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813-�so-ooxo City af Zephyrhills Permit Applic�tion Fax 813-780-0021
<br /> � _ Building department
<br /> Qats Fteceived phone-Canfact for Parini#�a ��� t�� — �—�t�
<br /> Owner's Na�e t � �h'�1'S C 1��.. �Zl�...t� Ow»gr Phone Numbsr vl J' �J��'"4���
<br /> Owner"s Address ���i� ����•�-��'^�'�h�,�S`� �"' Owner.Phona Num6er �� �
<br /> Fee Slmple Tikleholder Name �� � Owner Phone Number � I
<br /> , � _ .
<br /> Fee Simple Titleholder Address `
<br /> JOB ADDRE$� ��� ��� S� Z-2��1�I��f1l�`S,�i-�- LOT# �_,_� -
<br /> SUBD1VISiON �! . � P,ARCEI.ID# �����.D��^i � ���a � ����� !�
<br /> - _ (OBTAINED F.ROM PROPERTY,TAX NOTICE)
<br /> WORK PROPOSED NEW°CONSTR ADDlAIT C� SIGN' Q Q DEMOCISH
<br /> INSTALL � REPAIR '
<br /> PROPt}SEDrLISE Q SFR [� `CQMM ��] t?THEE2 ' T `
<br /> 7YPE OF CONSTRUCTION Q ' BLOGK ' Q FRAME C] STEEL �Q
<br /> pESGitIPTIOPI OF WORK'' F Ch-��1 1'�U�..XY� '�-���-- , ' - '
<br /> BUtLD1�IG S12E �� � SQ FOOTAGE�. - ,,HEtGHT e�—_____,�
<br /> .�: ,,.
<br /> 08Ut[.DING $ � � ...�,_ ,�:-._ . ..-
<br /> VALUATtON:�7F TOl'AL"CONSTRl7CTiON
<br /> QEl'ECTRICA� � ' � AMP SERVICE Q 'PROGFtESS'ENERGY Q V4t:R.E:C.
<br /> ��PLUMBlNG _ .
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<br /> QMECFIAMCA� $ ' VA�UATlQt+I�F'Pi�ECHANICAI.INS'TAIL�►Tit?IV ¢-
<br /> �� �� �� � .
<br /> [�c�s � RooFiN� ,[� sFEci��.rar [� OTHEI2
<br /> FINISH�D FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES. �NO
<br /> BUI�DER COMQ�ANY;� ;. � , . .
<br /> 31GNATURE REGISTERED Y/ N �'EE CURREP Y/Nil�
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<br /> Addrs�s � .� ' '�° :�. Licen§e`#�'� ` �
<br /> EIECTRtC1AN,. ��GBMPANY= � x � ' � � _-.. .
<br /> SIGNATURE �` REGISTERED ' Y/ N FEE�CURREk�-' `tY/N `
<br /> Address - . _ ~LT .. Ucense�#_�;� ': I
<br /> ��uM��� ;.� ��5:�,�1`�...��`' �'t'``�._ co�n�,a�nr , e.�'ltl����ti.���,ltic�"lS�.t�1C.. _
<br /> SIGNATURE _, _REGIS.TERED Y �N, :�FEE;CUFtRE� � Y N.. �
<br /> Addre�s �� ���h'`J� '�.� f�111�5,�"t- 3��� . , �. .�License.�# �.��.�- ��c��U�{�c� �._
<br /> NIECHAN1CAi:� " ., , C4MP�NY � _ :-,#Y .. . .._ . °
<br /> SIGNATURE - � � REGISTERED . Y,/ N . , _' FEE CURREP-� -. . Y/rN:
<br /> Addrss"s� .- _ Y = , � _ , � �. Cicense#~�. ..—.- _ � .
<br /> OTHER ' � - - � `� ';G06M,PANit - � .- • � ,� . _.
<br /> SIGNATURE =._- s ;`� ��' ` " REGI$TERED'� Y/ N.:.� `,FEe CURrtE� ' Y/N .
<br /> i4ddress` .i .�. . , . � - , . , Ucen's�#_� � ,
<br /> ,�... .. ;' �(:zS-�',,.. �,:-,.:. �3.:.' • •
<br /> RESIDEN17At�:�--:Attaotij{2}nPtot.P-,latis;:(2)sefs af;Butlding Plaris;{4}sef of:�ite'rgy:Fo'r'ens;°FZ-O=W,Perinit for new'czonstructton,
<br /> -- --- - _ �<- Minimum;ten;(10);woricing,�ays;after.:submiftal d'ate.':Requl�ed onslte;CUnstructlon-Plans;Stonnwa4er Plans wr/5Ut Fence tnstaUed,
<br /> t��" Sanitar"yFacUttle's.;&y�1�dumpster-5lte°Wo�kcaPermit,#or=sutidivisionsllargeprojeofs,;.�,�`=..,;, ' • � ' ��� °�`
<br /> COMMERCIAl. Attach{3)cbmplete sefs'rof`Bullding Plans pias a Ctfe Safeiy Page:(1}se#of Ene�g}r Fonms.l2-O-W Petmi#fo�new cons#ruction,
<br /> Minimum ten(10)wo�lcing days after submittal date. Required onsite,Canstruckian Plans,Stormwater Plans w/SUt Fence installed,
<br /> Santtary Facllttles&1 dumpster.Site Work Parmit for all new proJects..All commarcial requlrements must meet compliance '
<br /> St�FI PERMIT Attacfi�{2}'sets ofEngiiieer,ed�Ptans.��;.__;._-..- ,,,�4; - ._ �
<br /> •"*PROP�RTY SURVEY reguired,for_all NEW oonstruction., �• - �
<br /> Direatlan�: . .�- ' ` '
<br /> Fill out applicaUon completely.
<br /> Uwner&Contrector sign back af appitcatton.notarized
<br /> if over S2S00,a NoNce af Commenaement is required. {A!C apgrades ovsr 57500)
<br /> ' ^..Y tN?�,ai:F�3,'�,
<br /> "' Agent{far the`contractor)o�Power ofAttomey(far tFie bwner)wrould be�someone with�notarized letter fram owner authorizin�same
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<br /> DVER'THE COUNTElZ PERMITTING�- -;..(Front*of Application•Ontyi}Y �'
<br /> Reroats if shingles Sewers ;� Service Upgrades.,A%C Fe�tces'(Plot/Survey/Foatage) �.
<br /> � �
<br /> , DNvswaya-Not over Counter.if on pubiic roadways..iieeds ROW; • �
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