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<br /> a��=aaoozo City of Zephyrhills Permit Application Fex�$13-78Q-Q021
<br /> I �uftding Department
<br /> Date Receive-i � —f���l � ,:;:phone�Contact for�P������ _ B�3_ �/� :�
<br /> �Owner's Nam' �`e'� �'"""`� v�C�`�.�' Ownar Phone Number '
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<br /> �, Owner's Addre�s ° � ���t•."`. S 7 -(�� Owaer Ph'ane:Number�
<br /> Fee Simple TI le6older-Name � - � O�wner Phane Number '�� �
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<br /> Fee Simple TI, eholder,Addresa � '� �
<br /> JOB iiDDRE �� � / /`" � £'If� `S �" LOT# ��
<br /> SU�D1VlSIO I ; ��. ��"`'`'� � pARCE1,iD# ' .
<br /> WORK PRCPI SED , ._�NEW"CONSTR . ` "� AK'}DIAI:T ��] S1GN NED F�PROPERtY,r�TICE)DEMOGI$H :
<br /> e: INSTALL B ....REPAIR � : _
<br /> PROPt�SED�,SE .. Q - SFR. � COMM .. � � �OTNER , • .
<br /> TYPE OF COI STRUCTION�"� Q�� { 'BLOCK-." .Q' ' FF2AME � �;C�. 'STEEL' "�J`
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<br /> DESCRIPTIQ OF WORK' � ' " � �
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<br /> �t11t,DING:S1� E"� � •� �°SQ'FOt31'AfiE L��; ,HEI,GHT;C- �� �
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<br /> QBtJl�iNG • �� VAL.UATION�tOF:TOTE1l E:G?NS1`R!1{:TION^rv . � '
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<br /> :, GTRiCAC $ ��� AMP SERVICE, Q '�PRO�FtESS EAtEEZGY Q W:R.E.C.
<br /> [�]Pl:UMSING � . . � � �� -
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<br /> OME liANlGAL $ ` " � '- "\!ALlJATION QF;MIEChlAiViCAL![VSTAL"LATIt?N: , � �" �
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<br /> [�GA Q ROOFIi4G ;Q_ ;, 3PEGIAI�TY,:,..Q_�,. OTHER�; �. � � .� �
<br /> FIIVISMED FL�OR EI.EVATIONS PLOOD�ONE AREA � QY�S. LNO
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<br /> BtJF1.DER COMPANY=`= - . -- '`��.,� . , ,_ . � , .
<br /> SIGNATUR�� REGISTERED Y/ N .° "�;�'F.eE CURtt�•- " Y/�N •
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<br /> SIGNATURE� � REGISTERED Y/ N �E:cu�n�-� '�r y�°.Y/.'N " - •
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<br /> PLUMBER `.i, • ... , ;� ' . _G�MPANY ,4Y_�,Y.x- ;� ,.:..�,.__,. �_= .,: _�..
<br /> SIGNATUREi, �': . . - � , �'`_�GIS.TEREp -. . 'A,:Y,/,:N:s , .,FEe:CUIRREn:; -�Y�/4N� -
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<br /> StGNA7URE� � - �'' �- ' '� ' ' � ' REGI$TERED Y.,;/,N. ' ���cutt�En... Y/�N �
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<br /> SiGP1ATURE�, ., � r� . _; ,'` - °`� , 'd `REGISTE►�`"; , 'Y/ N:'; ;�E"CURit��• : -Y%N
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<br /> �lddress '�'?�:�i;.:•s`. '.n,:7:7.° ' _ .a � �rt ;.`., S , �
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<br /> RESIQEN71.��sA�;�Attaciii'(2)jP.,lot�Plahs;,(2}sefs;of'�u�ld3ng�Plans;'(1�)set of�Energy=Farms,_R-aW�Pertriif for new�co�stnicNort, „
<br /> � _ �-,,:Minimumsten,(>70)�working;dqy,s„after�sabinittal:daf"e.��;R'eiquired Qnslte;:Coiistiuctlon:Plans';Stormwater'Rlans w/Sttt Fence insialled,
<br /> �Sanitary'Facllltle,s �1;dw�pster-1Slte•Wor4c;Pertnit.fqr;sutidivlslo s/lerge�projec#s;wts��"�,:�i;- ''' ." ' � , � .
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<br /> COfVlM�RCI, y Attecfy{3)Ycisii�t�pfefe�seis'of'8iiltiliiig Plaits"plas'a't:ife Safety'Page;(1}set of Energy Farins.R-O-tIY Pennit�far ne�+.constructtQn.�� .•
<br /> Minimum ten(10)woridng days after submlttal date. Required onslte,Construction Plans,Stotmwater Plans w/Sllt Fence lnstalled,
<br /> Sanitary Facllltles 81 dumpster.Stte Work Pertnit,for all new<prajlscts::All commercial tequlrements_must meet compllance :" �
<br /> .SI�N AERMI Attadi(2)°'sets cf`Eng[neaiedsPla�n.s.t,-:==:':xa�'»-:.- . ,... -_ .. r=
<br /> I "'•PROPERTY SURVEY require�i f�r aIl NEW canstructlan._._. • � �
<br /> �Dtiectlon�: .-;sg������,..- ._. - . � - -
<br /> Fill out a'pllcatlan completely.
<br /> Qwnar 8i GcntracMr slgn bacic.of applfcaflan.aobarizad
<br /> !f over �50D�a Notie�of:Cammencement la required. {NC npgrades cver ST500) :.
<br /> '• ent f� tFie contrd�ctorr'or'Power of Attame 'fur the owner would be�someone wtth notarized letter trom owner autha�zln same
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<br /> OVER THE_G Ut�tTER:.PEl2MITFIt�lG�-.._�_(Front-of-APPIlcatEon-Only)-._--
<br /> Reroofs If shi gles Sewers Service Upgrades A/C Fances(Plot/Survey/Footage) _ ,,�
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<br /> Orivswa -Not over Countes tf an publla taadwrays::need`s RO�W'
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