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<br /> s��-7$aooao �ity of Zephyrhills Permit Appl�catian �a�-s��-zaaooz�
<br /> � i ` BufidiAg Dapatiment
<br /> Date Reaelve�t ` , . -. .Phana�Gan4sct'for:=Permitttn - ` ` �
<br /> Owner'a Namce ��S C� C B U � `-- .Clwner Phone Num6er 7��"���� +�f�� " '
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<br /> Owner's Addross ���irr ����� ��/ ,���� p�'� ��Q vn�Ph'one.Number� ' ;
<br /> Fae Simple Titleliolde:Name , - Owner Phone Number �� � ;
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<br /> Fee Simple Tlttehotder Addresa -
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<br /> �ae nao�ss ��G�b �,�,�L,T�LVD Z"�'�'fi�Y�'%H/'ti�S �"'�. �.oT� ��� ,
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<br /> SUBDIVISION� ��. � PARCEL-1� : � � � ' '
<br /> , � , (OBTAINED FROM.PROPERTY,TAX NOTICE) �
<br /> WORK PRt3P�SED *aNEW CON5TR' . �: ' ADD/ALT ��� SIGN' '� � Q DEMOWSH
<br /> „. _�: INSTALI, . � ;. �,REPAlR• - -
<br /> PRQPOSED�USE� , " :Q • SFR� Q COMNt . `- �_ ;OTIiER ' _
<br /> TYPE flF GON8'Tl2UCTION._� �Q+ `�''BI.OGK `' �] FRAiME ,�_ 'STEEL `Q
<br /> il : �, 'J.. . $ . �
<br /> DESCRIPTION OF WpRlt' �� �' t� �� �n� `'���"
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<br /> BUiLD1N6`SI�E�` !"� ��`$Q''FOOTAGE r ; „HEIGHT ���
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<br /> QSIf!!.DlMC, $ -r.•...,,..�-. .�.,.,�. .. • _
<br /> VAI.UATION:OF:TOTAL COySTRUCTION
<br /> �i ELEGTRICAL : $ � Q AMP SERViG�. ' �%�r�PRiaGRESS ENERGY [� W.R:E.C.
<br /> , . . n�"b. � fi.� 7� . � , . - ,
<br /> [�RLUMSlNG � .$ � /�yy '
<br /> � 1 .� , � F i. ' . ' � 4 V �`�'� •
<br /> OMECHi�NICAL' ' • $ ' �'NAi:G70.'TION OF�(tiIIECHANiCAL INSTACIATIt)N: � ,
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<br /> [�GAS „ [� ; ROOFlNG „L�. . SFEClAI;']'�Y,:.C�:•. ...OTNER�,- . , �
<br /> FINISHED FLOQR ELEVATIO�lS r� �� Fl.00D ZONE AF2EA ,QY�S. i+10
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<br /> BU�F.DER � CS3MPAFIY'' ,.
<br /> SlGNATURE t REGlSTERED y t N .":;.3:�F.EE GURREt�- `;Y/iV � ,
<br /> Address� :,; .;.a. � •n�;a - :LJcense,#I` `I �•,'...��,.. �'; . �
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<br /> ELECTT21C1Mt< <�' -. , �. ., ' }C.,rJMPANY� ;1P?rr�:��,..R:;3r.:� -(� . . '. _.,_ ,
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<br /> S[GNATURE'� �� � REG�STERF.�D Y i N FEE;GURREPu i ..,�-�Y I-.N' :'� - ,
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<br /> Address7. , . .. � .,. . . ,� , - , � ,. . .i .. L(cense;#=:;��OG?��0�.�. '
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<br /> PLUMBER'' � � . .. , .COMP�ANY ,..:.>,r.�i :t ,��s :.,. . , �.�.
<br /> 51GtrATURE�: .- s'.� . �. .. ` . ttE�tsT� � �X_1,:N:t; ,,:<FEE;GURREfi:` X-JN . .
<br /> Address, - � ,. � - } ' - " "" ,lJcer,isep#f�::. .��... •r' � c:, , .,__�.
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<br /> MECI�ANIGAL` ' . '' - . . �. . � COMPANY. ' ., r , , � , .S; ,. - . ' !
