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�,�-r��-v�r�o City of Zephyrhills Permit Application Fax-s�a-�so-oaa� .
<br /> _���' „� Building bepartment . ;
<br /> Date Recelved .. Phone•Contaict forP��mittin t�f J Ga � — Jr'�'l� ,
<br /> Owner'a Name _�( � Owner Phone Number (J����O O ""' � ?
<br /> Owner's Address � � jC� � Owner Phone Number �� fi �
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<br /> Fee Simpie T1Neholder Name Owner Phone Nnmber { � �;
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<br /> Fea Slrnpte Tttt�holde�Address !
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<br /> JOS ADpRESS ��/�� tr�/�� �1�. � !
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<br /> su�o�vis�aN _��i�'� ��- aa�c��.�o� � a��/`��OGI- d0�00 - D�dd :.
<br /> (OB,TAINED'EROM PROPERTY,TAX N0710E)
<br /> WqRK PROPOSED E NEW'CONSTR' � ADD/AL�' �' SIGN Q ° Q DEMOUSN
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<br /> � e, th15TRLL: REPi4iR -- .
<br /> PROPOSED+USE � Q SFR� Q �COMM C� OTMER �
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<br /> 7YPS OF CONSTi2t7CT10A! �Q� , B�OCK " �] FRAME C� Si'EEl Q
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<br /> DESCRtPTtON G1E WORK S� � �j ,: D LL c� LT Ll7Y� � /Gf7�
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<br /> BUlLDlNG SlZE � � �"SQ FOOTAGE��: liElGHT,A�_�� t
<br /> QBUILDING �$—� VA�UATtOlV`OF"i't?TAL�CONSTRUGTIt}N" � ,
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<br /> QELECTRICAL $ ' AMP SERVICE [� PROGRESS ENERGY .Q W.R.E,C. �
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<br /> OPLUMBING �>� ' - {
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<br /> QMECHANICAL $��,p� VALUATION OF MECHANICAL INSTALLATION 4 I
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<br /> QGAS [� ROOFING ,Q SPECIALTY C�] OTMER �
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<br /> FINISNED f�00R E�EVATIONS ���� FLOOD ZONE AREA QYES. NC? �
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<br /> � BUILDER COMPANY� !
<br /> ( SEGNATURE REGISIERED Y t N . ' -��cuRa�n Y 1 N �
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<br /> Address � - � �
<br /> I.icense#' - �
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<br /> El.ECTRICIAN� ; 'CQMPANY � ' I
<br /> SlGNATURE " REGtS4ERED Y! N ��su��t:�• 'Y J N i
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<br /> Address - - l.icense# (_ � , � �
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<br /> PL.UMBER ` COMPANY _ , `
<br /> SIG[�ATUR£° � , _R��ts7��tEo. _ - Y 1;N. ; l�e cut�t� Y l N
<br /> Addreas' ` .
<br /> �Ucense.# � ' �
<br /> MECHANICAL` ���,n� � - � COMPANY ��>J�1�� ��' G' ���
<br /> SlCit+lATURE - �-� � F3E�is�iEo� Y.l N �EE GURREt�._ Yd-N
<br /> Address �A ��''�/ `l�� I�Fr:.i ' , � Y Ur.ense#�C-����G'T,�' i
<br /> OTHER " � � �:COMPANY
<br /> SlGNATURE '°;: : `', '''�-. `� • `" REGISTEREo` Y l iti! .: _FEE GllRREI� Y I N
<br /> Address/ ° � � ' • � Llcerise# � . �-
<br /> , ..�, .� .,, ��;�. �: �,,,.._<,,:.. ... ,,. . .
<br /> RE3IDEN'I'IAL;,� °;Attach"^(2)„P1ot�Plaes;.:(2)seks:of;Building�Plans;'(1)'sefof-Energy�Farm's;�R=Q=W?Permitfor�newccnstrucUon,, � -
<br /> :_;�$3 Min4mum,.ten;(t;t,0);,woriiing�day,s;afteesubin�Etaf'date:�;Requir'ea dnsite;:Canstiuctloit�Ptans;�Stonnwater'Plans�wl 31lt Fence instslled,
<br /> �' � Saniis�ry Factlities�&�1xi dumpster�Stte�Work�P�ermlt fur,su6diWslonsAarge:praject"s_��w..;'._'. " '' � �
<br /> COMMERCIAL Attach(3)�eomptefe�e1s`of Buildfng Plans'plus"a'Ufe S'afety Pege;�(1)set of Energy Forms.R-O-W Permiffor new construicUon.
<br /> Mlnimum ten{1 Q}wocking days after subml#tal date. #tequirad anslte,Canstruct[on Ptans,3tormwater Plans+,v!Siit Fence tnstatled, - " -
<br /> _ Sanil�ry Facitities&1 dumpster.Site Work Permit for ali new:pr6jects.All aammercial requirements,:must meet compl�ance �� �
<br /> 31GN PERMIT Attach(2)`sets of'Eng�;nee�e.dcPlans:� :.. � �' ;• �::,' •
<br /> *"'PROPER7Y St1RVEY requlred_for all PIEW c:onsbvctIon..
<br /> DlrecHons: � .., , ,. �
<br /> Fill out applEcaUan cpmpletely.
<br /> Owner 8 Canhactor sign back of appllcaUon,nohadzed �
<br /> If over 52500,a Notice of Commancement la requlred. (A!C upgr�des aver 57500)
<br /> t* �'t.:ii'j•�rn�—.�r.'.' .
<br /> Pgent(for ttie canttat:tor}or"Pdvuer of Pittomey(for ttie awner)wouti!be someone with notarized tetter from owner authorizing same
<br /> OVER THE COUNTER,PERMITIING --- (Front�of•AppllcaUon Only)� - �
<br /> Reroafs Ifshingtes Sewers,r ::r_.-Ser.vlce�Upgrades AIG - '�Fences{PlotlSunreylFootage) , . .
<br /> Drtvewaya-Not over Counter if,on publio raadways�.needs ROW� " I
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