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$13-78Q-oo2o City of Zephyrhills Permit Application F�x-813aeaooz�
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<br /> ' 8uitding Department
<br /> Date Received , . `.�phon�.Coritact�far`Pertniftiri V `
<br /> Owner's Name �{'�� . /'�'�'�Ct�'i0/�. . , Owner Phone Number . ` �
<br /> Owner'sAddress �a�'�.�''y ���` �'I�V� �!�Y�y ���P� py�ner•PhoaeNumber � �
<br /> Fee Simple TlNehalder"Name� � " ��� pwn�r Phone Number ( .,�
<br /> . � . ,. '�7t— . +;: -
<br /> Fee 8(mple Titleholder dddress ; ' . , • . .
<br /> JOB ADDRESS ���B�J s /�V�'' �c.°�'I� r i� S L4T# ��
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<br /> SUBDIVISION � � , � � PARCELID#' ��'�6'Zi'OC,C��vC+fCO" CJO/6' -
<br /> - � � `(08T/UNEDFRQM'PROPERIYTAX'NOTICE)
<br /> WC1RK PROPOSEA ` NEW CONSTR •� � ADD/ALT �' SIGN [� �Q � 'DEMOLISH �
<br /> .� � + INSTAI;L 8 .- :REPAIR ,. ,
<br /> FROPQSED USE: �: SFR. Q COMM � -OTFtEFt' ' r� sr t- .t�" ' ' ; _
<br /> � : �- . . . .. ..,.
<br /> TYPE OF CQNSTFtUCT10NM , :�] � "'BLOCIC�' . C] � 'FRAME Q 3.T.EEL [�: � � -
<br /> DESCRIPTION OF WORK � S�'(„�Aer �;g 'n� (�-� ,�-�r�
<br /> (�l,�G�(Cl�..
<br /> BUIL.DING SiZE',`� � $Q.F.QOTAGE;�?�� � . ,.HEIGHT;,.�,�P,., . ,_ ,
<br /> .. Q BUIIDIi�lG , $ . _•.:�i=r-:.. t:,:::�,.»�... ._ .. ;
<br /> ��^�.�" VACUATION`aF"TCOTAL CONSTRUCTION ,
<br /> �,�I
<br /> QEI.ECTRICAC ��' AN1P SERVICE ' Q PROGRESS ENERGY '[� W.R.E.C,
<br /> QPI:UMBtNG �$'
<br /> ' �� - - � �
<br /> QMECHAi�tIGA� � $ `V/1t.Ui41'ION,OF MECHAPIICA�rtNSTAltAT10iV ���� �
<br /> Q�►s ,0 , �oo�i�v�. .,p s�ecia�rY -�� o���� � � p ��
<br /> FINISHED F�OOR ELEVATIONS _ FLOOD ZONE AREA . �YES. NO
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<br /> �UI�DER COMPAISIf : �_ �'as".,.�.1:'"t
<br /> SIGPIATURE RE131STEREp , Y/ N.. �E Cuwt�n'� '�.Y/.N.. . , , -
<br /> A�d�e�s '� .`~--- iC[� Ucense#�I �
<br /> ELECTRlCIAN�,-, � 4, `. COMPANY F ` - ,, 1 _-� t, .
<br /> SIGNATURE � RECaISTERED Y/ N �Gutt�n Y/N : '
<br /> 'y .. 'x� J ••�
<br /> Address � x _.Ltcense•#;
<br /> PLUMBER ' , , : COMPANY*= � = : , : . � ,
<br /> SIGNA►TURE � ' � . :REGIS.7ERED- «-�::Y/-aN � FEE:CURREA•' - "Y/'N.� �
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<br /> Addr��s � Ucense#. '
<br /> MECHANICAL; ' .� . . . • � � ' ,COiWPqt�tY . , �� -,;�.,< <. ;�, _ .
