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s��-�eaoozo City of Zephyrhllls Pem11t AppliC�tion Fax-e�3-7eo-oo2� �
<br /> Bultdfng Department i
<br /> Date Recetved , �—� �— � 7 Phone:Caatact far Perm[t�n �(.J ��� — � d ,� �
<br /> Owner's Name /�/' � �.��1�'.-- � Clwner Phone Numbec �
<br /> Owner's Address � ` T�'' �'� � � `��f�Z �� �
<br /> /"�i r l Owner Phone Number
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<br /> Fee Simple TItleHolder Nama � Owner Phane Number I �
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRESS � � l C3 j�' � G.iL� ,l �li i l`S� �< �,.�./��Z LOT# ��
<br /> SU80tY1SiON , � � PARCEL ID# �I�- �tP ---C�`j—C�6/D— � '— O'
<br /> - , ,, (OBTAINEDFROM.PROPERTY,TAXNOTICE)
<br /> WORK PROPOSED - NEW CONSTR ADDIAi.T � - SIGN 'Q Q DEMQLISH
<br /> _e. INSTAI:L 8 .,REPAIR '
<br /> FRQPQSED>USE � . � Q SfR Q �COMM [� OTtiER 4
<br /> TYPE OF CONSTRUCTION Q' •�'BLOCK " Q" FRAME �_ STEEC [,� � I ,-,
<br /> DESCRIPTION OF WORK' P �ti' /~�d� j h,rtil -� �
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<br /> . ' .����������, �
<br /> BUEI.DtNG SlZE` �� ' �'SQ'FOOTAGE��. . HEIGHT �
<br /> QBUI�DING , �� VALUA710N�0`F�'f0'i'AL'CONSTRIiC'LION " !
<br /> C���� . � _.
<br /> QEI.ECTRiGAL ..�$ ' :..� AMP SERVJCE Q PROGRESS ENERGY Q W.R.6.C, k
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<br /> OPl.UMSING $ ' � ���� ,
<br /> � ��� � �
<br /> QMEGHANICAL $ ' ' VALt1ATlQN OF'MECNANICAI tNSTR�tAT10N �� �
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<br /> QGAS Q ROOFilVG Q SPECiA1.TY � OTHER� �("�f��`�" {
<br /> FINISHED FLOOR ELEVATIQNS ��� FLOOD ZONE AREA [�]YES NO I
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<br /> BUtLDER �P..•-�. COMPANY` J��� ��?�I� ��C ;
<br /> SIGNATURE � REGISTERED Y/ N 'FeE cUtt�tEn Y/N '
<br /> Address Cicense# '��� j��f�� � � ,
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<br /> ECEC7RIClAN:: ., . COMPANY ' � .
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ` ��'Y/N i
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<br /> Addres$ ` • . , _ License# � � � i
<br /> PLUMBER '� ' . , CBMPANY . !
<br /> SIGNATURE' ' ` ' " RE�I$TERED Y/:.N. ,-; (:EEE CUFtRE� Y•/N. t
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<br /> , � , -.�.
<br /> J�1ddr888 '-` .� .
<br /> License,# � -'
<br /> MECHANIGAL:' ' � GOMP�WY " . i
<br /> SiGNATURE ' � ' ' _ r��is7ERen , . ..Y,/ N .' �eE�cuw�En� Y/=N . , �
<br /> Addre�s��� , ' • -�f � ` . �.r = ` . . ,. � � � License.#���. ��
<br /> , � :a-�
<br /> OTH�R `,, . _ � � ;GOMPANY � ; , , . �, `
<br /> SIGNATURE � . z°% C'` � ' ' � ' REGISTERED} Y/ N�... FEE CURREA Y/N �
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<br /> Ad+dress� .- _,.. ,.,- _ .. - �f � ticens"e# � � '__ '� . !
<br /> RE3lDENTIAl:'.� :;Atta%c!i'2 P gt:Ptaris;'.(2)sets;of'Biilldfiig�l?!a'ris;'('t}set of�En'erg}"r>Fbiins;,�R-0=W Perrrilt�far new constrtrctian, - '`'� �' • '
<br /> (_}:._! { �`;� . ,�, � � ' �
<br /> �, s.,:y.:Minimum�ten;(�10);working;d'ays�aiter„subrnittel date:�:Required ansite;;ConstrticUori Plans','8tomiwafer pians�w%'SIIt Fence installed,` •'
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<br /> San(ta'ry` Faolllyes�&;1,;dumpste_r,�Slte�,W,prlt�Permlt#orsutidiVisionsAa�ge;proJects�� t;;:��� , . � "- _ - ° � -
<br /> COA�MERGlA� Attach{3j`c6mpiete set`sY of�Sullding Plans'plu's a l�fe Safety Page;{1}set of Energy�Fotms.R-CI-W Permit far nsw canstructlan. ' _
<br /> Minimum ten(10)working days after submittal date. Required onslte;Construcdon Plans,Stormwater Plans w/SilfFence installed,
<br /> ry _� _ _..,_p. Wa�Permtt for all new�proJects:All commerclalrequlrements_must meet campltance:`• `µ° " •
<br /> Sanita FaciliHos&1 dum,ster.Site
<br /> .StGN PERMIT Attacc�ii{2)sets of'Engliieer,ed Plans..�.-: �_•-� :_ �'., _ - .� . , . , - � .. �
<br /> . '•""PROPERTY SURVEY reguired forall NEW constructlbn., - �--•- -
<br /> Dkecflons: .._. . � ., - .. , � . _ . _. ...� _
<br /> FiII out�appltcaHon comptetely.
<br /> Owner 8 Gantractor.slgn back of appltcatlon,notarizad
<br /> If over#2500,a Notice af Corrimencement is required. {AtC upgrades over 57500) :, • i... ..
<br /> '" Agent(for the�contracto�)'or'Povire�of Attomey(for tFie bwner)would be someone wltFi notarized letter tram owner authorizing same �
<br /> OVERTHECOUHTERP.-ERMI7TFNG.-. .-.(Fronkot-fippticatianOnly),. _ .�, _ ` ' . , _. _ � . . , I__.
<br /> Reroofs,If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
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<br /> Dr3veways-Not aver C,aunter€f on pubiic roadways:.rteads ROW` � �
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