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a7�-�aaoo�o City of Zephyrhills Permit Application Fax 813-78p-0021
<br /> Buflding Qepactment
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<br /> Data Recetve f�r., ! � �,.� � - ,G7��
<br /> •.� � . � : Rhone�Gontaet.for-=Pert»ittin �'. � �j�"'
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<br /> Owner's Narn , f 2-� �`"� ���� tlwnar Phane Nlumber
<br /> . Own�r'sAddr�ss 1•�/l�' �� S''�" �'�"`�f� ��"�a� ` �Ow�erPhone,Number � �
<br /> Fee Sim le Ti ^
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<br /> p leNolder.Name •� � ` Owner Phane Number `
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<br /> Fee Simple T�eholderAddre�a � - -
<br /> J08 AdD{tESS �� �"" � / � .�V a ' � S L01'# C��
<br /> SUBDIVEStO lT re°e. ��. ' .� • PARCEI:iD# .` - _ .
<br /> , , (OBTAINEDF.RqM.PROPERTY,TAXNOTIC@) .
<br /> WORK PROP SED Y:NEw CONSi'R' ADDlAI:T Q� SIGN' 'Q [� �DEMOLISH
<br /> , >er INSTALL �t ,.,,�.REPAIR . .
<br /> PR{?POSED: S� _ ~' :Q • 3�R. � COMM . C� -QTHER
<br /> TYPE OF CC1�3TRUCTIOPI'� [�� �r":BLOCK r Q FRAME " C�' 'STEEL "[� -
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<br /> DESCRiP110 OF WORK' �e¢`"�, ��I-�y l''1 e.�+e.�-- � bc� ay�-f
<br /> BU1t�DIt+IG'S! E'' �
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<br /> �'�` 1`SC4 FOQTAGE�: , . HEIGHT,: �
<br /> 08tlI !NG �_�''`� , _ . � _ �
<br /> �. {" � VAl.UATtON�t}F'TO`fAl-Gt)NSTRi:#G'CtON
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<br /> Ei. CTRICAC $ ��� AIUIP SERVICE ..: ;Q " Pf20GRESS ENERGY [� W.R.E.C.
<br /> QRL I MBIt�G � :$ ,. ' l�
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<br /> QME HANICAL $ " � VALUAI'lONOF;MECHAiViCALlt+tSTALLEtTit?I+i. �
<br /> [�GA{ � , ROOFING t[�. ;, SFEGI/#1,7Y,.�:�.-..OTl1ER, „- ^
<br /> FiNI$HED Fi.�OR ELEVAYiONS � FLOOD ZONE AREA ,QY�S. ,NO
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<br /> BU(4�ER CGlVIPANY`` � . `'::� -_ . - � �
<br /> SIGNATURE - REGISTERED Y/ N . '{`'FEE CURREk"' ` "�Y/>N `"' :
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<br /> Address' . - - s.: �°: �.,� . . ..�; � .,, r�Et nse� �' �
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<br /> SIGNATURE � � RECaI$TERED Y/ N FEE�eURRe��-� " ;k'Y/'N-- . ` �
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<br /> PLUMBER � ' - - 4�� � .
<br /> SIGNATUREz � ., , ., -., ,. - . C.OlI�P;ANY , � ��._._,,:�-; , .x . r,�._�,. :�- ::,� r...
<br /> �� ; 'REC,yI^aTERED ,.Y/„N>• i;,: „NF�:cu�n:•, , Y.�/.N,.
<br /> Address, - , ,y ` ` ' ,`ClcBnse�#r N: 4,.+ - �: ,r,� � _ ��.
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<br /> MECHAMIG ` . ,� • . , �.. ., . ' COMPANjI„ � - , . �; / - .
<br /> StGNATURE� .., ;*", , � - , � REGISTEBED Y%,N .`FE� .CURRE�.. .
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<br /> OTHER f`" ,,�>c ,��� _ - � ,_ • , _ �;;;.: ;.. , ,_ r._•., ''_ . ' '. '-
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<br /> "�' �°' 'REGISTEREDp.;,' Y/"fV;.. ;�e Cuttit��' Y/N.
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<br /> - -= a ``'� '+�ic8nse �
<br /> RESiDEN'il� ;;�Attaati 2 PC_of�Plans � , �., . . �4�-�v.<,..;,- . ,u��:.��..: . ,:.�, .. _ ,.�.t .-.f� . .:. :.:. - , ,r� r. ,
<br /> ,_ ;{_); :�(2)seis_of'Bu�tding�.Pfaiis;('1)set'of<Ener�#y=Farms;'�RA=W�Rer'i'ia!' r-ne�nr co
<br /> � ,,. ., �{'fa'�. nsttucHori, :>
<br /> -#;,;:��;�i�lttnimum�.t�en�(1,0)�,wort�tn�;d�ys�;after;'subii�iNel:d'ate:.;Rpquired onsife;'.Construc8on'Pians;'Stdmiwater=Pians w%�S11t Fence�ynstalled,
<br /> Sanita"FacillUes&�1=dwm ster•=SIte�Work;.Permlt;#orsGtidivlslonsAerge.pro]e "� 'T f - .. _. ' :,; ,
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<br /> COMM�RC1 � At#ach(3j�cx�mplete'sets'of'Bultdiiig"Flari's„'plus a Ufe Safely Page;{1 j sef o#Energyr Fccros.R-0-{1V Perrnt#�f0��18W CBRStrUGF10tl.- .
<br /> Mintmum ten(10}working days af#er submittal date.-Required onsite,Construcdan Plans,Stormwater Plans w/Sflt Fence installed, �
<br /> � Sanitary Facilitles&1 dumpster.S(te Work Permit for all new;prpjects:;All commerGal.fequirements_must meet compliance '" � •
<br /> .SfGNPERMlT Attac#i{2)setsoEEitgi�eer,edsi?taps:,;-:.=}z:°>'_,°... .. . .. ... . ... . ; ' .
<br /> '•'"PROPERTY SURVEY regulre�fior all NEW.copstructlan._._. - -
<br /> Dtr�cttons: .,:r��,�x}. .., . � , • '�
<br /> Flii out ap Ocatlon oomptetely.
<br /> Glwner 8 � nhacMr slgn back.of appl(catlon,nata�ized
<br /> 1€aver�t 0,,�.Na�ce.cf Comr»encement ts rsquieed. (A!C upgrades ovar 57500) -
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<br /> Agent(farl the oonUacto�)"or`Power`of Atfainey(f�a�the ownerj`would�be someone with natarized letter from owner autho�izing same
<br /> DVERTHE.0 lUi+11'ER�PERMITilNG_�._.�:_(Front�ofAppllc�tlan-Only} _,___. - - �
<br /> Reroois If shin�les ,Sewers ^ Servics Upgrades A/G Fencas(PlodSurvey/Foatage)
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<br /> Drivawa -iVot aver Counter if on publlc roadways..r�sat3s ROW
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