a�3-�BaflQap City af Zephyrhills Permit Application Fax 813-780-002�
<br /> •� ' _ , Building Depactment .
<br /> .�- � ::. - • :
<br /> Dat Recelv�d • , ��.� ��� _ ��`�
<br /> - j ::.Phone=Con4�ct;far=Peemlttin -
<br /> Owner'sName L�dV��C'.�.'L1.L� I�U/T� Owrn�rPhoneNumber ����.3/r.���c��v2~"
<br /> Owner's Address � /1�'� � �.' � L° G� b�Co Owner Ph'ar�e:Number•
<br /> Fee Slmple T1t1e6older.Name � - Owner Phone Number � �
<br /> �.8. . ,. .
<br /> Fee Slmple Titleholdet Addresa -
<br /> J08 ADORESS �c3 �p/ L„�� �Y �� �7 � ! , � ,, r'ft�Y`� LOT# �_,�
<br /> SU�D1YlS10Pl � � �I� ¢��E�.r� ��f �lo a/ Dl.�� `��v-D �.fcx�
<br />' . , , (OBTAINED FROM.PROPER,TY,TAX NOTICE)
<br />� WORK PROPOSE� .;_.NEW C4NSTR' ADDIAI:F [�� SIGN' '� " [� REMOI:ISH
<br /> , :e, INS't'ALL �, .f. REPAIR
<br />' PROPOSED;US� : Q SFR [�. - CQMM . ' � OTHER
<br /> TYPE OF CONSTRUC'170N'a Q" '�'BLOCK " [� FRAnAE � .� "STEEI. 'CJ
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<br /> DESCR1PTfON OF WORK �C.'.Cl, 1�` � L'`�1V �zs t..t- 3 7�'� �.. C�—r» tsltt�� i
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<br /> �tlt�DtPiG'8lZE' �'" �`$4`FOOTAGE ' ..NEIGFiT :��
<br /> QBUILDINtG � VAl.UATEON OFY'�OTAL GOhJSI`Rtt1Gi'ION � ' � �
<br /> � �
<br /> QEl.EGTRICAI �$ ' � AMP SERVtCE: Q ';RRO�RESS ENEt2GY Q W.R.E:C.
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<br /> �]MECHANlGAL` '$-��"��` ��y. VALGATION OF:IUIECN%1NICALlNS7'AL6RTit?N- ��
<br /> OGAS Q ROOFII�lG ,[�,], „ S�?EGIAL'f�Y,:�,] _,..,OTNER, � � �
<br /> FINISHED FLQOR ELEVATiQNS �� FLOOD 2�JNE AREA _,QY�S. ,NO
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<br /> BUILDER COMPIWY�' .:`.,:''> � . � , - , ,
<br /> , �tGNATURE REGISTEREO Y/ N ��'EEE cutt��� ' ° Y�/-N�'
<br /> ��1v9� �t;. ,1'v. ' , y-I,�'� �.'M _.'L7MG�iS�rR� '^�r','...,.�:i.i.. ` �
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<br /> ELECTRICIAtti1;� . . _ . - _ �}GOMPANY'�.' _ `x,=';#�:r:�;�f�,,t, >. _ - : - ` , __ .
<br /> � SiGNATURE � '� � �RECIS7eReo � Y/ N FEE�cu�t��.� °�'� ����Y/:N� � �� � '�
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<br /> Addre�s .� - . , , �`�`.�-.� l.tcertse�#�:!"�.. � �r• r� I
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<br /> PLUMBE1t� . � . ... . �. ,..G.ONIPANY • � ;f r:.x..��:.,� .�r. � � ' '
<br /> 'SIGNATURE`` - ;Ss , , .`REGIS.TERED >...Y/Q.N:s ;.;,•F�-cu�en.� Y=/.N.-
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<br /> Addre�s -- - � �. .. . } --Llcense.�#r 1:�,....-., . :. � - �,,, ' T��. _
<br /> MECl�lANICAL` . - ` �� , - ,,COMt?ANY. '�. /'= � �..e.,, `f'y�f� � .
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<br /> fGN R . , -; , .... _�,-����.9:� t,�l�.?`,. �a: , _.
<br /> S ATU E• ��isTEtteo > Y/.N . FEE CURREh,. _ Y/�N'.,.
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<br /> Addre�.�",,._ =.'7F'`�i�''/- �� "��� `2��ILL� 3�'�`� .,-_ ' .ucense#` .��'����q��- � ,' ,
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<br /> 03NE[2 �:` � - - - ' . ,' � � - ,CQ�IIPANX � .
<br /> IGNA1'URE< F"b� -
<br /> $ .: ��' -. ":' ,. �� . - . � '` - . "`` `�REGISTERED�`'.,- , „Y/ N_..'. " sFEE�CURREA � YYN
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<br /> EtE8lDENTlAL„�t�•_Attach..(2);Ploif P#ans;.(2}sefs:of=Bull'd3iigt Plaits;�(1}'se#�'of=En`ergy�Fo"rins,�R�0=Nt4Per`rri{!hir new�cons6vc�on,. . . �
<br /> �: �;,�.i;�itAinimum;.t�en;(;10)�wori4ing;d�y,s:aiter�"s"ubmitta�:dafa::Requlied onslfe;:Gon`sfiucdon'Plans;Stormviiate��Riane w!Sitt Fence instailed,
<br /> ""� Senitary`Eadllde§;&;1,dumpster��Site�Work;Permikt�r;_sutidfvlslon�/Ierge:proJeots;�hw�`.'=;�;wr,, _ �`��" ' " _ ' `
<br /> CQMM�#tC1At. Attac�tt{3)'coiitplete`sets'of'Biiltd3ng'Plaiis"jiliis a�Cife`Safety Page;(1}set af Energy Fatms.R-O 11{t Perintt�#or aew construc�tton.� ° ,
<br /> Minimum ten(10)working days after submlttat date. Required onsite,ConstrucUon Plans,Stormwater Plans w/SUt Fence.installed,
<br /> . Sanifary Facilttles&1 dumpster.Site Work Permit 6or all newrpioj�cts:All commeralal_requirements_must meet aompilance " -- � •— _
<br /> � .�SIGN PERMIT AtteCti{2)"&etsof�nglne'e,`ced�Plaps:i,�:��^�':r �.. �:� -,�>;..� ,. _..- ' '- ' •`-- _ � _
<br /> ""`PROPERTY SURVEY reyulre�wfcr alf NEW oanst_ructlbn._ ... . _„ '
<br /> Dlrectlans: =r�f��=�.=�,�� -� .�� ; .
<br /> Ffll out applicadon ccmpletely.
<br /> Owner&Contrackor slgn back of appltcatlon,notadzed
<br /> If over�!500:,$,Notie�of Commencement la reqal�ed. (AtC upgrad+�s over�T500j .
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<br /> " Agent(for the cantracto�)o�'Power`of Attor'riey`(fiar the owner)�would be�sameone�with natarized letter o ne a�yIo in s��rr!�•� q�. '.�y
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<br /> ClVERTHECOtlPiT,ER>.F!E[�1Vi1�INGa;�;,�-:z Ft'9ntof- IlcatIon_flni ' '.' '• �?:`�3"��:t ���Lt.i�`? ;a�i,, °
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<br /> Reroofsifshingles „a�"ewrer�.i i,�,:,�h$erv,ice�Wpgrades- ; _ 'p� ( _ :.,,
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<br /> D�1vew:ys-ftlot ov ".Count�r if on pu6lic.roadways::rs�s;ROW �'� � ';,'r °` ; . � '�'`�`'�`; , .�
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