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���-r�o-��zo Ci#y of Z�phyrhills Permit Applicatian Fax 813-7$0-0021
<br /> Building Department
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<br /> [7ake Recm�ived ���'•��j""' _ ,. phone�Gcntact fmr�P�rmitkin � — �� .
<br /> O�nrner'�Marnue �'�vc-C' Q /� Owner Phone Nurnb�r O��' ' �/
<br /> Owner's AcEdress � � v � ( //� 1.�� �n�r Phon�Idumber �� � ,
<br /> F�e Slmpte'Tl��eholder Nam� � �� Owmer�hona'Muenb�r � � '
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<br /> Fee 5imple Tltl�h�aicfer Addr�as� ,
<br /> JA6 ADL}�E�� ��{��CJ ✓�'"y/I'"�� ZOT� C___�
<br /> susa�v�s�a� /� �t� ',� ,�. ��c��.«� ; . �.,� OC�S—� f�C�t�t�C� C,���}'�
<br /> (OBTAINED FROM PROPERTY TAX•NOTICE)
<br /> WORK PRt�POSER �_.�fEW'COt�STR ADDlALT Q SIGN' �Q Q DEMOL2SH
<br /> ' e, INSTAL� 8 REPAIR -
<br /> P�OPOSED�USE Q SFR� Q COMM � OTHER
<br /> TYPE�F CONSTi2UGT{{�ld = Q� � BLC4CK ' Q FRAME � � STEEL 'Q '
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<br /> DESCRIF+'��t'�N Ct�wOEtK ��t" 1Lt't���" Zr�/� rI7 ' - ����_ '
<br /> �UlL�OPI�SlZE �� �' SQ�FOtdTAGE f��1 ,FUEtGHT�. �
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<br /> QBUILDING �� V/1i.UATiO�!OF't'OTAL'CQNSTFtIlCTiON �
<br /> QELECTRICAL �$ - � AflAP SERVICE C] PROGRESS ENERGY CJ W.R,E.C,
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<br />, OPLUMBING ��� '
<br /> �MECHANICAL $ VAI.UATION OF fUiECHANICAL INSTAl.LATION t
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<br /> C]�ns Q RQOFING Q SPECIALTY Q OTHER '
<br /> FtNISFiED F�OOR EI.EVATIONS �� FlOOD�Otd�AREA QYES. td0 {
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<br /> I �UILDEIR � �4�flAP�1Pe1Y "
<br /> �tCaE+�A:Tl1R� � RE6ISTEREO Y 1 N FEE CURREh Y I R}
<br /> Addres� ' � - Ltcense# C� � i
<br /> ELECTRIGI�PI: =COII�PAIdV ,
<br /> StGNATIdf� � RE�IS'iERED Y J N FEE CURREP' ' ''Y l N
<br /> Addee� , 1.lcense# � � � �
<br /> PLUM��R ` COMPAIdY
<br /> ����5��� � ;REGlS.TER�D, Y.I;IU. FEE GURREP Y-!N °
<br /> �dd1'eS8 I.ICSn38,# �c : LL ' +
<br /> MECHAPlICAL' � f ` / COMIPAIdY C..�/L%"''S �� � �C�f'�-
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<br /> �It3R#ATl!!t� ��'�`� ' a��1s��z�o Y.t)N . ��cu�t�t� �, YI N
<br /> Addr��s'` � � - License# ���,t'}�U(""���i� ,
<br /> O'�F9ER ". . . - ,COIMI,PANY
<br /> StG1NATURE .-�,: � ., , � R��isz���a' Y 1 i� .. fEE cuRR�ti Y 1 iU.
<br /> Adde�eas - � - Ucense#`� �
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<br /> RES9DEP�'PI _ .,r .,.,�,,. ,.. : ,�,
<br /> ' AttacFi" .� .
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<br /> AIR�:' • , (�),;PlotrPlaos;;(2)sets�:of�Buflding�Pla'n's;(1)set of=Energy��Farin"s,,R=C1=W�Perinit for new construcUan,
<br /> ,,:.�'Mfntmum4tent(:1.d};v,iorlcing$�ayrs;after�submlttal`da#"e.<:Requlred onstte,;C•ons*truc8on{Piaiis;rStormvi+aEer Pians wt Siit'Fenca instailed,
<br /> SanitaryFacilitles:&�1ydumpster+SitewWqrtcw�'ertnit;#ar,s,ubdivi'siqnsAarge=projects�.._,; '
<br /> �QMWIEf3C1A� Attach(3)'�i�mplete`sets'of'Buildtng'Plans plus a Life S�afefij Page;�(1)set af E�ergy Fortns.Ft-O-W Permitfor newe constnuction.
<br /> Minimurn ten(1 d)warlcing day�a#ter submlttal date. Requ6red onslte,Corstc�scHo�s Plans,Stomwater PEans w!Silt Fsnce i�s4atled,
<br /> Santtary Fadlities 8�1 dumps¢er.Site Work Permit far ail new�projeatts..Aii aammerctal r�quitements;.must meet compllance �
<br /> �IGN PEFliMIT AttacPi"'(2)sets ofi Engineer.e.d�l?lans:s - - ��� � .,• .,, ,
<br /> "':PRQFERTY St1FtV�Y
<br /> _. requlred,far a1t NEW construc#ian..
<br /> Directlon�: � �• '
<br /> , Fltl aut appllcaUon completely.
<br /> � Owner&Contractor slgn back of applfcation,notarized �
<br /> If oveP 52500,a Motiae of�aeo�m�ncerc�enp Is r�quired. (�IC upgrades�v�r�7500)
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<br /> I " I�qent(�fls th'e aantraator}'or'Pbwet of'Attomey(fo'r"ttie awnerj woulii be somraone witt�notariz�d tette�from owner authadztng same �
<br /> � dVERTHECOUQ�TER:P�RMETTING -- {Frontof-Application�Only)- �- }
<br /> Reroafs tf shingles Sewers Servic�Upg�ades NC �Fences{PEotlSunreylFaotage)
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<br /> Drlveway+s-Not over Counter if on public roedways:.�eeds ROW . ' '
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