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e��-�eaooao City of Zephyrhills Permit Application Fax-813-780-0021
<br /> g ^ BuHding Qepartment
<br /> Date Received y
<br /> -� Phone-Cantact`for PermittEn —
<br /> Owner's�Name O n Owner Phcna Number �J.3 '� �
<br /> Owner's Address � G'�� s'� .f Owner Phone Number �— �
<br /> Fee Simple TItleHolder Name /�'��1�i" d <�d��i►�:a ' Owner Phone Number � �
<br /> Fee Simple Titleholder Addrass ��? 2� S� /' ,.
<br /> J08ADDRESS ���� �,�� ST I�' � ' .� LOT# C�] -
<br /> $UBDIVISION �� � PARCEL ID# •
<br /> - , - (QBTAINED FROM PROPERTY TAX NQTICE)
<br /> WQRK PROPt?SED .:,NEW`C4NSTR ADDlALT � S{GN� O- Q DENtO[,tSH
<br /> ;e. INSTALL 8 REPAIR �
<br /> PROPCISED:USE . Q $FR Q GtSMN! ` Q -QTNER
<br /> TYPE OF CONSTRUC710N � �•'BLOCK " �] FRAME ��] STEEC 'Q
<br /> z
<br /> DESCRIPTtON OF WdRiC' �' G�'T$�t q,.c ' � �
<br /> BUILDlNG StZ� ���Z� �'SQ FOOTAGE��: ,HEIGHT -
<br /> [�BUI�DlNG , � � „ �_"._ .
<br /> 11 VALUATION`L?F�TOTAL CONSTRUCTION
<br /> QE�ECTRIGAI. �>_����-; AMP SERVICE j�iU � PROGFtESS EhtERGY Q W.R.E.C. „
<br /> OPLUM9ING $ , '
<br /> ,,� � '
<br /> QMECNANlCAL �� VAIUATtQi+i OF�MECHANICAI.INSTA�IATIt}N
<br /> QGAS Q ROQFING [� SRECfRI.TY ��] OTHER
<br /> FWISHED FLOOR ELEVATIONS �.�� FLOOD ZONE AREA QYES. NO
<br /> BUILDER COMPANY` ' �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N�"
<br /> Address � Eicense`# �— �
<br /> ���cst�c�+i .� � ::c'oMp,ar�r - �S�� �' � C�E'� r
<br /> $IGNATURE � REGISTERED Y/ N FEE CURR �� '-Y/N '
<br /> AdtlF8s8 , , � .-� � , , r LiCetlSe.#.��" �.�„�,,,�0�`��
<br /> P�UMBER ' _ COMP.AHY . . � `� .
<br /> SIGNATURE�`' '� � ' ' , REGISTERED - YI�.N>� ,• :FEE CURRE� � -'Y/N �
<br /> Address � �icerise,# � , , .�
<br /> MECMAI+I1Ci4t:` � � - COMP�,_RNY, • - � � � .
<br /> SiGNATURE � � ` ' ` " i�cis7�Reo Y./ N " ��E Cu�� Y./-N - � .
<br /> Addre�s� � � - � . � '> � " ' ` � License#f��. . � � .
<br /> t?THER - . - , _ _ � . .. _ . . _ .`;GOMPAPIY' . . , � _- , -.- .
<br /> SIGNATURE ..�c.` '•'�:' � ' .. .`:�` - ' _ - `REGISTERED� ` - Y/ N:.. FEE CURRE� Y/N
<br /> .,., r; ,.N.. ..,:-. ,., -., _ _. . " , .
<br /> Atttires� , T .. .; � , � _ � ' License# �� . ,;' "� _ �
<br /> E2ES1QENi1Al..,r,.'�;Attactr{2);Plof�Piaa's;.:{2)sefs=af�8u11ii1ngTPlaris,(1)'set'of�En'ergy�Faims;R=t?�UV•'Peririlt for new c�tnstructian, ` " - ` ' , ,
<br /> , .�_,.:...=.._,.�. . .
<br /> t= �� Minimurr9:ten�(10};woricing;days:after;subrinittal:d`at"e::Requlred onsike;:ConstiucUon'•Plans;`StormwateF'Plan`s w!S11t Fence`lnstalled,
<br /> - ���"'SanitaryFactlttl,es:&:'.1.dumpster�Slte�.,W,ork:Perinitfiorsutidlyislons7large:projeots�:. ,:�.,��� � ,. " � � .r,�, , �_
<br /> CQMMERC{AL Attach(3)��aimplete�sets-of�Building P1ans plus e�ife Safetyr Rage;.{1}_set of Enetg}t Eorms.R-0 W Pe�rnit for nav+i cansttvctIon.• -
<br /> Pdinlmum ten(10)�warking deys aRer sutimtltal date. Requlred onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence lnstalled,
<br /> Sanitary Facilitles 8 1 dumpster.Site•Work Permik far all new::projects.E111 commerclal�requlremen�must meet campllance'�f - � �
<br /> -SIGN pERMIT Attadi"(2)`set�:of Englneered;PEan's.:,.:..:
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