<br /> 1 AN � . •..rx:::,...,
<br /> 51GNATURE:� � - "' , • . . � " ` � � �� + `- ' KECalSTERED 7� Y/,N . �sECu�, �Yl:N: ,
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<br /> Add�98s+'r,.r 'a�' ,,. ,, -.�T .'i= • : .. . , , � '. � , • ,L(Cef188#`C�^ + . � � �., ..
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<br /> OTHER ., . � . �_ .__ .. ; _. ._ . .- ., ., - ;GQMP%tAtY �..r.,_ _
<br /> SIGNAYURE�" . t' 'i� '.;`� �'^ ,. . -� .`' . _ �� `REGlS'TERED' " , Y t iV,;.: ;FEE CURR�t+:�= ':1(7 N
<br /> , �ddrs�s,, .,'er -> :.: .. , ._.. `V _�r . _ _ �,"V'. 2_ , .. ,�..� � �� _
<br /> � �.,�.s's-;--- .�5 t•�u�. a; .� "'Llcense#�`�.
<br /> � � . .. ... ,n.�...� e.""l:'s�' ��y 3kra:,zc•x��.x, r.:F i .��i:e':• �.:<." �,:.,:�:.; . • .
<br /> ltESIDENTIAL,,�_�Attach'(2);Platfi�Rlaiis;.<(2)sets=ofB`u�ldliig��Plan"s;(1)set'of�Enei+gy�Forms;R=O-{NtPemi�it for nedu�donstruc�on, � ' . , . .
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<br /> -'�;,� �;�Minimum�4en:(•.1A)�workin„gtd�ys�.after;;subin�ttal:ilate,��Requlied onstfe,.Constriictlon=Plans;Stoiinwat�ir'Plans•w!SIIYF'ence install�, -�
<br /> _>:. �„ .t ,,.. - •.
<br /> � `+ �`Sanitary FaciilUes,;&s1�d,um ster-:Site°Work.Permit;forsutidivisionslla eo rnjects;?':,` � r �'� �
<br /> ,. �- r_# P.;.,,_. ►9-'p,y..-t L:,.�::;:'u`..,;'.. ,;`,';"=_� , ,. . .
<br /> GOt1f11�Y4E1tCiA� Attadi{3j`eumplefe"�sets'of'8ultiiing"Pians`pliss a�i:ife Ssfety Page;(1 j set of Energy Forms.R-C)`-W Pe`rm.ft�tor nern�-cor;`stii,iotton:�'"r'�r `
<br /> Minimum tao(14)workfng days after submlttal data. Requfred onsike,COhStNCU4t?_PIBitS,Stomswatsr�Ptans wl SNt F�ricetnstail�+i,
<br /> Sanitary Facilitles&1�dumpstsa Stte Work Permit.for all new,proJects:;All commerti �I.requlrements,-must:rneet complfance"'�- {`-
<br /> .$!GN PEl�N!!Y' Attacti(2)"sets ofEng,t`�eeredr,R{ans:�;�.<,;s:}d�- :: .: '�:,��,,., _ , ..--, , � :i ,. • , . ,
<br /> • ""••PROPERTY SlJRY�Y require¢for ai!IU�Vi!consWcflon.__ -. j - " -
<br /> D(iectlons: ;�"-,:zs��,t ... ... _, _ . . � - • . - ;
<br /> Ftfl out appllcallon comptately:+ . �` �~f
<br /> M Ownar&Contractar slgn baak of appltcatlon,notariz�d �'
<br /> � if over�500,a,Notice:of Coromerac�ment ia r�qul,red. (A►C upgrades over 57500) ,
<br /> •�rt,:v�:,�;�._,.�
<br /> '* Agent(fac the cootractit�j"or Powes�ofAttcrrie`y(for the ouioer)�woui�d be'someone with notarized letter?�m owner authorizing same
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<br /> OVER•THE COUNTER.PERMITfLWG�.:_.�:M.(Frcint•of Applicatian-0nly).,.._._ • � �� .. � -
<br /> Reroats if shingtes Seweis Servlcs Upgraders AiC ' Fences(PlotlSurveylFaotage} � _ _ - _
<br /> Driv�w�ya•No#over CauMer lf on public road~vuays:'.needs ROVU't ' � � � r� � . r .._. _� i � , r
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