<br /> SIGNATURE ' " . � , , ., , � ' REt3I,�STERED: ., , ,..>Yr;l'N,r - ,,:FEE:.CURRFP . Y/„N =�,',
<br /> Address' . - : - ° . , � � � ycense# � ' �'.
<br /> OTHER . �;.`�:,`;. ��� . ` „ . , aCO1yIPANY �--y' P�'Ctl,,.3•GtL' '. .�A��7�T.,-���p.�3
<br /> SIGNATURE �` " 4� . .REGISTERED Y/�N. - ��;GURrt�P ,Y�/;N<-.., � '
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<br /> �aares� ��j�� �,�'»�r�.�,.. cx��fc�;..;�.r -�;�c.1i��ccr � ° " �uc��se�#:�l�G .1�2��'€3� �
<br /> . . -. '4' - '.;}-- �,%`r�iw,,.,,'�...,�.i.��� •f _ - _ _ r•1;Y6,�i^--j.i,t�;.i.t.,;,.'��q`gF,:,;: +.s-;.s '�i�g��i:r',. . ., t.' . �
<br /> RESEDER�TIAt;.~,�:i0.ttach;2�„P1okP..ian§;2:'s`etsrofiBulliling;Plans,,.(1j,seti�of=Enetgj+=Fomis:'R=O=W�Pertriit:forneyr`,`:con"struc�on,- - .. , ,
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<br /> Mlnfr�um,.ten=�10. w,orkln.gzdays,after„sutimlttal:tlate."Requlr.ed:onslte;-Cons��.� ,.``� „�..�'�•� . ��`.� � �
<br /> , ,:(,4 )�µ_, r � tiucdon�Plans;�Stormwate�`Plansw/-,SIItFenc,elnstalled, .
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<br /> SaMtacy.Fac�l4de.s?8�n4,dur�tpster;:Sfte�YUor�e�Pert►5it:fqrsutidfv#sli�risllaige'piojects'::_„�;;";�_ �'.�;,+•_', '__ ' - ' .. . _
<br /> COiIrIMERCIAL Aftech{3}`is6mplete sets�of Buitding Plans ptus a'L�fe Safety Page;(1}set of Energy Forms.R O-W Permit far new aaristructlon. I
<br /> Ml�lmum ten(1Q)working days'after submlttal date. Requlred anslte,.ConsWcdon Plans,Stormwater Plans w/Sllt Fence Installed;,. ,
<br /> Sanlmry Facltitles&1_dum�ster..Site:Wotk,Permtt for�Il,new;priijects:Ali;`commesdat:cequlnaments must,meeY.compflance
<br /> S1GN i�ERMiT Attac�"(2j sets of'Ei�gi�it�ereif�.Plar�s',::;a,�;r?`° � , . , , .` . �
<br /> •""•PRqPERTY SURVEY requlred:for;all�NEW,constructlon..;_,;.;��._ - -- ,
<br /> ' Dire.cttons: �..::-�a..=;r� .: ...., ., _. �. _. .�_ .- .- �
<br /> FIII out applicaUan completely.
<br /> Owaer&Contractor sign back of spplfcatlon,natarized
<br /> If over$2500,.a Notice;,of.Commencement ta requlred._(A/C upgrades over_57500)_, �._ , -
<br /> .,i:t,.T.�y;�:;.�... ��. ... .4..__.... .,..._... .... --...n_.
<br /> " qgent,(for ttie'cont'ra6ta�)'or.Powe'r'of Attomey(for tlie.owner)wou4c!be someane_with notadzed letter from owner authorizing same
<br /> 'OVER`THE COUN.T.ER;P.ERMITTING=---:"��(Front•of�Appllcation Onfy)=` '
<br /> Reroofs If shingles Sewers Servtcs Upgrades A/C Fences(PlotlSurvey/Foohage) - • -- -
<br /> ,, ,�_��;�t ., � -, _ ._ .. � . - -
<br /> prlveways-Not aver Counter If on pubtic roadways.:needs ROW �
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