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�� ��;�saao-oo2a City of Zephyrhills Permit Application Fax 813-780-0021
<br /> �:.:, , Suflding Depastment
<br /> DateReceived ' .. . . ° Phort�•Contactfor.PermittFn � O�� /r�o2 — �l�
<br /> Oweer'a Name �� `�✓��}1@- .��/�� Owner Phone Number .
<br /> Owner"s Address � �/g�r - Owner Phbne Number �� - � �
<br /> Fee Simple Titleliolder Name � ' Owner Phone�Number � �
<br /> r;r .
<br /> Fee Simpte Titleholder Address '
<br /> �+ f y•-.-
<br /> JOB ADDRESS �'�� ,�� oZ L� / ! �� '��� LOT# �
<br /> suBoivisioN � � � �,��E��o# ll � �/ ��t� 1l�� al��
<br /> ` � � , (OBTAINED FROM PROPERTY.TAX NOTiCE)
<br /> WORK PROPOSED �°`NEW CONSTR ADD/AlT � StGM1I Q Q DEMO1,iSH
<br /> •:e. INSTALL �. REPAIR �
<br /> PROPOSED.t18E Q SFR [� GOMM � �� �{aTFiEFt .
<br /> TYPE OF CONSTRUCTION • Q ' BI.00K ' Q FRAME _ �� STEEI. Q -
<br /> pE3CRIPT10N1 OF WORK � /�rS �Gy G"j G�'!>�G � ��� �
<br /> BUILDING'SIZE �� �:SQ FOOTAGE��_ � HEI,GNT'��—______�
<br /> 06UII.DING � � VAlUAT10N`OF TOTAI:'CON$7RUGTION , ' � r
<br /> QELECTR{GAl _ ,r � � AMP SEFtVtCE �Q PROGRESS ENEF2GY Q �W.R.E.C.•
<br /> �
<br /> QPLUMBING� $ `
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<br /> �ECFfi4N1GA� $ ���* ' VA�UATIaN G1F'MECHANICAL tNSTAIlATIE}N
<br /> C��. � .. , . .
<br /> �c�s � aoo���v� [p , s�ec�A�.�nr � OTFiER= -
<br /> FINISHED FI.00R EI.EVATIONS ��� F1.00D ZONE AREA QYES NO
<br /> BUILDER COMPi4NY '
<br /> SIGNATUI2E REGI6TERED Y/ N _ FeE cuRr�n Y/N�
<br /> Addre�s - Ctcense# � �
<br /> ElECTR1C11AN� . . , COMRANY � . .
<br /> SIGNATURE '� REGISTERED Y/ N FEE'CURREP` '�Y/N
<br /> Addre�s ' ` � . � � .. Llcanse�#.� � �
<br /> PLUMBER COMP.ANY � ; .
<br /> SIGNATURH`' , ,.REGIS.TEREq — Y/.N.. . ;FEE CURREK ' Y-/N. � .. ,
<br /> Addreas �, ,License# � - �- � t
<br /> , �/
<br /> MEGHAMiCAE:' � c.,. COMPANtY �� f. R`14I S`�/Y.Y�
<br /> 51GNATURE� • �,� '� RE,G,ISTEREP , Y.,/ N ' FEE CURRE�- Y GN ,
<br /> Address:" '���'��ll�11�' � ����—�l LZr.S ' _ License# �����"��
<br /> . ,...�. , . . , , -
<br /> OTHEi2 " � _ ` � ` _.. � .. :G�M,,Pl1t+lY � � . . .
<br /> SIGN�I7URE�. �Rr' � `�� - ""�� • � ' d ` � " REGISTEREP Y/ N>._ �'FEE CURRE� Y/N
<br /> Addre�a . � ~ � . - , - - � ` ' Cicense# � � �
<br /> .. , � . , -4s='.., "^ `— 26t�._.:.�,.f.. ,-�.. .,.: _ . �.�, ' ,
<br /> RESIDEN'FIAL;; -',�Attacfi�{2):;Ptat Pians;(2)sefs:ofoBuitiling!`Ptans,'`(.9}sef of=Energy�Foiin§;R=0-W'Peimlt far`new canstn=ction, � ..
<br /> _ ::�-Minimumrtenz(•1,0);worktng;days„;after�subnniftal°dafe::;Required onsife;:ConstruoBon=Plans;�`Stoimwate`r'Plans w/Silt Fence instailed,
<br /> ~•�".�'��V.Sanitaiy�Facillkies;&,1;dumpster�Slte°Worfc;;Pem�it_for.�subdivislohs/large'rproJects �- ' - : . � � ,-
<br /> C�MlWIERCt,A4. - Attach(3)�comptete sets oPBiilllding Piaris ptus a�l.ife Seifeiy Page;(i}set of Enet�y Forms:�-o w�erm�t�or ne��ons��on. -
<br /> Minimum ten(1p)wo�icing days after submittal date. Required onsite,CansUucNon Plans,Starmwater Plans w/Silt Fence installed,
<br /> Santtary FaciliUes&1,dumpster.Site Work Permtt Eor aU newprojebts:All commercial�equlrements.must meet compllance '� •
<br /> StGN PERMIT Attacfti(2)s'ets af"Engineeret��Pian_s.; �:;;";=- .; .. ° ,,�,. - ,
<br /> «"""PROPERTY SURVEY requlred_for all_NEW construc.tion... - '
<br /> Directiona: .-£,•Y. ,,.. , - �
<br /> Fill out applicatlan completely.
<br /> Owraer&Contrac#or stgn back af appi[caUon,notarized
<br /> If over'�2500,a Nottce.of Commencement 1�required. (A!C upgrades over i7500) .
<br /> ,�;.�_:;. ,.
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<br /> Rgent{for the contra�toc)`or Powe�of Attomey(for tlie�owner)�would�be someone with notarized letter from owner au#horizing same
<br /> �VER THE COUNT R PERMi::.. . • . F n of• ty)_ .. � . � � �'�ve�,� 1t F.§„�� ,,.t��,�
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<br /> Rero fs if shin les '�e� e ��•�,.., ences(PlodSurvey/Faatag ) ,. : ,g � . �, s a �� �-`*. , �' -
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<br /> Drivewaya-Not ver,�rv,�fer,�on p�bii�r��a�ay.S.•needs�Q �C , � �-i,,,,Fi;,, .� sr,�r��?;°=�
<br /> ,4;, iU�,i:�7��,7K_S.SfrC,�,. �!>+. ��mre � 7..,; Jb,4t���t a? w ' ItC�, J e,,�
<br /> t i ;j :r �y��"� .:I�,�.y*.�+.'. ��'u`if��::iYi�ts tllr`��Fi}1 iAi'�Ji,�di7 °'e<cir�'''RY
<br /> si�ju�;� i�i�r 'r2:tiA$tT??<tH �',y.y..%,`-� �
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<br /> 13£�°t giii�}S�i8n.{lli�C�!��"Jit���3sf1�.�+.�`' °r�'tl•r-`�`
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