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<br /> a��-beaoozo City of Zephyrhills Permit Application Fax 813-Tsaoo2�
<br /> , Building Departrnen4
<br /> Date Recelved • <
<br /> ,i � • :;;.Phonejco�+���ror.P��mic�n � 8/ ?Ss3 - -9736
<br /> Owner's Nar�v� `c�y L L l�u 5'�j q i.� Owrner Phone Number C��7/��tc �orl` �j r i rr .�`
<br /> ownePs Adareas �8�a yS �i h�I�Gd.w�e� //gv e. � f,;.: � 7�'3� 9�36 ,
<br /> 3 S�! ' OwnerPh'one.Number•
<br /> Fee Simple TIt1eHolder.:Name Owrner Phone Number
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<br /> Fee Simple T tleholder Addresa -
<br /> JOB ADDRE53 $'6�/S` �.V ' ol LDW�r�ve, z� � ,./:Ll5 F` 3�S�f 2 LOT# �
<br /> SUBDIVISIO , � PARCEL ID# � • ° '
<br /> , .. (OBTiiINED FROM.PROPERTI(,TAX NOTICE)
<br /> WORK PROP SED � NEW�CONSTR ' ADD/AL7' �� SIGN" 'Q ' Q ;DEMOUSH
<br /> .,. ;.e�- . �;INSTALL � ....,REPAIR. '
<br /> PROPOSED..US� , .. Q SFR, �] COMM . 0= �OTHER' " PQ i��p -c�/ip�1 ow-- dr G.�- en
<br /> TYPE OF CONSTRUCTION'4: �` `'•'BLOCK r Q FRAME '� '�' STEEL 'Q
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<br /> DESCRIPTIO OF WORK' • ��- �c!cQ �'c r� N/`�`�IL w i r�d o rv$ "
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<br /> BUILDING:SIZE` � � � • 'SQ`FOOTAGE�; HEI,GHT
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<br /> �BUILDING $ � VALUATION'OF'T'"OTAL CONSTRUCI'ION^~ `
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<br /> QELECTRICAL $ - AMP SERVICE. ' ' Q . �PROGRESS ENERGY Q W:R.E:C.
<br /> QPLUMBING � .$ - ' '
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<br /> QME Hi4NICAL . $ , "VALUi4TIQN OF�MECHAN,I,CAL�IN$1'ACLpITION.
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<br /> QGA [� , ROOFING w0; -:,- SPEGIAL'lYr:O.�.:OTHER; ,.' _ �
<br /> FINISHED FL�OR ELEVAYIONS FLOOD�ONE AREA ,QYES. ,IVO
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<br /> BUILDER . _ - � _ �>J ��OMPANY`" .. . . . -�:..� , . _;�r • , .
<br /> SIGNATURE �/�f��-�Y2f �Z���� REGISTERED Y/ N ,`�°`��FEEcua�:.' ""' Y/=N' " �
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<br /> Address �- ;,• s,-., . , �.� ., :.=,Llcanse�#''. �4' ' ' '
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<br /> ELECTRIC . � , . � . - t�CpfNPANY; - �>'; ��^��`':'=;��'-:� , .,
<br /> SIGNATURE� � �REGISTERED ,f Y/ N !FEEtCURRE��`=( 'r �'tY/.N={ . `,
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<br /> PLUMBER' .. C.OMP�,ANY � �;..,._.��:�� , , ..t.�� _; ;..� ,_ ,
<br /> SIGNp►TURE�'''- "� � , : , � � ' - TREGIBTERED� .Y:/,;N:� ~:fF�;cuwte�:•: �Y�LN..;;.::x.
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<br /> �MECHANICAL . � . � - . � . ' ' ' COM�PANY � �. - -. • • .. ,�;•1, . ;
<br /> SIGNATURE:_ - ^' _, ., .. .. , _ , �. : , .. ,_, ,„,.. , ., .:,,...�:>;�..,.,.�. .,.. ,
<br /> FiEGiSTERED Y/,N FEE CURRED:. Y./N:`
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<br /> SIGWATURE�: _ ,F '.;>. :� .. -���t . i ' �`y' � `REGISTERED ..` , .Y/'I�F:..,. 'FEE CURRE�`� . l(7 N
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<br /> l�ddress �::�.�.tp;,,�,:,...::a� f:r�-.ra�:�:• � �'.' �-> :.�.:a - _. ' �:-:. . , _ . ..
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<br /> 13ESIDENTI,,_ ;'x;�Attact�;:(2);Plot;;Plaris;;(2)§ets;of'BulltlingtPlans;a(a�)'set'of Energy��For►ims;�aR-O=W�f�erm`IC#o`r-new�constriicNori, . ...
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<br /> 2r�-Minimum�,�en.(1,0)�wori�ing;d�y,s�aftei�sybi%�iltal'date.`;Requlretl onsite;'Constiucdon-Plans;�Stormwater�Rlan's w/Stlt Fen'ce�lnstalled,
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<br /> Santta FadllUes&R1��dw,m ster.Site°Wor,k�P._,ertnit;for;sutidiv_i'sions/la e� ro ects,-w.��,;." - ' ` �
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<br /> COtYIRA�RCIA!! Attach(3)�eortiplete sets'of'Buililfng'�Plan's'`plu`s a Life Safety'Page;(1)set of Energy Forms.R-O VN4Permit�for new construotion:� �• • �
<br /> Minimum ten(10)worlcing days�after submittal date. Required onsite,ConsUvcdon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> . Sanitary Facilttles�1 dumpster.Site Work Permit for all new<projeots::All commercial s,e,pulrements_must meet compliance � �� '-
<br /> . SIGN PERMI Attecfi"(2)"sets of`Enginee,�edrPlans.SC°`A.=Fp�` .. <5'� "i'�i.. � - .-- .'• �. , -
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<br /> i "'•PROPERI'1'SURVEY required for all NEW oonstrucH'on.,.. '__ _,f�. . _ -. _
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<br /> Dlrectlons: .-r��;.:,:�;,..,::.-� .. � - - , ,. .
<br /> Fill out ap 11caUon oompletely.
<br /> Owner 8 Contractor sign back of applfcatton,notarized
<br /> If over�2500,a Notice:of;Commencement Is requlr�d. (�IIC upgrades over�T900) ..
<br /> II ''Na4..�`./�:d'ut'��:`yfp:�; " - .
<br /> " Agent(fo II Bie contractor)'or_Power of�Attomey jfo�;the owner)would be someone iivith notarized letter irom owner authorizing same
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<br /> �VER'THE.COUN•T.ER�PERMITTiNG�••,-�;--(Eront�of-Application-Only)�rr-- ' ` '
<br /> Reroofs if shingles Sewers � ,Service Upg;rades' NC., ��Fences(Plot/Survey/Footaga) ,_
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<br /> Driveway�-Not over Counter if on-public roadway§::needs I�OW�
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