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s�3aso-oozo City of Z�phyrhills Permit Application Fax-813-78p-0021
<br /> Building Depa�tr»ent
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<br /> Date Received �(� j'T
<br /> ° Phone�Cantact�fcr Rerm�tttin '
<br /> Owaer's 41ame r , , Ownar Phane Numbsr ,
<br /> Owner's Address ��'C�� 4�s�rru,U�.��� ��� ' �Owner Phone Numbec � � �
<br /> Fee Simple Titlehalder Name � � Owner Phone Wumber � �
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<br /> Fee Simple Titleholder Address ,
<br /> J08 ADDY2ESS r.�. `�I'7'�� �o�..�WJi�-YX (Z-- � � 407# ��
<br /> SUBDIVISION �! �� PARC�L ID# t�` �� a-� -0(� ����o� p�p ,
<br /> � , (OBTAINED FROM PROPERTY 7b91E NOTICE) '
<br /> WORK PR4POSEp �NEW�CONSTR ADDtALT �� SIGN 'Q Q DEMOCISH
<br /> ���, INSTALL � �. REPAIR •
<br /> PRQPOS�D;t7$E Q SFR Q GOMM � OT#iER ` '
<br /> TY`PE OF CbN3TRUCTIOW Q BLOCK " Q FRAME �]' STEEC �] �
<br /> DESCRIP'TION OF WORlC cS 0�_ � �
<br /> BUILDINCs StZE ' SQ F04TAGE��, ,HEI,GHT��. �
<br /> D����a��C' �� VALUATION��F TOTAL CONSTF2UCl'ION J3
<br /> QECECTRICAL. , �� AMP SERViCE Q 'PROGRESS"ENERGY Q W:R.E.C,
<br /> �P�UM8ING t �$ '� � ' ' j�,,�jf�
<br /> . ��l�;i"�t
<br /> QMEGHANICAL $ � VA�UATIQIV OF'iti�EGHANICAL INSTALIATION' �� '
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<br /> ��,as �oo��� sP�cta�n C] o�HE� -
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<br /> FINISHED FLOOR ELEVATIONS FLOOp ZOP1E AREA QYES. NO
<br /> BUILDER COMPANY'= . , ' "
<br /> SIGNATUI2E REGISTERED Y/ iV FEE CURitE� Y'/fV"`
<br /> Addre$s � ��' =t ` �Eicense# � ��
<br /> EIECTRICIAN. � GOMPANYt� -� ��` ...- � ,_. � _ .
<br /> SIGNATURE � REGISTEREb Y/ N FEE CURR��a�� ` `�rY l N .
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<br /> Addressa - � , ;-- 4tcense.#-,�:__���.Y� �
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<br /> P4.UM6�R ' GONiPANY • .:, _ , �+: _ ": . :
<br /> SIGNATURE' ` � ,REGISTERED, Y.L�.N :FEE CURR��-; �Y/N. - �
<br /> Address , .,t.icens.e,# �, :. . ' ' �,-
<br /> nn�crt�w�ca:� � , , , coM�i►�nr ` , , . . _.: ,.
<br /> S1C3WATURE " � � REGI§TERED , Y,/:N FEE�CURREP< Y./^N�
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<br /> SIONATURE:. ;: , , �� -R�cisTe�o ' '1f/ N_..' F��cuR�n /N
<br /> �� E �`:, � � ,._ � . . - , ,. , .,.�._ ,. _. ..
<br /> Address �:.. ;:�?w, . � .t..�C- ' License#_ 'C-'CC_°=�S 1� ``�Z- 1 � ,
<br /> ..�. ,-,:..« ,._ �., ,. ,•_.- ._:: .. �
<br /> RE8IDEN'T1A1:�=� 'AtNaoh"{2},,P.,.lo#��P•,lans:.,{2}sets�;of,BuiCiling�Plans;(1)set aF:Energy>Forms;TMR=t'?-ti'N`Peimitfor'new canstruc�on,
<br /> •� �..Minimum;ten;(,1,0):wprking;days::aiter„'subiniftal'date.�:Requi�ecl onsite;:ConstruoBon�Rlans;`SMrtnwater Plans w/SIIt Fence installed,
<br /> "•����.,<�����- �- � , . ..
<br /> Sanikar`yFaciltUesc8�;l;dumpste�Site�Work:Permit#or.subdivisions/large.pr,oJects,;,_,,,� u;t ' � � "° - _-.
<br /> GOMMERClAL Attach(3}corriptete"sefs of 8uittling�Plans plus a Life Safety Page;(1}set of Eaergy Farms.R-O-W Petmit for new construction.
<br /> Minimum ten(10)warking days after submltMal date. Required onsike,ConstrucHon Pians,Stortnwater Plans w/Silt Fence installed,
<br /> San(taty FadliBes�1 dumpster.Slte Work Pertnit frar all new pmjects:_All commercial requl�emenGs.must meet compliance �
<br /> .-51GN PERMlT Attaeh(2)set's'of Eng"ineered;Pians..,�� .�--=-:,..�: _. - � "
<br /> '•"•PROPERTY SURVEY required,far all fVEW conshuctlon., . � - � ,, - •
<br /> Direction�s: • .r. : .. _ . ,
<br /> FIII aut applicaUon campletely.
<br /> Owner 8 Conbac�ar stgn back a#applicaUan,.notarized
<br /> If.over 52500,a Nottce,of Commencement fs requlred. (AIC upgradea aver�7500}
<br /> .. �.:m�,�,�.�;.., .
<br /> Agent(for ttie ccntraator)or"Powet of Attoii►ey'(fo�`e ow�er)would b.e someone virith notarized lekker from owner authorizin�same
<br /> DVER TH�COUNTER RERMi7TiNG -. •(Fronk ofiAjaplicatiomOnly) �� � � " � }
<br /> Reroofs if shingles Sewers � 3enrice Upgrades A/C.. . Fences`(PIaUSurvey/Footage)
<br /> Driv�ways-Not over Counter if on putilfc roadways::�;eeds,ROW �,.
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