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a�s-�saoo�o City af Zephyrhills Permit Application FeX-s�aaeo-oo2�
<br /> Buitding Department
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<br /> Date Rscetved . P,.honaContaict for�Permtttin
<br /> Owner"s Name � �.. � y ' t� 4,7`� Owner Phone Number �r �J7��� ��
<br /> Owner's Address �� �6 � �,» - Ow�er Phane Number � �
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<br /> Fee Simple Tltleholder Name �/\:6!�''L.� ��C�C�r r..,c..L�� Owner Phone Number
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<br /> Fee Simple Titleholdar Address � D `S �
<br /> JOBAbDRESS �� 7 L' / 6 �� � / - LOT# [�
<br /> SttBDIVISION � �� � PARCEI,tD#
<br /> , (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSEO _NEW`CONS'fR ADDlAI.T �' SIGN 'Q [� DEMOI:lSH
<br /> INSTALL � REPAIR
<br /> PROPOSED=USE , � Q� SFR [� CQMM � QTHER
<br /> TYPE OF CONSTRUCT10N Q� �` BI,OCK " [� FRf\ME [�,,,.] STEEL 'Q
<br /> DESCRIPTION OF WORK f�J i'"l t/ �-• � *�'Gcf�to�., . Dc D �
<br /> BUILDING SIZE � � �` SCt FDOTAGE ��� - HEIGHT �[��
<br /> QBUEE.DlNG � � - �-=_ . . �
<br /> �,�� VALUATiON��1F�'fOTAL CONSTRt1CT10N
<br /> QEI:ECTRtCAL � - �� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> [�Pl.UMB1N{3 =($ � '
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<br /> QMECHANlCAL $ VALI3ATIQN OF MECNANICA�.II�tSTALLATlON �� �! C,��
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<br /> ' QGAS Q FtOOFlNG .Q SRECIALTY [� OTHER
<br /> FINISHED FLOOR ELEVATIQNS �� FI.00D ZQNE AREA �YES ;NO ���;,.L=-LC!
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<br /> 8EliCDER COMPANY. ' �~ �`�-�
<br /> SIGNATURE REGISTERED Y/ N . •FEE CURRE� Y/N�.
<br /> Addre�s = - . °:�i., Licsnse#'L,;,.��—'���r��-'_""
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<br /> E�Ecr��c�a�: ;coM�a�nr:< = � .� , _. . .
<br /> SIGNATURE '� REGISTERED ,Y/ N FEE CURREA- �` -Y/N
<br /> Addres8 ., 1 _ L1cenSe#�� �
<br /> P�UMB£R � � COMPANY , .` , .�;L �, � . ' . '
<br /> SIGNATURE' ' ` ' REGISTERED Y L.�N•. FEE CURRE� Y/N. �
<br /> aaare� _ _ � ucense;#` . . _ * �.
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<br /> MECHANIGA� " . COMP�,WY ' -
<br /> SIGNATURE � � ' � " Recis'reReo ; Y/.N , _�ee CurtaEn, ,,Y./N, „
<br /> Addrsas: � ,. . � ' Ucense# � � � .
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<br /> OTF3ER -' � - - 'sGOMPANY„ :.
<br /> SIGNATURE -� � �`� � ' ` �REGISTERED ` Y/ N,.. � FEE CURRE� Y/N
<br /> Addreas {, :} sT ; � , , � . ` � . . tfcense# 1 I .
<br /> REStDENT1AL.': � At#acli'{2)„Plc#zPiasis;(2}sets"sof=Bia1lding'•!?tans;`("1}`sef"of Energy�Folins,R='Q-UVYRermlt fdr new ccnstructtan,
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<br /> �.5;_Mlnimum�,ten,,(1.0).worfcing;days;afte_r,:subinittal`date:::Required onsite;:_Constructlon-Blans;Stortnwate'r'Plens w/SIItFence installed,
<br /> � "" SanitaryFacllitlesr&;.1;,dumpster-�3iteW.ork:Permit;for"sutitlivislonsAargaprojecfs_:._.'=_:.._-:._` ' -
<br /> CdMMERCIAI. At#ach(3)'coenptete sets'of`Builclirig Plans plus a(�fe Safety Page;(1}set of Energy Forms.R-O W Petmit far new canstnsction.
<br /> Mtnimum ten(10)working days afker submittal date. Required onsite,CanstrucUa�Plans,Stormwater Plans w/Silt Fenca fnstalled,
<br /> Sanitary Facilitles&1 dumpster.$Ite.Work Pernilt for all new:projecks:,All commercia#recjuirements.must meat compliance
<br /> StGN PERMIT At#ar.Fi{2)sets af Eiigiiieered:FEans..,�- :`5-"� .. , ' '
<br /> ••""PROPERTY SURVEY reyuired for all.NEW cpnstructlan. � ,
<br /> Direetions: - , __ ` -
<br /> Fill out appllcatlon wmpletely.
<br /> Owner 8 Contractor sign back of appficatlon,notarized
<br /> if ovsr�2500,a N,atEcs cf Commencement is required. (NC upgrades ovar bT500)
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<br /> Agent(for the contractor)'cir Power of Attomey'(fo�tFie owner)�would be someone with notarized letter from owner authorizing same
<br /> , DVER THE CdUNTER PERMITtiNG - (Front of-AppllcafEom Oniy) " �
<br /> RerooFs If shingles Sewers Service Upgrades A/C Fences(Plof/Survey/Foatage) ,
<br /> Drlvewaya-hlot over Counter if on pubiic roaduvays..iieeds ROW
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