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<br /> e��.�eaooao City af Zephyrhills Permit Application Fax-813-780-0021
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<br /> Buitding Department .
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<br /> Date Recetved - - � Pitone�Contact far Perm[t#in Y
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<br /> Owner's Name �' � �l� �� � Owner Phone Number �3 ` t9��""'�J ��� �
<br /> Owner's Address �s�, ,Nf1" 2, �/��� Owner Phone Number �
<br /> Fee Simple Titleholder Name ��'�C � Owner Phane Number �� �
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<br /> Fee Simpte Tltlehold�r Address �J ��
<br /> JOB ADDRESS ��� � � ��in,C�� L07# ��
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<br /> susniv�sioN � ����.:�--�:�� � PARCEL ID# '�j 1��� I -��to—o p$pp - I%4
<br /> (OBTdUNED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSEU � NEW�CONSTR ADDiA1:T �� S1GN 'Q [� DEMOL.ISH
<br /> e; INSTALI. � =,REPAIR �
<br /> PROPQSED:USE SFR� Q �COMM � OTHER
<br /> TYPE OF CdN3TRUGTION � ��BLOCK " 'Q FRAME [� STEEL Q
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<br /> DESCRIPTION OF WORK" ^ 1���L C� S h !N G-G�` ��'/I �I� Gl�-- �
<br /> BUIL13iNG StZE �� �� $Q FOOTAGE��� HEI.GHT ����
<br /> �BUtt.DfNC� • $ � �, � � �:
<br /> �" �� VALUATION iJF"f0`I'Al COtVS7RUCT10N '
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br /> OPl.UMBING $ _
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<br /> QMECHANlCA! $ VACOATION t�FaMECHANICAI tNSTAI.�P►T10N �
<br /> QGAS [� ROOFING Q SPECIAI.TY. C� OTHER � -
<br /> FINISHED FLOOR ELEVATIQNS �- _� FI.00D ZONE AREA C]YES NO
<br /> sut�.��� coM�Ai+nr �`�iYr�'l �D��tJ �t. �-� 1t�f�
<br /> SIGNATURE �/ REGI3TEREb Y/ N FEE CURRE� Y'/N
<br /> Address � Llcense`#' �G G I
<br /> E�EC'i'RlCIAN .: - - - COMPAt�tY� • -
<br /> SIGNATURE T' REGI3TERED Y/ N FEE CURRE�~� ' �`Y/N
<br /> Address � ° � ' � � .._ � ; . License# � , ,� � �
<br /> PLUMBER � . , COMRAFIY , . ' �
<br /> SIGNATURE' � ' ' � REGISTEREO Y/>N� , FEE CURRE� .Y�/N. � ��
<br /> Address �_ License,# � . " - -�
<br /> MECHAPIICA� . . , CO(YtPANY '
<br /> SIGNATURE� ' >' � ' `� ` �` � � � `` ' REGI§TERED Y./ N ..� FEE.CUFtRE�. X/N ,
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<br /> Addre�'�°' .' .� ` ' ' :. ` License#
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<br /> OTFlER -' -- - "_ ,, , , � ;COMPAt+IY, . _
<br /> SiGNATURE :� ' - •• � - ' - " ` REGISTERED Y/ N.:_ ` FEE CURF2E� _ Y/IV
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<br /> Address _ ��_ . . . � _ . ' Llcense# �u � . -�_�.
<br /> EtESfD�N°F��1i.:r�:�Attach',{2)aPtot:P;lans;:(2}set"s��of�8tiiltilingtt?laas;`{'1)setof=Eriergji;Forins;,�R-0=W'Periiiit"fornewcansWct3on, . ' " �� „ �� ` �
<br /> _ :. Minimumtten;(;10):working�days';after subrinlftel'date:<,Requlred onslte,Conetructlon F?lans;Stormwater Plans w/Silt�Fence Installed, �
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<br /> Sanitary Facillyes;&:1.4dumpster-8lte•Work<,P.ermit foc:sutidiVisionsllarge:proJects=� � " �;� ' ,`_ ., _: "
<br /> - �OMMERCiAL �Attach{3}completie`setS of 8ut18Erig'P{ans plus a�Ufe Safety Page;.{1}set of Energy Forms.R-O W Fermit for ne�+r ixinstnic�on. � � - -
<br /> Minimum ten(10)working days�after submittal date. Requlred�onslte,ConstrucUan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facllides&.1 dumpster.Site Work Permtt for all new�proJecfs:.All commercla!requlrements_must meet compllance" � � � �
<br /> SI�N PERMIT Attacti{2)se#�af Eiigtneei:ed�Plans:; :".;�-.:- �' ` ,. �, . � , _ ; . . R,
<br /> •`""PROPERTY SURVEY r , uired for,all NEW canstructian. _ .. . - - --. '` - �-
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<br /> :Directians: , -.�,_�q.: .�� . • , � . _. _,._ . .
<br /> FIII out applfcaUon complstely.
<br /> Ownsr&Contraetor s{gn back of appiicaUon,notarized
<br /> if ovar�Od,�Natice of Cornmencem��t i$required. (AJG tepgPades avar$7500j
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<br /> '" Agent(for the contractor)'or Powe�of Attomey=(fqr.-tFie�owner)would be someone with�notarized letter from owner authorizfng same _
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<br /> OVER�THECOIlNTER,PEEtMtTFtNG..,. w--(FrontofApplicatiomOn{y)_.�`-. , . , . " , _ . _ -
<br /> ` Reroofs!f shingles Sewers Service Upgrades A/C •Fences(Piot/Survey/Footage)
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<br /> � Drlvewaya-Nat over Counter if an public roadvusys:.needs ROHV
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