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- a9�-��a-oozo Cif�r of Zephyrhills P'ermit�►ppticatimn Fa�a7a-7saoaz�
<br /> �ullding Department
<br /> Date Rece[ved :: �hone Contac4 far P+�rmlttin ��� "LQ�. — � � 6
<br /> Owner's Plame �1,,� � � 1�'� �Jwrner Phone Numb�r _,
<br /> Owner's Address t.� W � Own�r Phone Plu�ber
<br /> Fee Simpl�Ti#iehold�r ldam� Awner Phoree Number �
<br /> Fee Simple�Titieholdi�rAddress
<br /> .t08 ADC►R��S �� � L.O'Y# �
<br /> �UBDIYISION $,, 1 4�1�1!�,�.,_,� PAlZGEL ID# �
<br /> _ (08YAlNED FR07A.PROPER7YTAXAlOTlCE)
<br /> WORK PRt9POS�D , e idEW CONSTR� ADDlA4T �� SIG(d� Q [� DEMOLlSM
<br /> IIdSTi01..L REPAIR
<br /> P'ROPQSED:USE � SFR Q COMM [� OTIiEft
<br /> i'YPE 13F Gd3t3S1'FtUCTt�B� [� SLdCK ' Q FRAME � S7EEL Q
<br /> a�esc���r��tv a�wo��c ��Y l �! . -
<br /> BUtLDtNG'.StZE � SQ FOOTAGE�� HElC`aHT'�„_�
<br /> QBUlLDl�lG ��� VALUATION�QF 7'OTAL COfVST'RGCTlON
<br /> C]ELEGTRIGAL $ AMP SERVtCE Q PROGRESS EIVERGY Q W.R.E.C.
<br /> �' ��. .
<br /> �. OPLUMBING $ 1�q-Zl--1` : �
<br /> . S Vl.���
<br /> [�MECHANiCAL �---^� VALUATtON 0�MECHANlCAL INSTALL,4TlON
<br /> , �c�as - [� ROOFING Q - SPECtALTY � ' �OTHER . M1
<br /> FlldlSHED PLOOR ELEVATtONS �`� �.FLOOD Zr3I�fE;4REA [�YES, td0 _
<br /> BUII.DEFt CORi�AtdY� . -
<br /> SIG[dATUR� REGISTEREO Y! N �E Cu�. � Y:/-N . ; . - � -
<br /> Address Licerise# � -'- - ' " 1 f
<br /> EI.EGi'RIClAAS+11 CORRPANY � - - . - � -
<br /> SIGNATUR� ' REGiSTERED Y/ iV ��curtt���� - - Y/N" �' -
<br /> �lr3�r�s� License# ��.-. - �.. I `
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<br /> PLURABBFt CQ�19Rii[dY � V.V � i.�:� {J(� .
<br /> SIGNATURE REGtS'cERED Y./,.iV. . FEECURRET Y�1
<br /> Acldress t �. License# ��c5 ��0�-s�1� �
<br /> RIIE�ti�YdlC�l; COl�ipt�! "
<br /> SIGWA?UQtE� , _ Re�ts��n Y.t t� . - �+�cuRR�R Y i N .
<br /> Ac4dre�s�� '- ' _ , � Ucense# r��.w —.—�
<br /> � . _ .. , - _.;
<br /> O'�Hl�tt - - - COMPANIY � . ,.
<br /> SIGNATURE '. - ' - �� �txE�►s't�v Y/ N..°. �E Cut�REi+ � . Y i A! . _ -- ;
<br /> 1�s9��s - � Liceiise#��_ `� , . `
<br /> � _. : . .. � .: _ �..,:. �.� .� .: ._ :�- . .,. _ y _ .
<br /> ;
<br /> R�StbEHlTIAL;= Athacfi"(2).Rlot�.Plans;:(2)`set�;ofBuilding,Plans,={.1)sefof=Ene'rgy�•Foqn"s;:R=O=W�Peririltfar_nawconstructton, _ _ _ _
<br /> • � Minfmum.ten�{10),working:days after..submitffi1 clate:�.Requfred onstle ConstnicHon:Plans,`Stoimwate`r"Plar�sri+/Stit Fence.3nstaEted, _ i
<br /> " Sanitaejr�Eacftf�es.&:;1:,dumpste�;Site"°Worlc�Rermit�€or§ubdivlsioitsqatge:prvJeats _��.-x• , .�� . : �'" - = � _ ' :.
<br /> CO�fiiVl��.Cli�l. Attach(S)ccinpiete sefs og Builiiirig Plans plus a l.ife Safety�Page;{!}sei of Enetgy Foims.R-O-Y1t.Perrnit far neHi ooristiui�iaa:� -� -
<br /> Minimum ten(10j wrotktrig.days eiter.submltta!date. Required-onsite,C.4r�strucBoii Ptans,'Stasmwaker P}a�s w%Silt Feoce insEailed, . .
<br /> 5anitaty Facllitles&1 dumpster:Stte Work Permlt for al!new ptojes:ts.All cammercial requtrements must�+eat compRasice- =
<br /> SIGR!PE�N!!T Attachi{2)sets of Eiigineier�d�Plans: �. -.. ., � _ � - - - �
<br /> «•••PROPERTY SURVEY i�equired.for a}!NE1A►�nshuction... �- � _ ,
<br /> ' QUace�ons: t . . , ,_ .,. ...
<br /> Fill oat applicaUort completefy.
<br /> '- Ownee�Gontractor slgn back of apptEc�EEon,naEarized 3
<br /> �, t€ovsr$2500.a�im4#ce�a�ComYnenc�ment is required. (�IC ap�e�d��ov�r gT500)
<br /> " .:=s�ui{�ar ftis cantractor}or'Pbwer of A4famey(far tlie oumera would be someone withi nota�ized letter from owner autharizing same
<br /> �iCiF��:����"TER PF_RAd17tiHfs .•{Front af-Appiicatian Onty) .
<br /> "��_ . �s Servic�Upgrades NC Fences(Plafi/Survey/Footage) ,
<br /> 1.,'e� � - ' _ . ,z �,y •+ -
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