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813-�ao-ooao City of Zephyrhills Permit Application Fax 813-780-Q021
<br /> Building Department
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<br /> Date Recelved
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<br /> Owner's Nar�f � `V" ��� Ownar Phana Num6er � '
<br /> Owner's Address �0�/"!� v� �� �. p"U ' Owne�Ph'one:Number~.
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<br /> Fee Stmpie Tlt�ehoidar.Name .r� ��_����� Owner Phane Number � �
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<br /> Fee Slmple TI eholderAddre�as � 7"T �' _ �`7' �' ��� � ' v�•�.�
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<br /> ,i08 AS}dFtES3 . � ! 't t ��✓ Ty LOT#
<br /> SUBDFVISION • � PAttCE�:ID# � - .. .
<br /> . (OBTAINED FRpM.PROPERTY,TAX NOTICE)
<br /> WQRiC PROP SED ` .� NEW'CONSTEt ° ADDIAI�T StGN` `Q. - Q DEMOI;lSH
<br /> � �,. 1WSTALL � ,.. REPAIR � -
<br /> PROPQSED?U3� . _ - � � SFR. [� 'Ct3MM , � Q QTHER '
<br /> TYPE OF CONSTRUCTION"<' �Q" •�6LOCK " � FRAME ` .� STEEL 'Q �
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<br /> DESCR1PTttN�d OF WORK r, ' .L.�c " `1 s? n.- J,�!G✓� �., r :� t„�N r"7 d� � N
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<br /> �tltLDlNG'SIZE� ``t-��I,�� �'8Q FOGrTAGE r ,HE1.CsHT s�
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<br /> ��!IIQ��G $ 'y VALUATtON"(}F`TO'i'l4�GONS7F2tlG'flOt+t n
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<br /> ELE TRtCAL $ " AMP SERVtCE. '��] '��PROGRESS ENERGY Q W:R.�.C. '
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<br /> OPLU� BING . . $ � � � �/� �1��� �1. _ L,,,f �r
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<br /> QMECHANICAL $ ' • � YALUi4'flON OF�INECtiA1VECEU:IiVS't'ALLATION
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<br /> QGAS .. 'Q ROOFING :Q,'-;�- �PECIAL7�1!�;��:f'.;,OTHER,,,. . :-. . , �
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<br /> FINISHED FLOOR ELEVATIQNS FLOOD ZONE AREA QY�S. ,NO - .
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<br /> 8Wl.O�R COMfP%1NY�`:�::� --_ �"- ` �
<br /> StGNA'TURE , REGISTERED Y/ N .' "�='��E euRi��� ` a Y/'N �
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<br /> ELEC7RiC,lAP1 .. , ,. , , ._ , •: �tCOMPANY' <_ `�}_=_`�� _;' . - - - : .
<br /> StGNA7URE '� REGISTERED !1Y/iN FEE�cu��{ �`p�'r}�Y/:IV ' " •
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<br /> Address , . :�csnse,#�.�>.- '
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<br /> PLUMBER� � . ' " , � ' . G.QMPANY ,s ,- A ;_ - �5_ ,�t ~ .,,:.,- - �
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<br /> SlGFtATilRE' '`� . " ` `�REGISTERED ..Y/,.N;>, ,{,�:cut��:�� ., - Y=/.N,.,.�-
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<br /> Address _ . `, . , , . � , . - - :I:tcatt,se#j�. , .--�, - � _ ��
<br /> MECHRl�lIGAL . � ,. , , ,. _ �' �" COM.PANY . , .;;:� -_ �:: `.,i,.,.,�F -.�, . ;_� � � � ,
<br /> St{3NATURE� ' :,. . .�. � , .. , L - : , ,.;; � , _ ,_...
<br /> REGiS7EftED Y/.N �FEE�CURREA,. YJ�N` .
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<br /> StGNATURE� . �,� s�-_.,.,,.��,:. _ :�� �,-r . .. •t•'- > � x. , . . ,
<br /> `REGISTEitED~" 'Y/`1V.:... 'FEE�CUFt'RE�'�� Y%N
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<br /> `*RESlDEN'i1AL"F,n::AtkactlA 2 PI�t�Plalri 2� .. -�, �,,..�., .,�.,_:,�.: � •�� r.Y,;�,;,,:�,,�., b;-. k,�'�z w s�' �.c�r �:N.,, z;f>:� r'" ... � . � '
<br /> F_)¢ si.�( )sels:ofEtu�l$irigtPlans,�(Aj`set�ofxEnergy�Forms;�R=0-V1t�Peir�iiti#or=ner+sr�cxinstriictlori,
<br /> -, �y;�i�ttlnimum{.ten{{1,0};waci4in�,d�y,ssafter,�submltfal�:d"af"e.�:;;Requlred crisife;'Gonstructlon'Rlans;�`StomiwaterPlans w!�itt Fence installed,�
<br /> ' `��" SanitaryFaciliye,s_;;&;1idwmpster�„�Slte°Wor.lc,Pertnit;forsukidi,v'IslonsAarg�;Pro)"eots;�a�'==: .;, •:;'n�;i, ' .. - � .--- -'
<br /> COMNl�RGIAk.' Attach(3j i oisipteteY"sefs'`tsf$Biitiding'1'ians pliis a'1:tfe S'ate�tiy Pz��;(i}set"of Energyr Fomns.R-0-W Petmit for nerit consUucflo».- F .
<br /> Minimum ten(90)working days after submittal date. Requlred onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fencs instalisd,
<br /> Sanitary Facilitles 8�1 dumpster.Site Work Pertnit for all new:projects::All commercial.sequlremenfs_must meet campllance` � �
<br /> .-SlGN PERMlT Attach"(2}"sets af�rig,i`r%ee;�:ed;l?lans:x,�:z�t�x�-=-� -,�.,� ��, >>__. . � . �� '
<br /> � •••*PROPERTY SURVEY reguire�fqr ai1,t�EVll con,struction._... _ - �� -
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<br /> Ftii out ap�ticadon compietely.
<br /> Owner 8 Ccnt�actor slgn back of applicatlon,notarized
<br /> tf over�00.a No"Nc:e:of Commencameot ta requlred. (A!C upg�des aver i7500) .
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<br /> '* Agent(for�the contractor)'o�"Power of Attoiney`(fo'r`tl�e ovv�ier)would be�someone with nakarized letter trom owner autho�izing same
<br /> OVER't'l�iE.CQ�UNTElZ�PE1�MITf1[+IG�-�---�:-{Front�of-ApplEcation�{}n1y)------ ` _ :� •. '
<br /> Reroofs If sh(ngles Sewers Service Upgrades A!C Fences(PlodSurvey/Footaga) _
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<br /> Drivsw�ys-No#over Coun�eriF�m}7ubfio�roadwaysr:rieeds-ROW -. ., <��'-'��""•`�-j_���=�.`�.-�..{.:.'_.,::N,�.y^ .."."'
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