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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
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<br /> Date Recelved _ :�;p�ane�Gantaet for�P�rmtttin :� � - '
<br /> Owner'a Name � G�; 1' --`���l��� ' , Owner•Phane Number _�
<br /> Owner's Addreas ° �. �Own�"r Phone Number� �� ��
<br /> Fee Simpls Tltleholder-Name �� �� 0wrner Phane Numtier "•�� � � �
<br /> Fee Stmple Titl�holder Address
<br /> �oa aoaR�ss ��v�b �10�56/'Yt ,�I t> �or� ��
<br /> suso:v���aw � � PaRc��.i� I�d2�";�-�f—b1�d-C2��G� —I�O o�
<br /> � f- " . ., (OBTAINED:F.ROM PROPERTYTAX NOTICE)
<br /> WORK PROPOS�D �.�NEW CONSTR ' � � ADDIAL�'1' �� 31G(V` .`Q. =:Q DEMOI:ISii
<br /> �. ���,� INSTAI:L. 8� ..:. R�PAIR -s. - <
<br /> FROPOSED?U5� , ,y _[�• SFR= � 'GOM{UI ` [� w OTFiER '� , - ' `
<br /> TYPB OF CONSTRUGTION Q� ' BLOCK " Q 'FF2AME "C� ,STEEC' �[� �
<br /> 8E3CRIiiTiOT!OF WORK. .� �� o��Oo"1 �.�� S vr'=�T�;� l�'/5'P��' ��'l�i� U�
<br /> BUI�DIN�:SIZE`'�� �'St�AFOOT�GE�: .�HEIGFiT ,C�� � ,
<br /> QBUtCDt1VG $ VAt.UAT103V�t�F't'OTAL:C0151S1RtlC'flOid x, " ` :
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<br /> Q��EGTRICAl. � � � AMP SEl3ViCE Q �PROGF2ESS EtVEFtGY Q W:R.E.C.
<br /> OPLUMBING;-- $ - --
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<br /> �CHi4NIGAL � $ VAl.ClATtON OF MECMANtCAI IIVS?ACtATtOld �� � /�
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<br /> � [�GAS , �] ROOF{N.G Q SPECIAL.'(Y [,-� QTHER� �
<br /> I FINISHED FLOOR ELEVATIONS �----^� FLOOD ZQNE AREA [�YE�. NO . � ,
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<br /> �UE�DER C�l1APANY, ,. , -
<br /> SIGNATUItE REGISTERED Y/ N 'FEE CURRE� ° Y/N�` -"
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<br /> �ddress _ • Llcense# � �
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<br /> �ECEC'x'RtC��, , . _ �=GOMPANY , � � ` , .
<br /> SIGNATURE � ;REGI8TERED Y/ N FEE CURRE�"'"'` :��Y/N'':'
<br /> Addre�s�. � . _ ���: � � .. l.icense=#�:('- .�•.. I
<br /> PLUMB�R `� ' ' � ,�_ rx GQ�IIP�WY' , • ' .,..,
<br /> SIGNATURE' - " � � ' _ �,� RECa1S.TERED, Y./.N�• _ aFEE GURRE�,� �Y./N` _ °
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<br /> SIGMATURE> • U `GJ��`Q''(%�L�C`C '� V� Q�� "''�. ` REGI3TERED ,. Y.,/ N FeeCURREn. Y./N ,
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<br /> ,�ttaress.�'�=.t � �°��'�r� �' ��/�3�t,.�: , . ' � ttGanse#`, _ � �� a�
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<br /> StGWATt1REc ;,: +'��..?' , , ,. �`• ., .. .. 'C �� �REGI$TERED �Y/ N;.= FEECURRE� � Y/N�
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<br /> Addre� .t`x�,,;•:��. "^�°�_ ��-� -`_�° ,;��, - �:s ,.� �; , llceiiise#`t� ��
<br /> �. ,, nj ah<Y �:V_.'n'i^:. ' 6 F,�^.'�'`r t" S': E`y���i:sP .2.:r, �.,,F :.��. . ..... . ..... . :,�.:.,n- .. ,
<br /> �RESIDENTIAL*s�;;�',Attacti;(2}µP2ot:Platis;::(Z}"set`s`<of�8ui'!'ding}PE�ns;`(.1)'setiof'�rt'ecgyr��ormsi=R'�0=t+lt�Peirnitf6rriswc6nstritctlon, , ; . _
<br /> �n�-;fru 3�Minlmump;tenc(,1A);�v,vorlting�daji$s�fte�usutir".in��fa1'date��'equlred a"nsite;;Co'nstiu�don'Plansr'Stomiiwrate�`Pians-w%SIIt�Fence instalied,�
<br /> " 'Sanitary'Fscil(pes:&f1:,dumpsternSlte�alV.arkrPertnitfcr�.sU�idivi�lonsAarge;pruJe."ct"s;�:,• ':�A � f" � . .�%�'. , %� ° � '
<br /> `GORRMERCIl4t. Attach�(3}�corriplete sets�of Btiltdin�Plans�plus aMt;lfe Safi�iy�Page{'1}set of Energy Fricros.R O-W Pesmtt for newr cansUvcSon. �
<br /> Mlntmum ten(10)woricing days af#er submittal date. Required onsite,CansUucUan Plans,Stormwater Plans w/Sift Fence instslled,
<br /> Sanitary FaclliUes 8�1 dumpster.$ite Wark Pertrrit for all new<prttjects::All commercial Cequir.ements.must meet compliance '' �
<br /> „�SIGN>PER[Y!!T Attadi{2�:sefs af"Eiigi�eefed;;Plajns:��=�:��:�µ'r.��;;.;:F •�-..,; ,. � - .
<br /> � � . "*"PROPERTY SURVEY reguireci for all NEW cqnstrucd'a.n.,.,_. _ -. -�• -
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<br /> FIII out epplicatlon completely.
<br /> Glwner&Contractar sign back cf appltcatlon,notadzed �
<br /> tf ovsr$Z500.a.Notice.of.Comnnencement 1s required, {A1C u�tgrad�s ovar�7500) _
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<br /> AgenC(for the oantracto"r)'iir`Power'of Attom`ey(fii�tFie dwner)'would tie someone with notarized letter fiam owner authorizing same
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<br /> :DVER''t'iiE COUN.T,ER;PERN11TfCNti--.._._;�,.(Front af Appllcatlon-Oniy},-._�...-�
<br /> Reroofsif shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Foatage) _
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<br /> Drivsw�ys-Not over Caunter if on pubtic roaduvays::need"s fiOW`
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