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a�$-�eo-oazo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> ' Buitding Qepartmenf
<br /> Date Etecetved . . �� ' Phone Contac#'for.Permittin
<br /> �.C1 � 3 t Zo_ a2
<br /> Owner"s Name �.C�t.:n1 �+ �'r' �ar�1 �2 Oenrner Phane Number �00 � !�,*"�.�'{ O
<br /> Owner's Address 3�2. g c�5a�n7 J�, cre� 0 �K Owner Phone Number �� �
<br /> Fee Simple Titleliolder Name �I.�A u i q�. G. �N F;e Y' � Owner Phone Number � �
<br /> Fee�Imple TltleholderAddresa 3��0 N�OO�I�T 21 Ue. .2e „Q�.� �(5 rr( ,���
<br /> JOBADDRE$S �.�� � 6�. �' L.A.NC' ��. �� 1n�`�r Ff 3�j.,}�e"4'd LOT# �+�
<br /> suaaivisiaN ��e.r�z�� �D�o�`��.r� PARCEL ID# ��y^4-'�' �-Z { -�d z a �-C�o d0 0- t�b�0
<br /> (OBTAINED F.ROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED 3 NEW CONSTR ADDlf1�T � S(GN Q �[� DEMOI.ISii
<br /> INSTALL � - REPAIF2 �
<br /> PR4POSED-.USE . � SFR o �Q�� .. o OTHER
<br /> TYPE OF CONSTRUGTION Q� ° 'BLOCK " Q FRAME � STEEt, �[�
<br /> 4
<br /> DESCRIPTIdN OF WORK-' J/''v5'�"�t,�� �0 �pC f ' „5 j��d
<br /> BUI�DING"812E' 10' X t tf �.,� SQ�fO�TAGE J D HEI,GHT + I� �,, �
<br /> �BIfIWfNG . r$ ,,,�'2 i � �Q VA�UATiON�'t3F=T0'fAl CQNS'i'RtJGTtON. ' '
<br /> L�� .
<br /> QE�ECTFtIGAL , .� � AMP SEF2VECE Q �PRt}GRESS Ei�lERGY Q W.R.E.C. �
<br /> QPLUM8ING $ ' �
<br /> ��.� . Q/2i� rr`l�� ���- �'�a�
<br /> QMECHANICAI $ ' VALOATION OF,MECHANICAG tNS'fALlAT10N ���i� �tt���'- r'�Y'�
<br /> , . u � ��1 � � ����
<br /> �GAS Q RQOFING Q SPECIA�7Y �� OTHER j �
<br /> FINISHED FI.00R ELEVATIONS FLOOD zONE AREA QYES NO +
<br /> BUl�DER �� �1�r�� COMPANY' �T�? f,? C3
<br /> SIGNATURE � REGISTERED Y/ N 'FEE CURRE� ` Y'/N�
<br /> ���$� " ticense#'� �
<br /> ElECTRICIAN:. : 7; ..CONIPANY" .
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' " ��Y/N
<br /> Addr�ss -� ' . . Llcense# � �
<br /> PLUMBER ' , ' . • CQI�9PANY . , . •
<br /> SiGNATURE � , Re�is�Re� Y/:.N. , ,. ,FEe cuR�n Y�/N.-�
<br /> Address LicenseN#�� � } �..
<br /> MECMANIC�►t:' �_ � ' , . GOMPAt�tY `
<br /> SIGNATURE � _ ` � ° — � ' ' REGISTERED , , Y,/ N �� FEE CURREA. Y/N �
<br /> Addre�s` ' , � • �.� ` ` � ' . ` -, - - � License# �- . � .
<br /> OTHER . . . - .. , .r . - •
<br /> `;CON'IPANY'� ,
<br /> SiGNATURE �'. - ` ' ^� • � � '�' � ' � "REGISTERED` � Y/ N... � . FEECURREA Y/N.
<br /> Addre�s, , � ° ,,.>. �, _. . _ ' '�ioense#�� = _� '
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<br /> ---_J�E3lD�NTEAL';�--Attacti={�}.Rtot�PJads,..{2)se�s:�f=9utl�ing:l?!ari"s;{1)'s�foF�Energy=Fb�s;-RL{}=Vif�Perinitfc;nsw•cais6vction: .. — _ --
<br /> � , � . Minimum,ten,(:1,0}��woriiing}days,ai#er;subimlftal date.�Requlred onsite,:C6nstiucUdn�Plans;$tormwate�'plans w%S(It Fence.installed, �
<br /> ....v..,.... ._. ,,.,a.,. , .
<br /> -Sanitary Fa,cillUes;&�1,idumpster,Site•Wor4r,,Permitfior;�"sutidivislonsllarge:project�- .:-.,,. - "-; `.;" ; `"` ` ''� �=:`�'„ ' ,
<br /> GOMMERCIAL Attach{3}ccinplete sefs`of'Buf(ding Pians plus a Ufe SafKtyPage;.{1j set of Energy Fonr►s.R-Q-W Petmit far new constniGtlon:= ���-
<br /> Minimum ten(10)working days after submittal date. Required onsite,CansUuction Plane,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaoiliHes&1 dumpster.Site Wark Permit for all new_projects.All commercial requlrements must meet compllance� '�`�� ' � ��
<br /> SIGN PERMIT Attac�`{2)'sets of�EnglrieeradwPl@ins.; ;..;:�- -. . � . - , � . -. . . .. � .
<br /> �KM ✓i
<br /> PRORERTY SURVEY reguired for;all_NEW construcdon.,., ,. . . ,. - _� -. - - .
<br /> I Dkectlons: , . - - . . . , � , . . . _ .
<br /> Fiil out applicadon completely. �
<br /> Owner 8 Contractor sign back of appl(caflon,notadzed
<br /> if over�2SOQ a Notic�af Commencement Is requlrsd. {A!C upgradea ovar 37500j
<br /> .. �� ".r:,:.:;.,:'�:�� . � _. _w._
<br /> Agent{far the contiractor)ar Powe�of Attomey(for Uie owner)'wquld be someone witFi notarized letter from owner authorizing same �
<br /> DVER 7HE COUNtER,PERMFT-TFFlG.... -.--{Fron#of-Appllcation-Onl .,.,. �,."` . -. _. . � . , c."�..., -�,
<br /> Y)_. _.. ..�
<br /> Reroofs If shingles Sewers . 8ervice Upgrades A/C Fences(PlobSurvey/Foot�ge)
<br /> ,_. ... ..,. - - _. � _ _._ ._ - - -
<br /> Drlveways-Not aver Counter if on public roadwajrs.':tieeds t20W � ..,-Ny. _ , _ ._ .,•r- _. .� , _
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