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813;780-0020 Fax-813-78p-OU21
<br /> r City of Zephyrhills Permit Application
<br /> 8ultding Department .
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<br /> Date Rece�vetl • �
<br /> � � - ��=:Rhons�Co�act:for�Ferni[ttin .
<br /> Owner's Na le l � "e. Owner Phone Nurnl�er t��,,.� / �- � �/
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<br /> Owner's Add� ss ,,� / ?� �./� ' Ow�er Ph'one:Number'� �_�
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<br /> Fea&Imple tl�liolderName �� .. , � � Owner Phane Numb�r '�— �
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<br /> Fee Simple T tleholder„Addre�a -
<br /> JOB ADdRE S C7 „�,� / T� s � . LOT# ��
<br /> SUBDtVlSEO � . � � P,�RCE�t8# .' _
<br /> I (OBTAINED F.RQM:PROPERTY,TAX NOTICE)
<br /> WOt2K PROP03EQ < NEW COtvSTtt . � T ADQIAI:T �� SIGi�E' 'Q �- Q DEMOLISH
<br /> �i , :,�:, INSTALL �� REPAIR� � �
<br /> PROPQSED:.U$� Q - SFR � COMM .. � Q �QTF{ER .
<br /> 7YPE OF CO� STRUCTION"�� 'Q" �`�'BLOCK ' � FRAME � .[� 'STEEL `Q
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<br /> DESCRIP17d OF WORK' � C �I� '� C�
<br /> �WI,DING:S1 E'' � � ��`$Q`.FOt3'i'AGE � :.HEl.GtIT�C.. � ,�
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<br /> �$����N�'' � VAt,UATtO�l;`!3F'TGt1'Al.Ct3NS;Fi2UG'i'ION - '
<br /> QEI.�CTRIGAC g AM1P SERt110E. �Q "PFtO�RESS ENERGY Q W:R.E.C.
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<br /> QFLUM8ING � �. � . . . .,. ,� , , ��U'-��
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<br /> OM CH�NlGAL' � $ - j} VACUATlONOF�MECFfANiCAIiNSTA[LATItON.
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<br /> Qc,As C] , RooF�N� ;p.,-., spEcia.nr;C�.:� or�E�,_ . �(�
<br /> FINISMED F(�OR ELEVATIONS FLOOD ZONE AREA ,QY�3. ,NO �
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<br /> BUll.DER coM��r�� . . :.��..:�� , - .
<br /> SIGNATURE REGISTERED Y/ N .'`:'�`�`FEE cu�n:� � ;° Y/N'� '-
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<br /> El.ECTRtC , . ,?GOMP,ANY�:. �E.� r'� ;°.���'-=�.- �. � .. _ �
<br /> SIGWATUREi � � REGISTERED Y/ N , FEE C4,RRE�"'' �'�iY/.N'_ , '
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<br /> PLUMBER ' , Y GOMPE!iNY � .«.-.;,�.� ;a ;. „�,:,: -:- �,� :_�...
<br /> SIGNATURE' � ��, - • � `RECi1ST.ERED -Y_/,.N:: ;.��:CUwtE�:•; �Y�/.N:... �
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<br /> Address .,_ . .. , . -• � t-UcertseY#iC�.:-...,:_:..f;. �:...�.���
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<br /> MECNANICAI:{ � � coM�P�,r� �S'��� ��'�o� :1�:�1: �:���° �1. 1
<br /> SiGNATURE - � , - '� ttEGIS7EFiED ., Y„/.N " FEE CU E�._, "Y./Cld.
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<br /> Ad�resY - .�, .. . . , v-� . _ , _ ;Ucense#� �1.����„�� �
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<br /> OTHEE2 'f` r � � ._ . _ � .. _. ` '7 � .COMF%1Nlf �.z,�__... .._ _�. _
<br /> SIGNA'itlR . � . . _ , � , � ,.�,,,, ,,., , .-. , . ,
<br /> E. �� `�;: `:,>� � `°� '4 'REGI3TEREDp� Y/ N:..` ;FEE�CURREA'�'� y Y'/N
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<br /> Aii� 'S:a}`,�u't��* ' ��`S.�"$': .+} � . �'''} .� �_ � � �I��S�7/'s� v . - .
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<br /> `RESiDEN'EiJ0.�:s. �'�Attact�(2);Pt4t�_P#a»'s;,�{2):sets;d�"8u1ldingi:Rlans,'(1�}set�of�Eriergy�Farms��+R-0-1N�Per'rrilEfdrnew;constnii�toti, ,.
<br /> ' ;y���;.s,Minimum��en,(;1A)�,wa,rt�in�;d�ys�after„subi�"iitfa��`date:.�Required onsite�GonstivaHon:Plans;Stormwate�'Plans wJ Siit Fence lns�iiled,
<br /> y;i"�" SanttaryFadllUes,�&z1},dwrnpster�SiteWorkPemrit,[or,�sutitl�visions/Ierge;qro�ecta:'vw-;�t;;�:,k : '�';n�=�'`� . . a=, � .
<br /> COt41MEitC1 Attadi 3��eom``lete�sets'of'8u"lidin 'Ptans`. lus a i:[fe Safe�`�Pa e, 1 set of Eae� Farms.R-O-VY Petmit far naw+:constructton.- __
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<br /> � Minimum ten(10)working days after submittal date: Required onslte,Conswcdon Plans,Stonmwater Pians w/Silt Fence installed, -µ, -
<br /> Sanitary Fadlitles&i.dumpster.Slte Work Permlt for all new:proJ�cfs::All commerctal requirements_must meet compllance '
<br /> . stGNPHRMl� attacti(2)"sefsof'Eoglneer.edsPla�is.i;�;�;;_.:_�.�:.,.�-,'.,:�=;f��. ;.,..- .._. ..' �_ . , ,
<br /> � ""PROPERTY SURVEY requlred f4r all_IVEW,aanstrucBbn._ .. - ' �
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<br /> Dlfectlons. I :.�k;��:,,+..,,,. , ` ' � i
<br /> `Fill out applicaUon completely. ^
<br /> Ownar&'�GonhacMr sign back.of appl[caUon,rtatadzed
<br /> If�aver�,250Q.a Natica o�.Commencamere#la required. {NC upgrades over ST540) _
<br /> » I ..=1:��,„�;;�r�,?;�;., ' -
<br /> Agent(far the conVactor)or'Pow'e`r of Attomey(far the ovvner)would.be-someone wlth notarized letter from owner autho�izing same r
<br /> aVER TtiE C�UNTER�.PEtt11MMITTINGu.:._..�.,_(Frant-of llppllcation-On{y}:=..__.:,-�; �`.°_ - : �
<br /> Reropfs If shirjgles Sewers ;Sarvice Upgrades;A/C _ Fences(Plot/Survey/Footage) _ ;,�
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<br /> Ortveways-f+lat ovar Coanter if an pabiialroadwaiys::rieed`s�ttOVY�, ,� y.. .
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