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t31a-lSv-tIO2G City of Zephyrhills Permit Applicatian Fax 813aso-aa2� �;
<br /> BuUding Department . ,
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<br /> Date Recelved . ., phone�Contact for<Permittln �l'�j ��� — Q�� i.
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<br /> Owner'a Name �'/� 1 uG � � Owner Phons�Number ���J"' �`
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<br /> Owner's Address Jr'¢' �(at✓ �'"/ ;2 �U Owner Phone Number -� � �
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<br /> Fee Slmple Titleltolder Name � � •Own�r Phone Number •� � r
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<br /> Fee Slmple Tittehotder Address ;.
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<br /> �oa,aoo��ss 3 a 4�P Et,�� vrl�y (U , �.or# . �� ;.
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<br /> susa�vis�oH I��-Na G t�71�.5� PARCE�.tD� � � ��-'�'- �i����0 LB�dt� ��;7p r
<br /> (08TAINED F,ROM PROPERTY,TAX�NOTICE)
<br /> WQRK PROPOSEp :NEW GONSYR' ADD/AlT �' 31GN' Q � Q DEMOLISH
<br /> ?�. INS"CALI REPi0.{R . .
<br /> PROPO5EDrUSE - ` Q SFR� Q -COMM C] OTHER
<br /> S'YPE OF COWSTRUCTtON < `Q� • BIOCK " Q �FRAME , � 5i'EEl Q �
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<br /> DESCRIPTtON OF WORK �E`'�—'` s �� G ffr9-�I E' -- p�-�- �! �',a�r1 �{'��,,�'j �'t�,d ; ,
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<br /> BUILDING"SlZE�' "SQ FqOTAGE ` _ _ �HEIGHT,T � � I
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<br /> QBUILDING �� VALt1ATlON OF�"tOTAL COI+IS'1'E2UGTi�'?N" � '
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<br /> CJELECTRICAL �� AMP SERVICE [.� PROGRESS ENERGY .[� W.R,E.G. '
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<br /> �JPLOMBING $ �- i I
<br /> MECHANICAL $� VACOATION OF MECHANICAL INSTALLATIOM �
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<br /> QGAS Q ROOFING ;Q SPECIALTY C�] OTMER '
<br /> FIt�11SHE0 FIOOR E�EVATIONS ���� FLOOD ZQNE AREA QYES. NO ;
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<br /> DUILDER COMP'ANY"
<br /> 81t3NATllRE R�GIS7EREo Y I N -'FE6 GURREh ' Y/N •
<br /> Address ' -- ' Llcense#'( 1
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<br /> ELECTRICIAN.. COMPANY • �
<br /> StGNATURE � REGISTEREd Y 1 N F��cuRR���� � ' �Y 1 N �
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<br /> Address , llcense#.[' � �
<br /> PLUMBER ' � COMPANY �•
<br /> 81GNATUR6� ` ' REGISTEEtED,. � Y.1�N- rFEE Gi�RR�A Y-1 N �
<br /> Address 1.lcense.# ;� � -
<br /> MECHANICAL" ' � � .�-y� � COMPqNY. �l'2 5 �y7,11�- 7�` L�' �+
<br /> 3lC3FlA'NRE . ! G�'�-� U / lrL�A-.�/J'�'�J�,", � ttE�fs�.Reo Y.1 N ." �E cut��tEt� Y.l N
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<br /> Address'� f � � t � � " . '� � I.icense# ��-��-.r t�-c� �'c��'__ '-��
<br /> 07HER . � ;COMPANY._� _ ,
<br /> StGFtATURE _•,,.: : : .:: ' - . ' '` RE�tsiEii�o YI N-:: " �cti��E Y7N
<br /> Address, � . _ - � � � , Cicerise#'� � �
<br /> RESIDENTiA1;,,4: ::AfteCF1''(2j,;P-.,lot�Plan`s;:.(2)sets=ofaBullding�Pla"ris;�(i)'sef of=Energy%Forinsi;R=t�IN�Permif fo,r`.new canstrucdon, �.
<br /> �. -Mtnimum�ten(1D)�uiro eq t•:
<br /> -'} �� 1:�_.,.,_�� .��„..�.�,__:.ri...ric(ng.id8tys;after suEiialital'date.�<R uitsd onstte,:ConslivcScn�Plan�;�S#oimwater P1ans�wJ Stl#Fence Instailed,
<br /> `'�� SaniteryFacil(ties:8�=r1,,dumps,ter,•Site,�WorlcyP+�rmttfiar,subdivis;ionsAaige�proJscts; ;"':."� �" �
<br /> COMMERCIAL Atmch(3)�eor"riplete"�ets'of`6uildfng Plans plus a Ltfe`Safety Page;(1)set of Energj►Fcrtns.R-O-W Permit for new construcUon.
<br /> Mlnimum ten(10)working days after submlttai date. Requirad onsite,Construc8on Ptans,Stormwater Ptans wl Silt Fencs instailed,
<br /> Sanitary Facili8es 81 dumpster.Site Work Permit for all new.project's:All commerciai requlrements:must meet campllence �
<br /> 31GN PERMIT Attac#�"(2)'sets of�Engiiieere.d,:Plans.G �.-�� ���., ,., .: -
<br /> ••••PROPER7Y SURVEY requlred for all,NEW con�G'ucttoa.. �
<br /> Directlons: � .-�- � • . '
<br /> FI{I out appSication completely.
<br /> Owner&Cantrector slgn back of applicatlan,notarized �
<br /> If over 5250Q a Natice of Gommeecement la required. (AIC upgrades over$7500)
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<br /> '" Agent{for ttie�contracta'r)'or`Powe"r of�Attbriiey(for the cdmer)would be someone wlth notarized letter frorr�owner authorizMg same
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<br /> QVER THE COUNTERrPBRMITIING - - �(Front�of-ApplicaUon Only)-� •- � � ,,.+;,; ,.,; , .-�`"`"�4��="��'`�r=��n-::�� .
<br /> Reroofs tf shingles Sewers Senrice Upgrades AlC FeRcas{PiotlSurveylFoata9e) � . , ', �; �<,.:i'.iY•= ,,,r��,,,:, �fi
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<br /> '•�Fn S ,k�_. 1 rt. � ::Y:.' f!•„ � '.1 .��:/�7. >:��t T
<br /> Driveways-Nct over Counter if an public raadways?:need's ROW:,,;,•.. �,,,,a�,. .`"'�_ : � �- �,� -fj
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