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<br /> a�a-�so-oo2o City of Zephyrhills Permit Application Fax 813-780-ao2�
<br /> Bu!lding Depariment
<br /> Date ReceOved
<br /> , � ' �� ' /-� •° Phone�Ganfact for.:Perrrittfln � SaJL� - �/�17��`
<br /> Owner's Nama .�Gc/f �c v�p,'"' .u�.�1''�,c.'u- ���- Ownee Phone Number /� ' � �'f�K��
<br /> Owner's Address o2�U Q '� Owner Phon�Number - �— y�
<br /> Fee Simple TltteholderName �� � Owner Phone Number ��
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<br /> Fee Simple Tltleholder Addresa
<br /> JOS ADDRE3S Ga..�vH-"(�'.- LOT# �_,_�
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<br /> suea�v�siat� , � � �,aRce�rcx� � a �.�v o2 1 _O C3- ---t�—o o � G ._D /�
<br /> , (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORKPROPt}SED � NEwCONSTR ADDlA�T [� S1GN` Q Q DEMOCISH
<br /> •e. INSTALL 8 REPAIR •
<br /> Pl20PQ5EDrUSE , ' Q SFR, Q GOMM ''� ,OT(iEi2 � '
<br /> TYPE OF COIVSTi2UCTION` [� BLOCK " Q FRAME � � STEEC Q
<br /> DESCRIPTION OF WORK' �� !/�v � �.{'/ /�f I'�CI�- � �`—
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<br /> BtJ1�D1NG SIZ� °` `8Q FOOTAGE�_�;- HEIGHT+�}�� O 0,`.�L� �f��C..
<br /> QBElIi.DING ���� VALUATION*tOF`'TOl'AL CONS'FRt1C1'iON . , •
<br /> QE�ECTRICAI. � � AMP SERVICE Q �P120GRESS'ENERGY Q W.R.E.C:
<br /> QPLUMBtNG • ,$ ; ` , ; .
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<br /> �MECHANIGi4l �$ }�� i(i4LUATlON QF:MECHAi�lICAL lNSTALLATION
<br /> .I__.LF� �' �'"�.
<br /> �GAS Q RC?OFING .[� SPECiAI.TY �] OTHER ° `
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD 20NE AREA [�]YES NO
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<br /> - -�4lI�t3�e� -- .____________.�_ _ - - CON4P'APt1'� - - — -- -
<br /> SIGN/�TURE REGISTERED Y/ PI FEE CURRE� Y/.N .
<br /> Addraas license# i �
<br /> ELECTRICIAi11. . ' .iCOMPANIt � _
<br /> SIGNATURE �` REGI3TERED Y/ N FEE`CURREk� � Y/N '
<br /> Attdr��s , . - " � , . ,- License# t . , � j �
<br /> Pt�t1MBER ,. �� � . GOEVIPANY ; , `
<br /> SIGNATURE` � `' � a RE��STERED Y./..N� : ,;EEE CURREP Y/N.-
<br /> Addre�s � � . .Ucense,# I , - �
<br /> �n�cr�aa�c�:. . _ � -- -- - - �_ coM�a�r � .�<.�', ,� 7 �.. a��o �c.�r
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<br /> SIGNATURE• ' �"'�S`, c"��'" REGISTERED � _..I N. .',- FEE CURREA Y N =
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<br /> Addres"s°��+� .,�c�� � `' `' �j� � J �� License# ��. `� _
<br /> OTHER = . - , ' , `'COIIlIPANX _ �
<br /> SIGNATURE�- '=�'L'> "' '" �- s ' ' � ' REGIS7ERED ' Y/ Ns..: � FEE CURREP � Y/N
<br /> Addce� � ., ' ' . � � . -L°EcenSe#� y � .
<br /> RESIDENTIAI:,,- Atta��(2},p._tot=.P-,la'ris;.(2}�et`s:of'Bu1lding7Fttans;{'1}'setaf"Eoerg}i}Foiii�s;��R�O=WP'srici,ltfarnew�r�struction,, '
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<br /> •„ ,;�,a�;Minimum;ten;(10)�wori�ing,days,atte.r.;submlttalwdate:�.Requlred onslte;;ConstrucNon=Rlans;Stormwater Plans w%Sllt'Fence installed,
<br /> "' Sanitary'Facllttles&lydumpster,SlteiWorkrPermitforsubdivislon§Aarge:projeafs,;,:•� ;.;.- ' - `��
<br /> CQMMERCiAl. Attach{3)complete se#s-of Btitldiiig`Plans plus a�Cife Ssf��ty Page;('1}seti of Energy Fatms.R O-W Permtt for neuv canstnsc�on. -
<br /> Minlmum ten(10)wortcing days after submlttal date. Requlred onsite,Construcklon Plans,'Stortnv✓ater Plans w/811t Fence lnstalled,
<br /> Sanitary Facllitles&1 dumpster.Site Wark Pertrrit for all new.•proJects.A!I commerGal req�ltements.must meet compflance
<br /> S1�N PERMFT Attacti{2}'sets"of Engiiieer,ed;Plaris:, ._:;,,°< ,_ . , ' , - -
<br /> •••"PROPERTY SURVEY requlred.for all NEW con.structlon., �
<br /> Dlreistlons: _ , '. • .
<br /> Fill out applicaUon completely.
<br /> Owner&Canhactor stgn back of applfcaUon,natarized �
<br /> If aver�2500,a Rlatice of Comm�ncement is requlred. {NC upgrad+�s over 57500)
<br /> `" Agent(for the`conUractor)'ar"Powe�of Attomey'(for tFie owrner)would be someone with natarized letter from owner authorizing same
<br /> DVER THE COUP!'FER,�EttMlT[ING- -,-{Front of�Applicatton Onty}- ` �_ ,
<br /> Reroof�If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Foatage)
<br /> Driveways-Not over Countet if on public roadwiays..deeds ROW ,
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