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a�s-��o-002o City af Zephyrhills P�rmit Application Fax 813-780-0021
<br /> � ' Buiiding Department
<br /> Date Recelved �1� � -.Phooe Cantac#far ParmE�tin _
<br /> Cfwner's Name �j'Y'1�� 1� G1 1"i''-: Owrn+�r Phone Number - -
<br /> Owner's Address Owner Phone Number �� ` ��:- .'
<br /> Fee SlmpYe Titleholder'Name �— � � a � Owner Phane Number._ 'r� `�
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<br /> Fee Simple Tltleholder Address ° - � �
<br /> JOB AL1pRE�3 LQ,` � � ' LOT� �� .
<br /> SUBDIViS10P1 ,�'"�(Z`�,t'1��'�Z15 �ARCEL tD# ' • OOC� �Z}. -
<br /> , - ,. , - (4BTAINED EROM PROPERTY.TN(N4TICE) - -
<br /> WORK PRBi�OSED NEW CONSTA AC}D/ALT �.,.�" StGN" .'Q, - Q �DEMt}L.18H
<br /> , e. w 'INSTALL :. , REPAIR �� _ - : .
<br /> PROPOSED�USE � �° Q� - _:3FF2; . Q. ,",COMIU� , ,.�� �OTNEF2"- . ,
<br /> TYPE QF CONSTRUC'fION Q �BI.00K '"•��] „ -FRAME � � STEEC 'Q '
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<br /> �ESCRIi�T10iV OF-WORK '�Al� � � '
<br /> BUIL�tNGSt2� r�� c� � SQ:FOOTAGE,�t� ... . ,HEIGHT� ��t
<br /> BUt�i3ING $, ,J� }-� �. yALUATION>C1F``'TOTAL CONSR`Rl7CTION ' - -
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<br /> QELEG`Cf�ICAI. � �} AIUlP SERVICE Q :•PROGRESS ENERGY � W:R.E.C. "
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<br /> QPLUMSING $ 111. � . � /
<br /> � � � �� G%' _
<br /> QMEGHANtGA�. $ VACUATION OF,:MECNANICAI.INSTAt.LATlQN. 5�/
<br /> QGAS � Q ROQFING Q SPECIALTY �: , OTHER - -
<br /> FINISHED FLQOR ELEVATIONS � FLOOD 20iVE AREA [�YES .NO ; -
<br /> BUILDEit . 2(;}, � COMPA4IY: ., '�- -
<br /> SIGNATUi3E REGISTERED Y/ N . ` FEE.CURI2�� ' Y/N" �
<br /> �lddreas �Y`•JG�- � - . . . ,.,1:icense:# � Cl �
<br /> ��,�. � � ' -
<br /> EIECl'RiC1APl; , � '� .. ��hCOMPANY;;, t�t'�y�� •� L�.
<br /> SIGNATURE
<br /> ���� .," „ REGISTERED Y/ N FEe:cURREn.r .Y�fV.� '
<br /> -�c�dPess �- ' �.. _ _ _ ---_-- ___------_ _____-"--� _._ _
<br /> _..� _ J— - , _. . _- -�:Ltcense#��"_�- `' — - -
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<br /> PLUi4�BEt2 � . � , . G.OR�PIEWY_ _ ' _
<br /> SIGNA7URE' ��' � � ; REGISTERED - Y/ N FEE CURRE� � � Y/N ' ' _
<br /> �lddfe88 � � � ..� � --LicenSe.# ��`.� �.
<br /> WIECHA41tC�iL" , � _' ` -, . � � GO�PI�PIY �
<br /> $IGNATURE `- �` t� REGISTERED Y,/ N ,; FEE CURRE�-- 'Y/N _ _ .
<br /> Addreas' � � - _.. '. , - ., -- . License`#��^ � 1 -
<br /> OTtiE3t �� , . „ ,,, ,_ , .. . 4 �,COti�PANY" r - , , ' � -
<br /> SIGNATURE�, .., _ , , .. � „ ' ' REGISTERED` Y! N,..: =FEe cURRE� - Y I N ,
<br /> Address �., . - ' .. �� , . . , , , License#��� � � .
<br /> � 4,�.r" '�..' .x rv'' ' 'H: . r.... .��. .,�r., , -.. . ' 'n '�' ..
<br /> E2ESlDEN'i'iAG.;::. :Attach{2),P2af Plans;:(2�sets;of+BiiiliiingFPtaiis;(.1)set af�Energy=Foiins;�R-O�W'Pemilt fot riew construcNan, ' � .
<br /> � ,--,..Minimumy�ten+�,(40);working;days;affer,;submlttal'date.%Requlreii onstte;;Const'riicfton`Rlans;�Stormwater Pians wI Siit'Fence-installed;
<br /> ��'���Sanitary Facll(Ues.&;9�,dumpste.r,-Site°Work�Permit forrsubiliyisions/large pro)ects;,,-�,�„; _ ' ' � � . _.
<br /> at. ...., � _ . .
<br /> ` COMMEt2CtA�:`- -Attach-(3j`camptete sets:of Bu�tdiiig"Plans plas a�Ctfe Safely�Page;(1}set of Enet�y Farms.R-LT�W Permit far new construcUon.r - �
<br /> Minimum ten(10)warking days afker submittal date. Raquired onsite,ConsWctian Plans,Stormwater Pians wi Silt Fence tnstailed,_
<br /> Sanitary FaciUties&1 dumpster.Site V11ork Permit for all new�projects:.AlYcommercial requlrements,must meet compilance =
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<br /> StGN PERMIT AttacFi{2)sets df Erigineer,ed�Pians.:�,_<,;,.;:, � '- = ., -. _. �
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<br /> ••"`F'ROPERIY SURVEY reguired.for,all NEW constructlon.. � � ° ' ' �� _
<br /> Dlreation�: �., ". , _" ,. ,
<br /> Fill out applicadon completely. -
<br /> Owner 8 Contractor stgn bach of applEcaUan,notarized
<br /> (f aver�2500,a Notics of Commencement i$reqatrse�. {A!C upgrades�av�r�7500} � � _
<br /> '" Agent(for the contractor)or Powe'r of Attbmey�(far ttie owner)'would be�someone with notarized letter from owner authorizing:same - -
<br /> t3VER TNE COUPiTER PEFttrtITTFPiG-- - -;-�(Front of-Applicatian Onlyr) - " _
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
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<br /> Driveiidays=tVotover.�Countertifonpubiic.roadways..i►eedsRt}W' � -. .�.,r,.,..,,�:_, r, :` _ ,
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