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� �8���aa-ooaa City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Buitding Department _
<br /> Date Recelved - �'`� . – �'�� .
<br /> : Phane=Cantact�'for Parmiitt�n =
<br /> Owner's Name �/ v�d�a G �C� Owner Phone Number p ,;1"� /� �
<br /> Owner's Address �7��� G�' t?�'7 .� Owoer PhoneNumber � ]
<br /> Fee Slmple Tltleholder'Name �� � Owner Phbne Number �� tt-1
<br /> Fee Simple Tltleholder Addr�ss
<br /> JOB AClD�ES$ ����� e!�- Z'�I �=- LOT# C��
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<br /> SUBpIVtStON �— � • PARCEL ID# � �7 �1 l✓ � ���' �l1�
<br />' � � . (OBTAINED F.ROM PROPERTY,TAX.NOTICE)
<br /> WORK PROPt?SED �.NEW CONSTR ADDlAIT � � SIGN Q• Q pEMO�tSH
<br /> - , ;e,. INSTAtL ;_-REPAIR �
<br /> PROPOSEDrtlSE � Q SFR. Q ��COMM' � �OTHER °
<br /> 7YPE OF CON$TRUCTION �]' BI.00K " Q FRAME �� StEEL `Q
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<br /> DESCRIPTION OF WORK .t .�L G�1�l�J"tU e�C3I.$� � COn� 15J�,�G✓/�f� . � �T� -
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<br /> Btll[.DlNG SIZE �� � SQ FOOTAGE ` � � .HEtGHT�.C_`---_+�
<br /> Q$���'�fN�' 1"' � VALUATIOR1:i.'1F`'f01'Ati'CONSTRUCTIOIV -
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<br /> [�ELEGTRIGAI y f$ ��� '� AMP SERVIGE Q PRfJGRESS ENEF2GY Q W.R.E.C,
<br /> � ��
<br /> [�PL•UMBtNt3• �� - , '
<br /> r�r VALl7ATlON QF:MECHANtCAL INSTAi.CATiOfV
<br /> I QMECHANtCAL $ � ��. '
<br />� - L ,_ � „ ���-
<br /> QGP.�S Q ROQFfNG _Q SPEGIALTIF �� t}THER
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA [�YES. Np .
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<br /> B�IE.DEit COMPAt+iY� . • ;
<br /> StGNATURE REGISTERED Y/ N . � FEE CURRE� ' Y/N
<br /> Address ' License#'��, �
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<br /> ElEC7RICIJ41d:.,�, , . _ ° ,aC091�1P,�WY . ' , . � ` (
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�"' � ''Y G N
<br /> ' _.�. _. .. � ... � �
<br /> Addre� . , . ,- LtceriS@#.�` _
<br /> PLUMBER" � � . . `, ,.COMt?ANY ` : .� � ' I
<br /> SIGNATURE� 'ry'` _ REGIST,ERED, Y/,N• - �1FEE CURRE�, Y/N. � I
<br /> Addre�S LiG@nSe,# ��
<br /> M�c�aN�ca�: - `��'; _ ' co�iP�r�ir �}.�f2.`S � ��� �
<br /> SIGNATURE� � � " ` y" j REGIS7ERED:,, Y,./.N. . ; FEE*CURREA=. x: X:/�N • . , �
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<br /> �,���r�-r ��-- —- l�f�`� �. - a � _ ._ . ���nse#���� �3`��,�' � -
<br /> ;,.:. 3: , : _ . �� � ..
<br /> OTHER �^ '' � � � ~ ` ' ;CQlVqPAWY ..1�;. . . .
<br /> SIGNATURE "'-�� ' ` ° . � ' ' 'REGI$TERED; ' " 'Y/ N:.., "'FEE CURRE� �' Y/N
<br /> Addres$� -�°r:: 1�. . tz: =,' �- ,}� ' �_' ` � ' L`iceiise# f" ' ` ' 1
<br /> RESIDENTIAi:,;;�,Aitacti:{2}.,F36#�Platis;;;(2}`sets;of'Bui'!'dings F?tan's;{'1}se#of=Eiiecgy'�aiins;ft-0�ltViPer_`init far�`new coi�struction, " ` ' �
<br /> 4 s.�Minimum kenti(�10)�wrcrking;dajrs`aftei�"subm�ttai�date.�,Requi�ed onsite,ConstnicdoirPlai►s;'Stormwater'Plans w!Siit Fence�installed,
<br /> �. ,,.,<r....�. p , _
<br /> Sanitary Facilfties;&9�;dump.ste_r,rySite:Work;�Penmit`for:sukidiyislonsAarge:proJects;bc..,;;�" ` m° . - . ' '�� :. '
<br /> COMMERCtAl. Attach{3)�a�mplete sets`�of Bu[Idlitg Plans plus a C(fe Safety Page;(1}se#of Esiergy Forms.R-O W Petmit foc new construc#tan,
<br /> Minimum ten(10)wrorking days after submithal date. Required onsite,CanstrucNon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities 8 1 dumpster.Site Work Pertnit fur all new:projects:.All comrtier+cial requlrements_must meet c�ompllance �
<br /> .�SIGN P�RtY1FT Attach'{2)sets�of'EngirtieeredcP.:.�ans.s>,�;...:�;"°: � .;°.,,�_,•. .. .." s ' '
<br /> "•'"PROPERTY SURVEY required for=all IVEW construcUon..._ �
<br /> ' . Ditections: ,,v., .. . . ,.
<br /> , Fill out applicadon compl�tely.
<br /> Owner&Contrac#or stgn back of appllcatton,notarized �
<br /> if aver�:500,a Notics.of Cammencei»ent ia r�qutred. {A1C upgrades over�b7500) , �
<br /> 4a .
<br /> '" Agent(for the`contraotot)�o"r'Pouvei�of�i4tt�me�r(for tFie pwner)�would be someone with�notarized�let�er��""�i"��au"�'i'b�i�i�5gs��iti��"'��'�`�'�'
<br /> < � 4:{,r;:7.r�M`.1�`)'t i ,' . ,� i.F.��s;;a"�' �`+ z'i,i" ,.<
<br /> °OVER:THE GOUHTER:PEI2M!'fTlNG._.:-r„�(F!�Es�sa�,App!lt�ttion Oniy)-. _ - °° � ;;t:,,��r=�_�.,;rFt :: �.,
<br /> Reroofs if shingles Sewens 5ervic�f Upgrades„NC + Fences(PladSurvey/Footage) ��q�$ r�t �,;; ,- :,� w,
<br /> ..... -.,.....,........... ......._. .^r'-,� l4 i:>,i"�4t �a.'v.`,.s.�:i�; :'},.. .. t'J�:riSl,.# � : : {t" " - _,-f'V
<br /> Orivaways-Not aver Coun#er if an�pubtictroai�ways:.need"s ROW,,, �,4�;.,,,, . '�
<br /> c�= ,�x�`i"`'Vi«r"'•��a'�f?"'�:��'•nra�".�{��"x-.w;:;3rw2-v.-'s•;' , ' rQ`�-}�'•':t:" . -:,.z�'�;
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