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a�a-�so-oo�o City of Zephyrhiils P�rmit Application Fax 813-78Q-0021
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<br /> Building Department .
<br /> Date Received . ' �,:.phone.-Cor�tact�for�P.ermittln - �
<br /> Owner's Name d,d� C) / Owner Phone Numbec 6�< v'��� 7 v v� ,
<br /> owner's Address -��a C�A-� lU'" �`-� ��-/P/�� Own�r PFione Nurnber �— � -
<br /> Fee 81mp1�Titleholder-Name � � � Awrrtier P6ane Numder ��� � ���
<br /> Fee Slmple Tltleholder Addr�rs� .
<br /> JO��DDitESS . ` L07# ��
<br /> SUBDIViS[OPI � � �ARC�I.ID# ' ,� 4 -
<br /> - . � } � ,�, (OElTAINED;ER4M PROPERTY,-T/1X NOTICE)
<br /> WQRK F�RO�OS�D <,; NEW CONSTR'': `. = ADDlALT • C� SIGN `� � DEMQE»tSH
<br /> ���.� INSTALI. 8 .;.,.:REPAIR �- � �
<br /> PROI�QSED?USE . ,. '•[� SFR:- � GQMIUF [� �OTHEF2� , . , , .
<br /> TYPE OF CONSTRUG7'ION , �[,�,�'` ' BLOCK " Q 'FRAME _� `STEEC .Q
<br /> DESCitiiiTiON OF WORK� r ��7 R N/1/�/7/.t� ^ - - ` -
<br /> �t11�D1NCs.SIZE
<br /> '� �"'SQ'`FOGi1'AGE�: HEIGIiT,`.� �
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<br /> �--^-�8���;�r'' $ VALCJATIO[V�{OF�TC}TAl CONSI'Rl`JG'[ION �
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<br /> Q�l.EGTRIGRl, �$ ' � AiUrP SERVICE Q -PROGRESS ERlEFiGY Q W.R.E.C.
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<br /> QFLUMBING (� � °
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<br /> � Q MECHANIGAL $ f_ .. . • FJALlIATIOM OF MECHANtCAt IPtSTACtAI`!ON- ����1��
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<br /> QGAS �] ROOFIN.G [� , SREClAL'tY �� OTtiER•: 4
<br /> FINISHED FLOOR ELEVATIQNS ��� FLOOD�,ONE AREA QYES NO 4 .
<br /> �UEE.DER ��' COMP�i41Y=' ; , - . -
<br /> SIGNATUC2E � REGISTERED Y/ N 'FeE cut�REP ` Y%'N�: "
<br /> Addre�s ' � �_.�>� ,. ' . 'Ltcense# i - � 1
<br /> EC�C't't@ICIAt!t„, . � ,`COMPAI�tY' � , .
<br /> SIGNATURE � REGI3TERED Y/ N FEE CURRE�s� =°} '��Y/N` �
<br /> Adcfres�:, , ,., . . _ . , ,e }°� ' , Cicense:#�;1:; ` ->- � � 1
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<br /> PLUMBfit�,' � � . �� , , . C0141PA!!IY:r ` . .� , . _ :,_ -
<br /> SIGNATURE'`� ' " ' ' �RE,GIBTEREQ, YIF.N, �FEE CURREK Y./N
<br /> Adtfress , . „ f -.rt':It�rise*#���..T•:.. .� - � � :�•� t •
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<br /> flllEGMAt+IlGA1:� ' . ' . `: . _ , . - CCINEP�iNY ' _ . ,r,-�,�.. "-
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<br /> � � �, �. -
<br /> SIGNATUREt ;"` i=` . '�, ��: . ";` � , � ' REG�ST�ERED _Y,./.N: . FEECURRE�;.: Y../cN'- , - -
<br /> Addre�s`uF:;,� ,�,;� , ,� �,:. �._ � . r�. . . tf= i ��. , ' . . . �ican$e#`.� � ... ._ . I _
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<br /> ' StGNATURE' ,.'<<3;. ��` �:.t:.".�.� . _ <, �:: ..:�-: „ , ,, ,� ,REGISTERED` Y/'N:`;r FEE CURRE� ,.< Y/N.
<br /> :�t�,y-�� '«�,�_, ... . „ ... . - _. . . ...- .. � . ,, ` - :i�?` ' y • _ ' '". , f'r� .
<br /> I'4MR��8�S ic+,"xu;t�"t'.'75`° ?;,,Y.:i��;:.:x�^rt? :�`;:-�`• '�sa� ���CBtiS$tt'� �
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<br /> �RESIDENI'f�41:„;>��,Attacti;{2);�?lottP#aits;:.(2)sets:�f��uilillrig?#?lan's;(1}setaf��nerg}rrFaiins;ft�lt►liRei•mif tarn'ew consUt�ctlon, ,
<br /> �;a-�•��;;Minimumg�ten�(s10)uvirorlfing:t,'d8y,'s�afte.r,'sutiinifial�iiafe:�Required onslte;:ConstnictlongPlans;�Stormwafeb Ptans�w/Sitt'Fenceinstalieii, °
<br /> ` �. �.-. �,. . y .< �. .. .,,, .,.
<br /> Sanitary FaclllUes&1�dumpster.>:Stte 4Vorfc Pertnit,for:sutixdivtsiohs/large�p:�n)ect$,:;.�>;!�; :. >, .. ;,. � :;� , �>� �
<br /> COMl10ERCIAi. A#tadi{3)'cbmplete sets'of Sui[c11ng P1ans�ptas a.Ctfe Safety Page;(1)set of Eitergy Fotms.R-t71N Pesmi##or new canstruction.
<br /> MiNmum ten(10)waricing days�after submittai date. Requtred onsite,CansWctian Plans,Stormwater Plans w/Silt Fenc;e instailed,
<br /> Sanftary Facilides&1 dumpster.Site Work Permlt,for all new;prciject's::All commercial�Cequlr,ements_must meet.complianca `' -
<br /> ,��StGNPERMlT Attacfi(2):se'tsof`Engl�i�eeT�asi�P�la,�r�s:,�;-.;,:x;;�:�,��;.�,�;�.i'_�i=:,• „ .. .
<br /> """PROPERTY 8URVEY requirecl for all NEW�aansWctio.n..,_ -
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<br /> � _+L1�1@.t't�OA8: ,k?>:.;"t.-�'r.=c': �.. _ . . .a =,.
<br /> � FIII out applicaBon wmplekely.
<br /> 4wner&Contractor slgn.back af appl(catton.notarized �
<br /> If av�r�590,a.Notit�of.Cammencemsnt ts requFrad. {AtCµpgrade�over�7500) .
<br /> :,.:�w:;y;'�'`'.�:�:n a
<br /> " ent for ttie'contractor•o�Powe"r'of Attariie for the aw�er would tie'someaine with notarized letter froen owner autho�izing same
<br /> A9 ( ) Y(•._ _:.,_..._ � A ,
<br /> °gYER�THE CQUi�1TER�PEl�Mi1TIt�G�...,�--;.-.(Feant af Appl�catlan�Qnly),__.�_.�,, : ,
<br /> Reraofs if'shingles Sewers Service Upgrades �4/C Fences(PIoUSurvey/Foo#age)
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<br /> Driveways-t+iot aver Counter if an pubilc roadwa�yis:.'needs R{�Vitr�
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