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e�sasaoozo City af Zephyrhills Permit Application Fax 813-780-Op21
<br /> Buitding Department
<br /> Da4e Recelved g�� �g� ��
<br /> ,: Phane�Cantactfor°Perniittin `
<br />' Ownsr'$Name f�A�1/U��/�} �./�C�le Owner Phone Numtaer ��3" !�� /
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<br />' Owner's Address 3 t�7c��p. dN d �"�� Owner Phbne Number -� �
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<br /> Fee Slmple Titleholder`Name � � Oxiner Phone Num6er � �
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<br /> Fee Simple Tltleholder Addre�s
<br /> �oe�,���5� 3g a �� da� � �oT# ��.�
<br /> sueofvis�aN ��ood t�i�t1 0 5 ��ce�.io� ��� a'� �1 la,�l� ,Dl��G� d�j�Z9
<br /> , (OBTAINEp FROM.PROPER7'Y,TAX NdTICE)
<br /> WORK PROPOSED : NEW'CONSTR � ADDlA�T � S1GN o. � o � DEMOLISH '
<br /> �e= INSTALL � REPAIR � ' ,
<br /> PROPQSEQ;USE Q $FR Q COMM - Q •C}THER . ` ' ,
<br /> TYPE OF CONSTRUC'1'ION - Q� BLOCK " Q FRAME C� �STEEL Q -
<br /> DE3CRIPTION OF WORK' n �G�'.S� �G G �br.�-'� � U"f -o �N� � T'Qn/�
<br /> �UILDING SiZE � � �"SQ�FOOTAGE � _,HEFGHT }���
<br /> QSU{l.D1NG , �� VALUATiORl�`(.iF'TOl'A�'C�NSTRUCl'ION ' L
<br /> QELECTRiGAL , ' �$'�, AMP BERVICE Q PROC�RESS ENfRGY W.R.E:C. ,
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<br /> QPLUMBIitilG �I___ � 1 , ,
<br /> OMECNi4NtCRL $ VALUATION O�:MECNANlCA�1NSTA3.LATlON
<br /> .. �l���o _�t� . . -
<br /> [�GAS Q RQOFfNG Q SPECiALTY' � OTHER � -
<br /> FIIVISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA [�YES. ,NO .
<br /> 81i1�DER COMPANY. ' `
<br /> SIGNATURH REGISTERED Y/ N ��e cuR�n ' Y/N"
<br /> Address � * Licanse# I �
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<br /> ElECTE2lCIAN; ' COMPANY � ' °
<br /> SIGNATURE w' REGISI'ERED Y/ N �Ee c0�n'�'' �`�Y/N
<br /> Address - , . .; License#-:� . � �
<br /> � P�UMBER ' C�MPANY . � ,� -
<br /> �� SIGNATURE' ' "' � , ,REGISTERED Y./-N,a ;; .�FEE CURRE� '" Y-L N. ' , '
<br /> Addre�s . ,.License,:# i�. , - .. -�- ,
<br /> r�Fc�n��c,�: - � � .��Ze�.o�c�t. � co�p�r. �h��,S �f�rnP���5�"�f �.�G
<br /> AN
<br /> SIGNATURE � REGI57ERED , Y,/ N . , � FEE CURRED Y/'N
<br /> Addres�. - �� f G�r1�- - �' v�, _ . License#`�1�� 7.c'��"7r� . 1
<br /> . :Y.'.
<br /> oTtiert ; _ . . � ';coM�a�nr ` ' � .
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<br /> $1GNATURE' .� � ' '� � ' ° ' ` ' � REGISTEREo � ' Y/ N:.:: `�FEE CURR�� Y/N
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<br /> Add[888 ;. .:.',..::._ ,,..� ;. r:' , , . ". - , . " - 11a8t1S8# �i .
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<br /> RESIDENTIAL� � �Attaich"{2}„P..tot;Pians;n:(2�`sets=cf'BulidingTRlaiis;`{1}`setof=Energji+Foims;�Ft�W'Piamiitfar'csev+rconstructloii, � ` . .
<br /> w ,�.s=�:Minimumtten+(1,0);wqrking�:days;atter„submlttai date,�:;Required onsite;':Constiuctlon:�Plans;Stormwater'Plans w%811t Fenr,e installed,
<br /> ��`Y��'�Santtary FacillUes�&��1,�du,m,pste_r,-Stte•Worlc�Rertnit tur;subiitvislonsllarge'=prnjects-�; : " ' '� � "'" ;�• �.'-
<br /> COMMERCIA� Attach{3)�c�oi'tmpteteTse#s`of Bulld(ng Plaiis�plus a'Life Safety Page;�(1j set of Energy Fortns.it-O-W Petmtt far new cosishuction.
<br /> Mintmum ten(10)waricing days after submlttai date. Required onsite,ConstrucUan Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new,:proJects._All commercial requlrements.must meet compllance"-�
<br /> i SIGN PERMIT Attacti'(2}sets of EnglneetedrPlans.,.;:: :--� •.. <. . � - ' .
<br /> ""PROPERTY SURVEY required,for all_NE4Y construcUon..
<br /> Directlons: . , , �. � .
<br /> Ffll out applicaUon completely.
<br /> Owner 8 Contractor slgn back of appltcatlon,notar�ad
<br /> If av�r�2500�a Notice of Cammencement ts required. (A!C upgrades over�7900)
<br /> � �M�-�:,�-.
<br /> '" Agent(for the contractor)or Power of Attoriiey(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> , OVER i'HE CCFUNTER PERM17'i1NG... ,. -(Etant�of�APPIlcation-Only�).r- - r, ` ' -- -_ _ .- _. � .� < <_ _�
<br /> Reroofs if shtngles Sewers 3ervice Upgrades A/C "' Fences(Plot/Survey/Footage) ., � , � �
<br /> .. _ .� . �... _ . � :. * Y
<br /> � Driveways-Rtot over Counter tf an pubtic roaduisys..nead"s ROtiY : , � '
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<br /> _ ,. . .. �_ -�. -. . . •<.�rva,,,,.�.
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