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<br /> ,�� a�a-7so-oo2o City af Zephyrhills Permit Application Fax 813-780-0021
<br /> : Buflding Departrnent .
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<br /> Date Received Phone�Confact�for�Permlttln � � ��� - �d 1�
<br /> Owner's Plame ��/� �!� Owner I�hone Numbe� �f������< ��
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<br /> 4wnar's Address ��� �t 8 /•�G'�!�? t3wner Phana Number ��
<br /> Fee 3lmple Tltleholder Nama �� � �� Owner Phone Number � ��
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<br /> Fee Slmq�le Titlgholder Addres� - •
<br /> JOB ADDRESS �I �� OJ�l`ZL�/V S I.OT# ��
<br /> suaaiv�s�oN � ��'.�n�� T��a� PARCEL ID# '� �� 0?1 �t��C?C�11��'1 t�5S'� .
<br /> , (08TAINED FROM PROPERTI!TAX NOTlCE)
<br /> 1titORK FROPQSED NEW CONSTR ADQtALT � SIGN" "Q �Q DEMOLlSH
<br /> �e-. INSTAL� �� REPAIR - ,
<br /> PltOROSEDfU$E C], SFR [� 'COMM �] •OTWER -
<br /> TYPE OF CONSTRUCTlON' - Q BLOCK " Q FRAME C]� Sl'EEC Q
<br /> DE3CRIPTION OF WORK` , ��- J�E-'Sr �"�� �•l�/f�''/� E-'"f..�LiL' � GJL"7Yl /VG=l�/T� �G3lf _ t�
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<br /> StltLDING S12E �^� St�Ft�OTAGE , , HEI,GFiT. ��� .
<br /> �BUI�DING ��� VALUATItON";OF'COl"AL COtVSTRl1CTIOfi1 � I .
<br /> QEL'ECTRICAL � ' .[$— ' AMP SERVICE Q `PROGRESS ENERGY C] W:R.E.C.
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<br /> QPI:UMBING•- $ '
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<br /> OMECHANICAL $ 1 VAI:UATIOiV OF MECHANIGAL INS7ALI:ATION'
<br /> . .�- ��_� . . -
<br /> QGAS Q ROQFING Q SPECIALTY [;;,� OTHER -
<br /> FINISHED FLOOR EI.EVATIONS � FLOOD ZONE AREA QYES. ;NQ
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<br /> BU[LDEi2 GOMPI0.NY°`• ' � - �
<br /> SIGNATUR� REGISTERED Y/ iV FEE CURRE� Y"/N` _
<br /> Addres� � a ;= s L"icense#�'� .-..�.—�
<br /> ELECTttiGiAN: ' ��CdMPANY':; , -. %„ :;. � ._. . . . .
<br /> SIGNATURE � REGISTERED Y/ N F�E cUw��n�� � � ��Y/N �
<br /> Addre�s . , . - n ; Ltcense.#,C , �
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<br /> PLUMBER ' COMPANY .`., '; � ., _ . � `
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<br /> SIGNATURE` ' REGISTERED Y./..N,? .�;: -;,_FEE CURRE�' ',�.°_.Y�I N.=-: ;-, , •
<br /> Aadress � �..;i.icense:#` ,;: _ �;� � .—f—�,
<br /> MECNANICAL ljt,tiryuE,, ,.y�!y�:s� CQMPANY �/5�'�" �`..�`, /` A-/,�J�.C7"!�"�'f�G,
<br /> $IGNATURE REGISTERED Y_I..N . • FEEGURRED, �•_wY,I°N
<br /> Address':•,, �'���'j`� t _ G� � � �'�Sy „ ;License#`(�-;..��-�?'�'� .�l�'�"� . .
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<br /> OTliER = ;COIIAPANY
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<br /> �IGIV/i7URE ,'- . �� „ ' ` ` " , - : ' + REGISTERED� Y I N..a, ` " ..FEE CURRE� _ Y/N.
<br /> Address. _ ', ::� � _ � - � ' ticense#'(' ��
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<br /> RESlQENTU4L�,. Attacti"(2j�Plo#%Plans;.{2)set��:of=Butlding'Flans;(:1)sef of.Energy�Forms;sR=O=W Permilt for oew=construoqoe, .
<br /> �: � ;:�Minimum;ten'(:1,0);woricing;daysriafte.r,�subiri�#tal'date:�:Requlred ansite,<Constructlon:Blans;Starmwafe��Plans w!Siit Fencelnstalieii,.
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<br /> ..:,,°Sanita'ry Facilitles�&;1.,,dumpster�3its�Work�Permitfiorsutiillrr�stons7large:pro;ec#s.,-_;:`�,, ,_ • .
<br /> C4MMER�IAL__. Attach{3)�ebmptete'�sets'of Builiifng�Plans plus.a�Life Safety Page;(1)set of E.ner�y Forms.R-O-W Permit for new cansUvcNon.
<br /> - - Mlnimum ten(10)working days after submittal date. Required onsite,ConstrucHon Plans,Stormwater Pians wl Silt Fence instailed,
<br /> Santtary FaciliUes&1 dumpster.Sl#e Work Permit for a41 neuv:projects:.Alt commerciai requtcements_must meet compiiance =
<br /> SlGN PERMIT Attactt(2}sets of Eiigii;tieer.eiirPlans.} ���� �- .., ..t ,� . . - -
<br /> - "••"PROPERTY SURVEY required,for all,NEW construction._ �
<br /> Directlons: � . - .� ,
<br /> Ftll out appUcaBon completely.
<br /> Owner 8 Contractor sign back of appl(caUon,notarized �
<br /> if aver 52500,a Noftce of Commencement ls required. {A1C upgrades over�TS00} ,
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<br /> Agent(far tlie'contraatoT).'strPiswe'rFof�Attortt�'��fitir`th`'�'owner�;waut�be someone with notarized t�kei��`irts►�ri'6i��r'�'�}ton�i�tc,�s&me .,,,,„,, . _
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<br /> 'C3VER T1iE COUNTER.PERMt1T11��; yfi iz(Fro�rt„Qf�Ap�{Ilcat�on't}ril ��:% , . ``';'..�`° „➢
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<br /> Reroafsifshtngles Sew�rs"€��,��.rSer'v�c,a�l�pgra�rt►�s:fA/�r4;,t(;riF,eiices`i(PIoUSurvey/Footage) `,� ���;�-}fL, �,,:,s.r;,;,;x� r,,��,��4a"t .<<T`�;"��,�y °;'i�
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<br /> driveways-Nat over Counter��f�on�ptitslic��¢ways 4rte;ed's`12�.ti�Y��'� � � 4 �;_,::;;:, f;;, *.,c,, ,.,•,.,.�'(„•�` '�.
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