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813-� o-ooao City of Zephyrhills Permit Application Fax-s�3-7sa-ooa�
<br /> Building Department
<br /> Date Recetved * , , -- P,hoaejCarrttact<far°ParrriittFn 9 t� – ,:,J L`� L�
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<br /> Owner's Narne L�l,�l�/��Vl �/� Owner Pho»e Humber ��`3� /v v � /�
<br /> Owner's Address �;�7 / � � c�,,2/ Owner Phone Numbsr � �
<br /> Fee Simple Tlt eFiolder Name � � Owner Phane Number � �
<br /> r. .
<br /> Fee Stmple Tit eholder Address ^
<br /> JOB ADDRES � � � y ��� LO7# ��r�
<br /> SUBDiVISidN � � PARCEI.ID# �� � r� ��� �/�d �/D �
<br /> , . (OBTAINED FROM PROPERTX TAX NOTICE)
<br /> WORK PROP SED �NEw CON57R ADD/ALT � SiGN `[� �� 'C] DEMQLtSH
<br /> .e: INSTALL � REPAIR �
<br /> Pt20POSED�tI E Q SFR Q 'Gt}MM �� •OTHEt2 .
<br /> TYPE OF CO STRUCTION - Q ' � 'BLOCK ' [_] FRAME � "STEEI. 'Q
<br /> DESCRIPTIO OF WORK �y S, r/ G (�f//a'N' G�j>(�,� l ,�D?J� OJ�.' � v'� �'D
<br /> BUlLDtHG'SIZE �� ' ` � 8Q FOOTAGE�� ,HEIGHT .����
<br /> ;
<br /> ���� VALUATION:OF TOTAL CONS7RUCTION
<br /> DIIVG
<br /> � ' .�
<br /> QE�E TR1CAl �' .� AMP SERIIECE Q PRfJGRESS ENERGY Q W.R.E.C.
<br /> QP1.t! BlNG C � , .
<br /> Q ME �FlANICAL $ �� �D.,_,y. YAl:UATtON OF;iV1ECFfANfCAI 11+1STALU1T10A1
<br /> � ��'. .
<br /> Q� Q Rt�OFiNG C} SPEGlA�TY C� . OTHER
<br /> FINISHED FL OR ELEVATIONS ��� FLOOD ZONE AREA QYES NO
<br /> 8U1l.t}ER GC?MPANY' _
<br /> SIGNATURE REGI$TERED Y/ N . FEE CURRE� Y/N
<br /> , Add�e�s . Ocense#'� �
<br /> ELEC7RIC . _ ' COMPANY '
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURREK° �Y/•N
<br /> Address " • . License# �— ' �
<br /> FLUMBfR COMPANY °
<br /> SIGNATURE' ' � ; ,REGIS'fErteD �Y./,.N.: FEE CURRE� Y/N. -�
<br /> Address � . • License,# �� ,�
<br /> 'r.
<br /> MECHAMIC ` ' �9 }���K� COMPANY. � /�J1��S t''0 �NiE C"�'..�-S�"��i
<br /> $1GNATURE Y/'GtJ'+�p���J.� REGISTERED , Y./ N F�Ecuwten YJ�N ,
<br /> Attdress:�. f f �'f�� � �'�/LL � license# ��a� ���T-��
<br /> OTHBR ' _ - . ` " ;COM,PANY � .
<br /> StGNATiIRE '" . • � � ` � � REGI3TERED� ' Y/ N.. FEE CURREn•� Y/N
<br /> Addre�, _ ' . _ � s1 , � , �_.,,_ �
<br /> Liceiise#
<br /> �,;_-: . _ . •
<br /> EtESlDEN �, :Attacti;(2),Plot Plan's;a(2}sets:oftButlding�Ptans,(,1}�se#cfrEnergy=Foitns:°R=0-W�Perr»It for new consWctlari, `
<br /> Minimum,tenry(�1p);workfng�days aftet;subrijittal date:::Requlred onslte;�EonstnicBdn'Plans;Stormwate�Plans w/SUt Fence Installed,
<br /> Sanifary Faqilltles.&;.1_;dumpster,-Site�Worle:PermitforsubdivisionsAarge proJects`� .s�� ` '
<br /> COMMERCI Attach{3)completa sets'of Building`Plans'plus a Life'�afe#j+`Page;�('1}set of Energy Foims.#2�0-W Permtt for new canstruc�tion. �
<br /> Minimum ten(10)working days�afker submittal date. Required onsite,ConsUucNan Plans,Stormwater Plans w/SIIt.Fence installed,
<br /> San(tary FaailiUes 8�1 dumpster.Site Work Permit for all new:proJeots:_All commercla!requlrements.must mes!compliance
<br /> 3lGA!P�Rf4lIT Attac�-{2)sets��f�Eiig[iieer.ed;Plans.,.:::�;,. , .. °..: . '
<br /> """PROPERTY SURVEY reguired for,all,�NEW canshuctlon. .,
<br /> D�rections. � . .- , _ ,
<br /> Fill out ap licadon complekely.
<br /> Owner 8 ntractac sign back of apptfcatlon,notarized
<br /> If aver 500,a#lotice of Commencement Is required. (A/C upgrades over 57500) ,
<br /> ' `" Agent(fo Nie c`ontractor)or Power of�Attomey'(for tFie owner)would be someone wlth natarized letter from owner authorizing same
<br /> {3VER TNE C�UNTER.PERMFT"-TiNG• -{Front af�Applicatiom Onl ' ' ����'F::..<,...<:>_.. ___a_>:.-�,�,�w ..
<br /> Reroofs if shin les Sewer� e�Ice�Elp'g�ades+�f�i.�.�f�nctes�R!¢t/Survey/Foota9e) ,,,;' � . , �, ,, . ';'.'
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<br /> f Drlvewa lVot aver Gounter Ktan�pdblic roadways:.neetls ROW �- � ` - k,;i.:r -�;
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