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Ju1.05.2017 07:04 AM A BARTLETT ROOFING 18137801805 PAGE. 1/ 2 <br /> . • e��7saoozo City of Zephyrflills Permit Appi€oation Fax-s��-�eo-0o2� <br /> 9utkling nepaRment <br /> �ateReCelved � PhottaCarrtaet`krPermittln � <br /> -t`IT[T1ZT <br /> Owner'�Name 0. Oamer Phane Number ��� <br /> Ownw'rAdd»s� � Own�rPhonoNumb�r I__._.__. I <br /> Fee Simpia Tltleholdar Nem� p���p��p��� �� <br /> Fee 9lmpte Tldehalder Addreae <br /> JQ9110DRE$8 LOTi� � <br /> 8tlBClVISlpN PARCEL IDp <br /> toeranianfRaM PaoP�nr r�xNmicE� <br /> WORK pROP09Eq � NEW CONSTR� AbDlAI.T � 310N Q � DEMQLISH <br /> INSTALL RERAIR <br /> PRGPOSECI U8L � SFR Q COMM [�] OTHER <br /> 7YPE OF CON8Tf1UC'fipN [] BLOCK Q FRAME � S7'EBt, Q ��"' <br /> DESCAIPlIDN OF WORK � � (' <br /> BtlIL01NRSFZE �� eqFppTAOE� HEIGHT � <br /> �BUILDINi3 VALUA710M OF TOTAI.CONBTRUCTION ,� i�i/+ °r <br /> ' `Utl�.� I <br /> QELEOYRIClU. � AMP g�{VIC6 Q pR04R�S�ENERdY Q W.R,E.C, <br /> �� <br /> �,�.��e�o $ -� l � � 3 0 <br /> �MECliAN�CA� y , VAI.UATION OF MECHANICAL MS7ALIA710N <br /> QOAS [� ROOFINO �] 5P�CIALTY Q OT}fER <br /> FINISHED F100R EL£VATIONSv FLnOU ZONE RREA �Y�S iV0 <br /> `� <br /> BUILC�R COMPANY �� <br /> $��A�� RFAIBTERED Y/ N Ff�CUiGtEA Y/ � <br /> Addroea 2 P. 5CI�. ueense� .�•�„!� a�i._S`F Q� <br /> ELEGTRIqAN �� CdMPANY 1�,..---- <br /> 910NA�I�URE REOIBTEREO Y N FfiECURREA Ylld <br /> Addt�e Weense�I <br /> PLUM9ER � � COPIIPANY f <br /> 81GMATURE tt�GIeTERED Y I N FEB CURREh Y/N <br /> Addroa �y�� <br /> MECNAPIICAL � CppRpqNy <br /> S�GNA'1'1�12E ReoI87ERfiD Y!N FEEQUqREn /N <br /> Address Ltcen9e#�w� <br /> 07HER � COMPANY <br /> SIQNATURE REoist�iEo Y!N FEECURREA Y/N <br /> Adtll'sas ���gs#� � <br /> 11f11111 [ IIIIIIIFIIIIIIIIIIIIi111i1111l11111111111111111111111111f1 <br /> RFBtD��p�, Attech(�Plot P�qna;(2)eet9 of BuIldiDg PIBns;(1)det of EDe(gy Fotme;R�O W warmit for new conetnwtbrt, <br /> MlnMtum ten(10)worktn8 daya eRer Bubmlttet detD, Requlred onaRe,Conalruaton Plehe,stormwater Ple�ns wl 5ut Fenee Inetelled, <br /> Senllary FaclllUaa&1 dumpster,Site Wak Pertnit for eubdlWelonoJlerpe pro�ecte <br /> COMM�KtC1AL AUaoh{2►complete ee�of eulldlnp Plens plua a Llle Sefety pepe;(1)aet of En�r6y Forme.R-O�W Petmtt for new oonsinictlon. <br /> Mtnlmum teti(10)working d�ya efler submltlal data, i2equlred orre�te,Conetruetbn Plens,9tormvYater Plane w!eAt Ken�e lnetaikd, ' <br /> Sanftary Faclllties&1 dumpster•Site Work RettAk for Wi new proJeote,AB oommerclel requhements must meek cotnpQane� <br /> 81GN f ERM►T Alteefi(2)6eta of Enp4neerod Plerro. <br /> '•~�PROPERTY SURVEY requlred for etl NE1M1l eonatrucNon. � <br /> DireaflOn!►: ' <br /> FlO out eppticetton c9mptetely, <br /> Own9rb ContreCtoralpn beck otapp!!Cellort,q0l6M2ed <br /> ���e*5x600,a Notice ot Comrtlertc+me�t(o roqutred� (AIC uppredoa Wer�/H00) <br /> " A9ent(fo�the cont►►e�m)or Power olAttomay(for Ihe oxmeq wouf8 be eomeane wllh noteAz�i lelter irom owner authodzing eame <br /> 01fE127HE COUHf�R P�RMiTTll�fa (eopy oi contma re4utre� <br /> fReraofe It ehEn8leb $eware Sarv�e llpgr�Raa A/C fenCee(PIOUSUIveylFO�age1 <br /> Drlwwyn-flet over 4Luntor N on pubxo�oaar�o.�m�wbN <br />