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y 813aso-oo2o City af Zephyrhills Permit Application FaX-813-780-0021
<br /> Buiiding Depacfinent _
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<br /> Date Recelyed Phone Contact�for Pernttttin � f}i�J ��;rL _ �(,�t,�
<br /> Owner's Name v GG- �"? Owner Phone Numher l �T/� ' '
<br /> Owner`s Address ,J o�. �/:�. O r7'7 /7�� Owner Phone Number .� � �
<br /> Fee 5lmple 7ltleholder Name Owner Phone Number
<br /> Fee Simpla Tltleholder Addresa .
<br /> J08 A[3DRESS � �� � j„�/�'�I �'�- LOT# �
<br /> sue�avistoN �t�� ttDr t�s� PARCEI.ID# `�� �� �1 "`��b 9� �C�,��Z� f l��
<br /> , (OBTIIINED FROM.PROPERTY TAX NOTICE)
<br /> WOitK PROPOSED � NEVv CONSTR ADDIALT � SIGN � Q DEMQLISH
<br /> INSTALL 8� REPAIR ~
<br /> PROPOSED>USE Q` SFR [� CQMM Q QTNER"
<br /> TYPE OF CONSTRUCI'ION ��' ��BLOCK ' [� FRAME � STEEL Q
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<br /> DESCitiPTtQN OF WORK' Il�S• r✓ � L'�-1 N e"L�L.�� � t�d77"7' d!'V�/V � /�/� �
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<br />� BU1�DlNG SlZE �r � SQ�FOOTAGE HEI,GHT��C��
<br /> Og�»'����' � � VALUATIONFt1F TO'I'At.CON51`R11C'i'iON
<br /> QEL•ECTRICAI. �—� AMP SERVIC� Q PROGRESS ENE32GY Q W.R.E.C.
<br /> [�PLUMBING ;L. � '
<br /> QMECHANICAL $ VALUATION OF MECHANiCAt.INSTALIATlON
<br /> �-�����.
<br /> �c�s 0 Roo�iN� _[� speclA�rr 0 o�t�Ea
<br /> FINISHED FLQOR ELEVATIQNS �� FLOOD ZQNE AREA QYES NO
<br /> BtlilDER COMPANY� "
<br /> SIGNNTURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Cicense# �—� �
<br /> E�ECTRICIAIV; . �COMPANY � �
<br /> SIGNATURE � REGISTERED Y/ N FEE'GURRE��' 'Y/N
<br /> Address ' � , Ucense# � �
<br /> ; ..
<br /> PLUMBER ` , � COMPANY � �
<br /> SIGNATURE` �� , REGI37ERED Y./•N ,� FEE CURRE� .'' Yr/N •
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<br /> Address License# � � _ . �
<br /> . � �/gftl�'`S l' �3fV� S'4�'��' �
<br /> MECHlWtCAl: COMPANY
<br /> SIGNATURE � � REGI57ERED , Y./ N . FEE CURREA� Y/��N
<br /> '�'� -�7� I ��� �l7�IL1,5 ' License# +Q� �T
<br /> Aadre�s � j 1����'? 3 �r. i
<br /> . � �� . . .. - .
<br /> � t�THER ="` �}` - � . ';COMPAt�lY �
<br /> SIGNATURE ''w� . + � ` "3 " ^ "' ' � " �REGISTERED� Y/ N..� �FEE CURI2E� Y/N
<br /> Address - =r_� ' - - � ` ' �Ltcerise#�� �
<br /> RESEDENTtAi:;;, ;Attacti�(2}„Ptot�P.laiis;,(2}sets:of:Biilldlrig�F'lans,'{1}'se#af�E'n''ergy'�Foiins;-R-0={At�Peimitfornewconstructlon, ' - �
<br /> -�Minimum:ten,(:1.0)�worfcing;cfays;after;submiftal`date':Required onslte;;Constiuctlon`Plens;Stormwater'Plans w/SIIt Fence installed,
<br /> .,�,�:" .�:i Sanitary Fa.,ctllUes,:&;.1=,dumpster,Slte Wo,rk�Pemtlt for subdivisio�sAarge proJects:: =:;.-.;;- ' -
<br /> C014ftMERCiA1. Attach{3)�coinpl'ete'sets crf Biiii�ing Pians plas a l.Ife+SafeiEy Page;(1}set of Energy Fomis.R-t?-W Pescniit for ne+rv canstruc#lan.
<br /> Minimum ten(10)working days afker submittal date. Required onsite,Constructian Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities 81 dumpster.Site Work Perm(t for all new proJects..All commeccfa!requlrements must meet campliance
<br /> SICah!PERMIT Att�acti(2�sets of Eiigineered;Plaris.;.--.,`;,:. - ,�.,
<br /> '•"•PROPERTY SURVEY repuired for,all NEW.constructlon..
<br /> Q(rectlons: -,.. ,.f.. . � ' ,
<br /> Fill out applicaUon completely. �
<br /> Owner&Contractor sign back of appiicatlon,notarized
<br /> � if cvar�250d,a Notice of Commencement 1�required. {AlC apgrades avar�T500) '
<br /> ,__ .,µ :� ..:.
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<br /> Agent(far the contractor)or'Powe�of"Attotney(forytFie owmer)`would be someane with notarized letter frQm owner autho�izing same
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<br /> � 4VER TtiE COUN'iER,PERMIT[,iFIG� (Ftiint�"of-,�'p,Pt�'t;atlo"n"��i{y):;: `" �.:,_�
<br /> ' Reroofs lf shingles Sewers �15�ervice Upgrada� A/C ;;'?;Fehces��"lot/Survey/Footage) �_i��i=�•°F�:� ��is,f'i"r, ,,��":;`%�."�r. ,y.
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<br /> � Drivewaya-Not over Cou�iteriif,an'pubiic ro�duvajis::ne:.�e'tls,�RO,�f' .`�,' ;r �'' �`f;w�� �`i''t''t�'� '�t���� � .��
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