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� ����-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �'' ,• �c :
<br /> � �'�" Bullding Departrnent
<br /> Date Received ' ,� Phone.Contact'foe°PePmitttn � �� — �(�j
<br /> Owner's Name Q./V 1`�il.. .. � . Owner Phone Nlumber U`�—7_ � 61�5
<br /> Owner's Address f�� � / ;S� • Owrner Phone:Number '
<br /> Fee Slmple 7ltleholder_•Name Owner Phone Number
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<br /> Fee Simple Titleholder Addreaa - -
<br /> JOB ADDRESS _ Il / �� 02�� �—�,/fL`,$ �, , �3� LOT# �
<br /> susoivisio� ' . , �,�cE�.��# �O� �!o al 1�19'� dD�l� �3�'D
<br /> , (OBTAINED F.ROM PROPERiY,TAX NOTICE)
<br /> VUORK PROPOSED s,NEW CONS7R' ADD/ALT �� SIGN' 'Q -'�Q DEMOLISH
<br /> , ,B� INSTALL ,� REPAIR �
<br /> PROPOSED>U$E , Q � SFR, [� COMM_ . Q OTHER . �
<br /> TYPE OF CONSTRUCTION"� 'Q' �r'BLOCK " �Q FRAME � Q STEEI 'Q
<br /> DESCItIPTION OF WORKI' 'j ���� �f� /� ��--OLL. � � /o'� /d � CO"m D�✓eJll�
<br /> BUILDING�SIZE' � � �' SQ'FOOTAGE' HEI,GHT�.�
<br /> QBUILDING $ VALUATION�`OF'TOTAL CONS7RUCTION - '
<br /> QELECTRICAL $ " , AMP SERVICE °'Q � ;PROGRESS ENERGY [� W.R:E:C.
<br /> QPLUMBING :$ � "
<br /> �.. .
<br /> QMECHANICAL $ VALUATIONOF;MECHANICALINSTALLATION.
<br /> � - y�}�8, bf�. .. , ,. . . :, . . . .
<br /> QGAS � ROOFING ,Q, , SPECIAL7Y�:0 �, OTHER�, :., .
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
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<br /> BUILDER COAAPANY�, ... .`;'.::' ; - , . = - �
<br /> SIGNATUFtE REGISTERED Y/ N . �"':'�FEECURREA." ' Y'/'Nr '
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<br /> Address ��� - _-. ` : :.� _. ,�l:lcense.#' •f' - `. - - ..
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<br /> ELECTRICIAN: , . , � � ;rCOWIPANY''"� � �R ;;. .+:-,... � . , ._� . .
<br /> SIGNATURE ' �cisreReo Y/ N F�Isur�E��{ ��t �>�Y/-N-� ' _ '
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<br /> Address ` . . , . ... . ,. � ' � Ll,cense;# -- -
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<br /> PLUMBER ' , �C.OAAPANY ,�::�,�..r. ;'t .. � ::�.: -. ���� •. �._ -
<br /> SIGNATURE`�'`��� ��'` ` -' � � 'REGI§.T.ERED ._Y:/,:N,�� , ,- �,�.cuaREn:• =�X-;/.N ;
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<br /> Addres$ ' � ' + 'License# s.� -- � •..� ' _ ' .
<br /> MECIIANICAL` � ` . ; , COMPANY /`iF �, D %�I. -!" . ��
<br /> , ;, - �;<<;. ,_= ��'S'f,�. �
<br /> SIGNATURE� �`'�� 1���- � � � J
<br /> REGISTERED Y/.N `..�..:; :.E CURRE�,;. ,.. Y./�N..,
<br /> ,,. ,t, ,.. .. . . _ _ Z_ � . < <y ,.. . . .,....,t..�� � �,G'D 3 .�`i�.�5 .
<br /> Addre�a's`� � °����!�'� �'� 'E' - fL.�� License#�` ��� �
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<br /> OTHER ,. ., .. . �. �- , . , �_,,;,y. -. - " • . ,r,...''_-
<br /> f'= •r= ;COMPAPIY_'
<br /> SIGNATURE•_ ..- - �, ., _�. :�.. . .� r;�;: .,_ , _.
