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813aao-oo�o City of Zephyrhills Permit Application Fax-813-780-oaz�
<br /> Buiiding Qepattment
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<br /> Date Recelved f, '�j2,,'' .; Phone=Contact�for Parn�iittin .= ��`� « t — �
<br /> Ownec's Mame v V"`�'� \�� A "`"`"'� " Owner Phone Number
<br /> Owrner's Addreas "7� 3'� �.�k �..S � �. ��-� �Owner Phone Number � ��
<br /> Fee 5lmple Titleh'older'Name � � Owner Phane Number 'r� ���
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<br /> Fee Stmple Titleholder Addresa - ;
<br /> J08 ADDRESS �� ✓� � ��ES l � �. ��'G LOT# I� f ;
<br /> SU80iVtSiOP1 �,t/�^��t'�� PARCEL i�# t`'/—�-cP'"2-1 -' ����f�—(��� ,�
<br /> , � (pBTAIPIEO FROM PROPBRTY,TAX NOTICE)
<br /> WORK PROPOSED ��IEW COai5TR' RDD/A�T � Q SIGN -0 �[� DEMOI.ISH ,
<br /> ,:�„ INSTALL 8 ,; REPi41R ` �
<br /> PROPQSEDt.USE - . � SFR. Q 'COMM � [� >OTHER " � '
<br /> TYPE OF CON$TRUCTION -� Q" � BLOCK " [] FRAME � :[,� ;STEEL '�] �
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<br /> DESCRIPTION OF WORK � � � �t ��� �
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<br /> i BUII.DItdG"SIZE�� �� � SQ FOOTAGE��� • H�IGHT;,�� . ;
<br /> �SUI�i}iNG $ '�. :,
<br /> 2,?j � $t �.Si VALUATtON:ClFTOTHL`CONSTRUCi`ION
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<br /> ELECTRtGAI. $ " AMP SERVICE �
<br /> I Q Q `PRt9GRESS Et+tERGY Q W.R.E.C.
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<br /> QPLUNlBING. ;� ' � �
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<br /> QMECNANtGAL $ ' VAtUATIQN OF MECHANICAI.INSTAIIATIC}Ri.
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<br /> � QGRS C] ROQFiNG .Q SPEClAl.TY, � OTHER
<br /> , FINISHED FLOOR ELEVATIQNS r�� FLOOD ZQNE AREA QYES. NO
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<br /> BUI�DER y��X�, < � � Cfl1YlPl�Nlt� �..P�—
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y Y N �
<br /> �ddress Ltcense#'� �
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<br /> E�ECTRICiAN;, , � ' ' ,.COIu1PANY � ' - .
<br /> SIGNATURE �' REGISTERED Y! N FEE'CURRE�" '�=Y/N
<br /> Addre��s� ' � . � ,. � � �_ - � - • � , .._ r Licerise-#�:� �� ( ;
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<br /> PLUMBER'' . GOMPMlY � � . ��° - . - ° �
<br /> SIGNAYURE ' � " REGISTERED Y/.�N t ,�FEE CURRE� = Y-/N. '
<br /> Addreas - , 1 , , ..Ucense#�� �. _. :�� � _- ' { �<� � i
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<br /> MECHANIGAl:" '- � �. _ , . . . COMPANY .:, .. `
<br /> SIGNA7URE• � " ` � � " ' REGISTEHED.,� , .Y,/ N FEECURREn Y%N
<br /> � Addreas.°'�� ,s° � :�' � .` _ ' � , � � � , License#-�. . I � �
<br /> ' OTHER `; -,�. ' . �.` . : r .. �;COMPAtiIY .. _ _ :.', . .. :
<br /> I SIGNA7URE ,'�` - -�� y'` �'° � • h '` � � ` �� REGIS7EREDY Y/ N.r.,. FEE CURRE� Y/N �
<br /> Address f 4._�_ ...,.` :�"y... r .�_ . , .. � � "• ' � lEcense# � ~� � I
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<br /> �EtE3iDEN11A1:,;=,;:';Attacti;{2}„Rlot:Plan's,^.;(2}"sets�afBullding�Plaiis;'(1)set`of�'Eneigy;Fo`rins�R=�O=Nt�"Perisilt#o�iiewaonst�vation, �
<br /> '`�l r��.�:;.:Mfnimum:ten�=(:10),working"dajts,`�after;"submitfal=date.���:Required o"nsite;Constnictlon�Plans;'•Stortnwater Ptans�w%Silt'Fence instaUed,
<br /> .��,,.:.,.1�..,-�, ,w-,,,.�.r�„�>..... :...... ... . . .., . -• -
<br /> Sanitary FaclliUes;&0.1.;dumpster�5lte�;Work�Permit,�crsutidiv,",isions/IaPge�p,roJects;,�.._�:,_;:�� �`` ' " �
<br /> COMMERCIAI. Attach{3):complete sets"b#Bullding Plaris ptus arCtfe Safety+Page;{1}set of Ene�y Forms.Ft:U-W Pennit for new construcSon.
<br /> Minimum ten(10)woricing days afker submittal date. Requ(red onsite,Canstructian Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles 8 1 dumpster.Stte Work Permit,for all neuv;proJects:.All commercial requlrements.must meet oampllance
<br /> SIGN PERt4�fT Attac�(2j sets of"Eingin�r`,ed�Flans�:-�..-,;�-�= �_ � ,:. � . .
<br /> ""•PROPERTY SURbEY reguired for all„NEW�cgnstrucdon., .. ' - �
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<br /> � ��Difeatlbns: ��,:::.=rr:�:..,�.:. . . - .
<br /> Fill out applicadon completely.
<br /> Owner&ContracMr stgn.back of appltcattan,natarized �
<br /> if`over 52504,a NotCce of Corrtmencement 1�t�equired. {A►C upgrades ovar S750d}
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<br /> '" Agent(forthe�conVactor):or.`Povirsr'of�Attorney:(fo�.tFie:owner)..would be��sbmeaine�with notarized letterfrom ownerautharizing same
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<br /> OVER'7liE COUNTER.P<ERMITTING:�,;�;-��(Fronf�of,-Afiplicatian Oiiiy): � � , ,' , , ,, , ..
<br /> Reroofs if shingles Sewers• � Service Upgrades �/C' �Fences(PlodSurvey/Footage) � - , ' , , � , ,
<br /> �'! �:> _ :+� - . _ ,r�,, .,�,.
<br /> Drtvsways-Mot over C.ounte'r if,.on;pubiic'roadwajl�..�eed§,i201N}, {+ , .- � � � � . , � j ,- � � �+P
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