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<br /> � _a�a-�eaoozo City af Zephyrhills Permit Application Fax 813-780-0021
<br /> �' Bu[iding Depariment
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<br /> Date Recelved p�,qne=Cantact,for�PermtttFn � t� l � �d ,� — .�� �� '
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<br /> Owner"s Name G� t�' ��P.� L`L�.GLr�'.OII e- Owner Phone Number �l3 � ��'c�'�i3
<br /> Owner's Address � 1�,� ��e ���L� Owner PhoneNumber � 4�
<br /> Fee Simple Tltleholder Name �^ ,� Owner Phone Number �� � �
<br /> Fee Simple Tltleholder Addresa — 3 '�""Dn/ 1" ���7'd/�,�
<br /> JOB ADDRESS �� D(I��' /� l�� c�- 6�� Gp ��0'7Y/ Lf/VP�t}C� LOT# �� '
<br /> su�o�visio� �_ � PARCELID# L�� �� a� ���� a��� Dt�al� ,
<br /> - , (OBTAINHD FROM,PROPERTXTAX NOTICE) �
<br /> WORK PROPOSED �.,NEW CONSTR ADDIA�T �,,� StGN 'Q Q pEMOLISH
<br /> _e. INSTALL REPAIR
<br /> PROP05Ei3:tlSE Q SFEt Q GOMM� - Q OTHEi2
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FRAME � STEEL' Q '
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<br /> DfSCRIPTION OF WORK- �
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<br /> BUILDlt�lG SiZE r� � SQ FOOTAGE�_� , ,HEtGHT��C`-� �
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<br /> �����d���' , �-� VALUATION±Gf`F't'O`TAL CONSTRtJG`i'ION
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<br /> QEl•.ECTRICAL $ AMP SERVICE Q PRO�F2ESS ENEFtGY Q W.R.�.C. �
<br />�� OPLUMSlNG � . �
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<br /> I [„�MECHANtGAL r$ � YALUATlQN OF;MECHANICAl.tRlSTALLATlQN
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<br /> QGAS Q ROOPING Q SPECfALTY, � t)THEI2 �
<br /> FINISHED FLOOR ELEVATIONS � �—� FLOOD 20NE AREA [�]YES ;NO ;
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<br /> B41t�DER COMPANY•� `
<br /> � SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N ;
<br /> Addrs�s Cicense# � " ' �
<br /> ELECTRICIAN=. �COMPANY " _ , '
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE��' - Y/N
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<br /> Addre�s � . , License# .� �
<br /> , PLUMBER ` GOMRANY - •
<br /> I $IGNA7URE" � ` `�' ` REGI$TERED Y./ N, : EEE CURRE�� ' Y•/N. - �
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<br /> i /�lCldreBS LIC@(1S8�#
<br /> ��cHnr�rc,a�:� . � coM�ivrir. ,��r4''5 , Q 11-1���,��'�" �v��� �
<br /> SIGNATURE� s REGIS7ERED,, Y/ N . , : FEE CURRE� Y/�=N
<br /> Address`>`° 7��'� �1 � 2" 1L1� " � � License#+ ��f�� 7`"J�-���
<br /> OTHER „ ��,,�, . . ` ';COMPAPlY: .
<br /> SIGNATURE �` �` . � � �' � ' " REGISTERED" Y/ N,.. � �e cuR►tEn Y/N ,
<br /> ,4+ddre� , _ - +�; t� � , Lioense#�� � -.
<br /> �... ... - . _.. ,. ., F:;_.:,.. ., °. <- "
<br /> CtEStDEN't1AL`•.'`,. Atkatch={2}„Pl�it�Platis;._(2}sets�:.af:Buil�ii�g�Plaiis;'{-1}set of Erierg}i�Faiins;R=O=W Peiirilf#oi new constrtaction, . .
<br /> �;: 4�,�,;,Minimum,t�n_(:1,0j„working;days aiter:submiEtal'date.::Required onslte,,ConstrucHon=Flans;Stormwater''Plans w%S(It'Fence installed,
<br /> � -SaniteryTFacilities:&�1;dumpster-Slte�Work}Permit.#ors,ubdivislonsAargeprojeqts, ,. ` � � ' ;
<br /> COMMEE2Ci�t,. Attach{3}•compl'ete sefs'of'Bultding Ptaiis ptas a t.ife Saf�tfy Page;�(1}set af Energy�Forms.Ft L?-W Permit for new consUvctton. ,
<br /> - � Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stortnwater Plans w/Silt Fence Insta�lled,
<br /> Sanitary Facilitles&1 dumpster.Slte Work Pertnit for all new:projects..All commercial requlrements must meet compltance
<br /> SIGN PERMIT AttacF��{2)set�of�ngineer,ed�P_.laiss.. � ..��- - -° � �_ - " �
<br /> •`"•PROPERTY SURVEY required for al,l NEW canstructian.
<br /> Dtrectians: ., . . . . ,
<br /> Fill out applicadon completely. . �
<br /> Owner&Contractor stgn back of applicatton,notarized '
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<br /> if ovee 5�500,a Nattce of Commencement la required. {AIC upgrades over:67500} i
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<br /> °' Agent(for the cantractor)'or"Powe�of;Attomey�(for,the�owner),would,be someone with notadzed letter from owner authorizing same I
<br /> OVER THE COUNTER PERMlT°fiNG� -- fFmnt o�i�(�Tlic`�tion Ont�{1 , - ._��.<., =_,:'v.�:x����.�..=.t»�.:�.�.�;�,.z�:y��1r:
<br /> \ �'Yr 71��`'�i„r�i��:� ii, 3 Y •1��•. fiiti�iJ9? .' �ey(1 1''
<br /> Reroofsifsfiingles Sewers Seniice'Upgrades�`A/G� ..:�`�Fences;(PIot�SUrvey/Footage) `� .. ;•; ,� ,,.;,, • ';a�:;�='�� x� , -
<br /> , .s bl�3i 9tr�. 7 iti �f.iti5i ) ' 7�
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<br /> Drivewaya-i3ot over Counter if on putiflc`roadwrays::needs�ROW'` - �.,.�• �` , -.,, `3'•��:�•-
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