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.: 813�780-0020 City af Z�phyrhills Permit Application Fax-613aeaaoz� <br /> - BuUding Departma�# <br /> Dat�t2eceived v � t�hane Cantact for Permittin � 1 — �}�j t� <br /> Owne�'s @lam� 1 1 ,� Owrner Phon��lumber i <br /> Owner's AdcYrass . W c..� O�wner Phane Number i <br /> [ � � �I <br /> Fee Stmpie Titleholder Name O+xn�r Phane Nurnber <br /> Fee Simpl�TtN�holder Addr�sa <br /> JO�A(DDRE$S � �-�l l�' 1 �i� J�1 � LOT# � <br /> susa►�s�a�s ~ , �,�l.�t�,Ltd PARCEL 1� � � -CX�a- 1- 1 t�—UC�3L�C� � �}i i�G <br /> (08L�INED FROMA PROPERTYTQ1f NOTICE� <br /> WGRK PR�POSED , � NEW CO�DSTEt 8 RL7DlAlT � 81Gi� � [� DEMOLISH <br /> IPJSTALL REPAIR <br /> PRa�os��:u�� 0 s�� p co�� 0 o�r��� <br /> TYPE OF COP6STRUC'P10R9 �[� �I.00K " C] FRAME � STEEL Q <br /> �E$Cltt�i'ii�Ai�F Wl�itiC �� �{ �1 <br /> Btl1�Dt�tt`s�I�E� SQ FCOi'�iGE�� HEiGH7' ��____..� <br /> QStil�DihlG �� yALUAT10�1`OFTOT,dt.COi�S'i`RUCI'tON <br /> �}EIECTRIGAi. � �. AMP SEF2VICE � � PRC3GRESS EC�ERGY Q W.R.E.C. <br /> [�Q�.un�e��� � �� _ <br /> MECH,0.NtGAL �"-' �' ' <br /> Q $ � VALUfiT10lV OF MEGHANICAt.1NSTRLLATiC1Af C <br /> QGAS Q ROOFlt�1G .� SPEGl�TY C� OTNEFt ��` <br /> FiNISHED FLOOR ELEVATIQAIS ��� FLOOD ZOfdE AREA QYES PIO <br /> � �!!lLii�F� C�tiflt�Agllt <br /> SIGiVA'TURE REGIS7ERED Y/ f�l FEE CUi2REP Y/N <br /> �dre�8 LICBnee# � � <br /> ���CTR1C11�.�t C�AfaPAElt' - <br /> SIGPINITURE �' �GISTEReo Y/ Pl �CUR�t� Y/Id' <br /> �dP� i�canse# 1 � <br /> �i.UN1��R C�FIlPAMt <br /> ,"'a1GNATURE REGISTERED Y/ fd• . FEE CURRE�-- Y/P! <br /> Addr��s Ucense# ( . � <br /> ��c��c�t. ca���r <br /> � Stts�1A1'Ut3E RE�iSTErtEn .Y./ iV Fee CURREP . Y/N <br /> ' Addr� " � �icense# �-� � <br /> o�E� � - co�p� " � ���`� 11'�ll � I(�6'� <br /> SIGPIA'Yk1�3E REGISTERED Y/ N..� �EE CURREn /N - <br /> AtfaPras� ' �� �' � llcense#� �.•.3'�i t��t� ! <br /> ttgSlO�E�}YI��= �Attaci�(2}..Rt6t�.Piarts;CZ}set�af Biiitdir�g•Pl�ns:(1}set oF EnergyrFonn's�R�Q-W Perir�it for aew i�nstiucbton, <br /> .Minlmum�#em(10)worictng'd�ys after submittal da#e. Requtreit onsite,Constnic8on Plans;SMrtnwater'Pians w/�11t Fence instailed, <br /> Senitary Eaciifties.&,1,dympster.5lte Work Petmit for subd(vislons/large projecfs, � ' <br /> GOR9WfERCIt4L. Attach(3}comptete'sets of Bnlldirig Ptaris pius a.1.Sfe Safety Page;{1}set o#Etiergy Fasms.it-t}W Permi#far new constru�an. <br /> Minimum ten(10)working days afker submittal date. Required onsite,Canstrucdon Pians,Stormwater Plans w/Siit Fence lnstalied, <br /> Santtary Facllides&1 dumpster.Site Work Permit for all new proJects.All commercial res�ulreenenb.must meet r.ompliance <br /> calGP�P�R�f14T Attadi{2}'sets of Englneered Plar�s: - <br /> ••'*PROPERTY SURVEY required for all NEW constructton. <br /> flirectlons: <br /> FIII out epplicadon completely. <br /> 4wner E�Cantractor slgn back of appl[caUan,noYarized � <br /> tf aver�2500��Nath�of Cammsncemeet t�requtred, {AtC upgrad�s ov�r:�Y506� <br /> "' Agent(far the conlractor)or Power of Attamey(foe tiie oamer)wauld be someone with notarized letter from owner authorizing same <br /> OVER TM6 GOtfNTER.PE�MI'F7'!!dG �(Front at Appl�cation Oniyj _ <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIaUSurvey/Footage) <br /> �irivewrsys-iVot over Counter[f fln pubiic roadways..needs ROW <br />