<br /> 'REGISTERED�� Y/ N..,,. �FEe'CUR���'+ Y%N
<br /> ,'f�'�Fi•I!�•�<• ��•�,1_ .]-:. -.. . . . . " ." _ . _..-. e . , �. .. .- � tt• : '�,.i ' .
<br /> A�I�re$S .,i,p.�.�,:r..ir: -- � � ' '4� ' ,1:1Ce�ISe 1t�" ..
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<br /> RESIDENTIAL:�,. ��Attabh?(2)aPl.ot�Plans;;,(2)sefs:of'Building�Plans;�(:1)set'of�Energq�Forins;�R=O=VVxiPermit for new constructton,. �
<br /> �* ;�,�;.;;,>:MinimumGRen�,;(1A)�,worlSing{de�ys�aRer;;subinitfaF:date".;Requiredonsite;'.ConsfnicBon'Plans;�Sfortnwater'Rlans�w%3tltFenceinstalled,
<br /> `�''�`�Sanftery FadllUes_s�i1 ciwmpster,Site Worlc;Per►nit fo�sutidivlslons/leige�prnJects`2;:ya;.;�;�,`, : "_'�:` :�� .. � '< • `"=> ' ,
<br /> COMMERCIAL Attach(3)�complete'sets'of'Bulldfng Plans`plus a Life 3afety Page;(1)set of Energy Fortns.R O-VII�Permit for neW:construction. '�
<br /> Minimum ten(10)working days after submittal date. Requlred onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed;
<br /> - Sanitary Facilides&9 dumpster.Site,Work Permit for all newFprojbcts::All commercial res�ulrements_must meet compliance � �
<br /> � SIGNPERMIT AttacFi(2jsetsof`Engineered�Plaps:�,�:�;:�~s"r�-. .-. , �.,; . . ... ` .
<br /> "••PROPERTY SURVEY requlred.iqr all NEW const,r,ucdon._ _..�. •_._ � - - - •
<br /> _ ._.., - -�..
<br /> Dfrections: ="'�=��:" � -�
<br /> F(II out appl(cadon completely.
<br /> Owner 8 Contractar sign back of applfcaUon,nota�ized
<br /> If over a2500,Ta Notice;of�Commencement Is rsquUed. (A!C upgrades over 57500) , _ •
<br /> v:jN' "r,fj'i'E'
<br /> " Agent(for the conVactor}o"r b"'���"f�' o�ey��h�er��Id,�eksomeone wiith notarized lettef��rott►eanvr�aQthdi'izirig�ilmit,�,��� ,
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<br /> OVER-THE:COUN.T,ER;.PERM NG����";��(+F+�or�t.�'A�plication�tiry)'�.�-- �' '- ,? ,.. _ ,. �"��'"'�"
<br /> T;ki'fi.� 1+J 9.nfC- :�!1'�}�!�`:V�'k`.if�f `��.;i�'¢�> �
<br /> Reroofsifshtngles Sewe s.::c��i�Servic�'Up�ra8es�7�/C =r�faFeric�ss,(�IoUSurvey/Footage) � Rr ;=:r'<, �1:;
<br /> F a,, u �P"v� 4�1 IuF ;:?tst;s, trtni'�"� Y.,• Y�,�
<br /> _'.. __...-.-...._ ��S.TO:s gt-1pi�;�4+,i..4.r�,.lifr7�li�'1�5�1 •�"i ^t ��'� '. ` -, . � �.. ';5•e.+F;'�{i o�oi,y:' _,
<br /> ..e.. � ."�,a �.��,t,', ')P;k�l� i'i � iS;`�'.',tt:3iit0:.! :;<•.`cy,:r,'•'rp
<br /> Drivewaya-Not over Cou ter if;onipub�tc�roadwajisi:[�'eeds`E��1�,,�:�,. ,,;; t , �,;• '�%,,,';'�.;�
<br /> '�;i",+•'�• .ndLn`tif,.,a l,anai.��t,�:i tJGStn:�F:
<br /> •.i�zart�i�tt�t ir{fiN�GN�ti�:�lPiliiT C'1D,f��a ,,.,�,� :�,,,�,�,
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