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s��aeo-oo�o City of Zephyrhills Permit Application Fax-813-78p-Q021
<br /> ,. � ' Buiidir�g Depariment _
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<br /> Date Raceived „; phoee�Coiitact forvPermittin � � �7�ea� – �� ��
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<br /> Owner's Name � r4/2k'/�1 L.G. f� �e �� �, Owner Phone Number ��r�– a��f�D�
<br /> Owner's Address �� � �`L�I`��Gt. 1/� �� Owner Phone Number � �-
<br /> Fee Simple 7)t1eHolder.Name �� ` C -'�x`��'"����' Owiner Phone Number `� �
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<br /> Fee Slmple Tltleholder Address
<br /> JOB ADDRESS ��,�C I�� .,,Z/ � �� � �R/� J7�/LL Ie/� '�$LOT# ��^„�,
<br /> suaoivisiaH , � _ . � � paRc�c�.ia� �� � 07/ �f�Dd G��3l�t� t�d��'S
<br /> „ , (OBTAINED ER4M PROPERTY.•TAX NOTICE)
<br /> WORK PRQPt}SED NEW CONSTR . ADDlA1:T � StGN� Q ' � _Q DEMQC:ISH
<br /> �e; INSTALI. • REPAIR � - '
<br /> PROPOSED>t3SE � Q SFR Q COMM � � OTHEF2 ' ' ,
<br /> TYPE OF CDNSTRUCTION Q ° BLOCK " [� �RAME .� ,C� STEEL '[�
<br /> -� �ese: � ,_
<br /> DESCRIPTION OF WORK � Gr Ga V)A/v @– LL G� t,7Y� l»/�/�j"`S � %d/�
<br /> :. , . . . _ ..
<br /> BtJItD1i�1G SiZE �'� . �`SQ FQOTAGE � , „HEIGFIT�;���_�. .
<br /> 0 �. .. ...... . _ '., -'
<br /> BUt1.DING , $
<br /> 111_ � VALtlATION�OF�TOTACCONSTRUCTION
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<br /> QEE.ECTRIGAL , $ AMP SERVIGE 'Q PRfJGRESS Eh1ERGY Q W;R.E.C. .�
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<br /> OPLUM8IN{3� -.'� � .
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<br /> [,�]MECHANtCAL $ p
<br /> J � ' VRLUATION OF,MEGHANfCA�INSTAILA'fIQN
<br /> - �'":.3� �..
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<br /> QGAS [� ROOFING .Q SPECIAI:TY.C� OTNER . • �
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES. NO
<br /> BUIl.DEtt C4MPAl4IY` .
<br /> S1GN�ATURE REGISTEREp Y/ N FEE CURRE� Y'/N�'
<br /> Addres� , ., Llcense#��— ��
<br /> E�ECTIttC1AN: . :�COMPAFlY " , "
<br /> SIGNATURE }' REGISTERED Y/ N FEE CUF2RE�-> � '�Y CN
<br /> Address - . � , , . 'License#,l - �
<br /> PLUM�EI2 ` Ct?MPANY . . , £ - -
<br /> SIGNATURE' ` ' , .REGISTEREp Y../:.N:� .;;,. ,.;FEE CURREA '. Y./N —. .
<br /> Address � . , ,:llc�nse.# �. -�.,, ,
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<br /> MECHAI�IlCA#: t1��rn� ` . CQM.P.Al+IY _.f��}1Q� , 1UUf�1tJ,�'�j5�t-� �� _-111G ..
<br /> SiGNATURE `' �� 'v�'�"� REGISTERED Y,/ N . , �,FEE CURRE� Y,/^N . • , �
<br /> Addre�s�' '7�'�}�}' G - �`�–� J ��. . � ..License# ���!��./.TCS � ,
<br /> �T�tEEt ' - "' - " - .. , .1; � ��'� �. � - �-� �� . ,�:: �. , ` ,
<br /> .s COMPANY _
<br /> SIGNATURE �,- " �� �`-' ' ' _ � �' � ' REGIST'ERED' - ' Y/ Nr: FeE cu�t�n Y/N. _
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<br /> Addre� ,.,�_ -. . . ' � - �� � 3�
<br /> Llceii'se#
<br /> ttESlDEMTIAL,,� -. Attacti'(2},Ptot;Pians�.:(2)seis=of;Bulidingxt?ta'ris;{1)set af=Eiiergj+>Foi�s,°-}2�4VII Fer`rr`iit fcir'riew consWcttoii, " ` ' ,
<br /> - -Minimum ten.1,0.�workin "da s"�
<br /> r a �p � (_ )M , gy ys?_a�ter,:�submlttai`tlate.uRequlred onslte;<Consfnictlon.'Plans;�Stormwater Plans�w/SIIt Fence�installed,
<br /> ^L �4 .; �Sanitary Facilttl,es+&,1,durnpsterySite�Wor4c.:P,_ermitfor�subdivisions/large>project"s�v,__::':;• , ' . .=` ; �
<br /> COMMERCtAL Attach(3)°aoinptet`e-setstof`Bu1181rig Plans�ptus a C.Efe Safeiy Page;(1 j set of Energy Forms.R O-W Petmtt tor new c8nstsuctlan.
<br /> Minimum ten(10)woricing days after submittal date. Required ansite,Ccnstructian Plans,Stormwrater Plans w/Silt Fence installed,
<br /> _.--~' Sanitary FaciliUas&1 dumpster.Site Work Permit for aU�ew:projecfs:_All commercial requlrements.must meet compllance`
<br /> StGN PERMIT Attacti"{2}sets of Englnee[ed„Plaris.::.�..,;_..- .. ;, , ._ . � � ,
<br /> """PROPERTY SURVEY reyuired for all IVEW canstruction. -
<br /> Dlrectlons: ,__. _ , , � .
<br /> Ffll out applicatlon completely.
<br /> Owner&Contractur sign back of applfcaUon,natarized
<br /> If aver�2500.a NoticQ af Commencemant is requlred. {AtC upgradss over 37500)
<br /> " Agent(for the contractor)'"or"Power of Attomey(far Uie'owne�)would be�someone with�notarized letter from owner•autho�izing same_
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<br /> DVER 7HE Ct,'�UNi'ER PE[tMITTiNG�-. -�_ :(Ftont�af-APP11ca�fan.Qnly,}...� � ` �- . ' „
<br /> Reroofs if shfngles Sewers. Service Upgrades A/C .Fences(Plot/Survey/Foatage) " , � _ ' ' � ' ,
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<br /> Drlveways-Not over Counter tf an putitic roadovays,..needs ROW - _ ' ' ' ',' . ;Y ` ;r= < ..
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<br /> ' _ .l,",._ ' +. -.. 'v. s.}•`•��-'�-m �
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