� _ _ � � / ,
<br /> .�• � : ' Phone�Contact:foe�Permlttin - •
<br /> Own�r's Nam ��"�' G� �'S Owner Phone Number � '
<br /> Owner's Addr�ss ��� �� � SG � � L 1 ��efr�- ' Owner Ph'one;Number '
<br /> Fee Simple TltleholderWame •� � � � Owner Phone Number ��
<br /> ;�s.
<br /> Fee Simple T�tleholder„Address ,
<br /> JOB ADDFtESS ��� � ��1 � ��n S� LOT# �
<br /> SUBDIVISIO �re'e ,�'� ' PARCEL..ID# � - � �
<br /> . , (OBTAINED F.R,ONI PROPERTY,TAX NOYICE)
<br /> WORK PROP SED . NEW�CONSTR' . ADD/ALT CJ ' SIGN' ''Q• � ' Q �DEMOLISH
<br /> ,.
<br /> �.e,, w^INSTALL � -.;. REPAIR
<br /> PROPOSED:. $� . • :Q� SFR. [� COMM : Q •OTHER �
<br /> TYPE OF CO STRUCTION"� Q� 'r`'BLOCK �'' Q FRAME � .Q 'STEEL 'Q
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<br /> DESCRIPTIO OF WORK' • � �'� �"� �l'e / �tQ� o�'v'e�/" .
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<br /> BUILDIWG�SI E` f � � . ' ,`S4�FOOTAGE{�: , , .HEI,GHT�.�.. . '
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<br /> QBUI DING S ; VALUATIONaOF`TOTAL GONSTRUCI'ION^L -
<br /> L CTRICAL' $ .q p � AMP SERVICE. - 'Q '�PROGRESS ENERGY Q W.R.E.C.
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<br /> QPL MBING � '$ - - � _ �
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<br /> QAAE Hi4NICAL , $ ' , � VALUATION OF;tiAECHAFII.CAL INSTALLATION. ,
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<br /> QGA [� ROOFING• ,O: :,, S,P,EGIALIY,,;O;,..;.OTMER-;;; , .
<br /> FINISHED FL OR ELEVATIONS FLOOD ZONE ARF�4 ,QY�S. rN0 �
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<br /> � - ,t .�� -:�._ ._�„ �:,.. 5<i� _ -
<br /> BUILDER COMPANY" ; .`;�;:,`- v � , � -
<br /> SIGNATURE REGISTERED Y/ N • ��'���F.EE CCJRitEA�� "�'Y%`N" '' ��
<br /> " . ..+,tJr {'txF� r.:.i+ "f;�� _ . _ , _..
<br /> Addres F,; ;x; �- � .�„- f� w +License;#'' `°�' =
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<br /> ELEC41tIC�� ��,;,_»"_` `_ -: �aCOMPAPIY'-:: . xa., �::,:,,,-sr.z,�:,: ::r.• �>. '- ' - -
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<br /> SIGNATURE � �REGISTERED Y/ N FEE:GURRE�y'< ��;"��Y/N- -° � -�
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<br /> �ddress � �302 .E°31.�j/�12 �s- f �p-����L33 y� ;�;.=r.,:.:License�:#:T`L�:�3..�-��_� /..
<br /> PLUMBER ` - ., . '. - .COIIAPANY • .:z�:.,�'^ �.t ,:,,_. :,- .=: <;. . . ..,_ .
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<br /> SIGNATURE; • �,:, � _. � . REGIS.TERED YJ,,N_a :,;.,.FEE;Cu��:., - Y�/.N,_�: , `
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<br /> Address . ' ., " ,License�#.r � - � :. 4 . .. - , •
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<br /> MECFIANIC .t . =: -� . . � . " a COWIPANY ... , . �-. . . , �,:;.:;,�;�:w�.,� 4j �' « _,.
<br /> SIGNATURE: , -��'�. -,. .. . ,. , . , . „ ,;.. ,:= -
<br /> REGI$TERED Y/.,N ,FEE CURREI�::, �Y IrN-
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<br /> Addres' .._ �'u - �..... .� : . .. , - � _ . ,. -_ :k:� , , , � . ,
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<br /> OTHEIt r7�_ .. .. -, � , , . � .���, -�.�fCO�I,PANY _ ' � - - -
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<br /> SIGNATURE� _r. � �a', _ "` , - �'': , � _ . �¢ :REGI§TERED . — , Y/ N:..,: ��e'Cu��:"~. �Y`/N .
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<br /> =-� �"2 .�ot�.Plans'�2:sefs=_ofBuiltlin =:Plans��1 sebof=Ene ;Fortns;R�OiW�Pemiltfor''oew�con§tructio�i,_ " " ..
<br /> .RESIDER!'TIA�'��:.�, Altach;(_);P_._.. „( ) 9 �( ) r9Y,.� ,j -
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<br /> - �;�:���Minimum�,ten_,(;I,O)�wo,rl�ing,d�ys�:aRer�sabmiEtal':date�>-,:R.equlredon'site;'Consfiuctlon`'Plans;�StomnwaterPlan$�w1SiltFence�nstslled,�
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<br /> `SanitaryFeciltyes,&�1�,�dumpster,-�Sita�'Worlc�Pertnft;for;sutidivi'sions/IargeFproJ'ects;�wv�,;.;;��` ---_ • _.
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<br /> COWIAAfERCI Attach(3)LLeomple4e"sets'of'Builtlfng Plans'plus a Gfe Safety Page;(1)set of E'nergy Forms.R O 1N Permit for neai;construction.• -< •
<br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construcdon Plans,Stormwater Plans w/Siit Fence installed,
<br /> , Sanitary Facilitles&1 dumpster.Site Work Pertnit ior all neuiraprojl�ets:"All commercial.requi�ments_must meet campliance ``,
<br /> .-SIGN PERMl1 Attach"(2)sets of`Eng,i'neeredsPlans:,,�z.��_:`'~ _ _�- ..... - .. '' - '
<br /> "••PROPERTY SURVEY requirec�;(or.all,_NEW constcuction._.-.- -, -. � . ,.,.,.;,w _ " . '
<br /> Direc,tion�: . .ds;,,,J,,-;;�., . �.� _ _, . -,- _ .. . �
<br /> Ftll aut a plfcadon campletely.
<br /> Ow+ner 8 Contractor sign back of applfcaUon,�otarized
<br /> {f�over� 500,.a Notta;e of Commencement is requlred. (AIC up�r�de�over$7500) •-_ ,.
<br /> .,-.�.�p;�x,;;,;e r�zE�
<br /> '• Agent(f r the'contr�ctqr)Gr'Povir`e`r of'Attortiey(for the owner)�would be someone with notarized letter from owner authorizing same
<br /> DVER�THE:G�OUNTERa.PERMITTIWG��--•�-�••(Front�of-Application•Only)----� ' "��� ��� �
<br /> Reroofs if sht gles Sewers Service Upgredes A/C Fences(PlodSurvey/Footage) . _ _
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<br /> Drlvew ya-Not over Counter if on public roaduvay�::_i,%eed�+R4�W��:� �'::�� ' �
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