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<br /> ���u City of Zephyrhills Permit Application FeX 8�3aso-ooz� L
<br /> �,. Bullding G9partmerit . , ,
<br /> - f �
<br /> ., ,etved �„ � .: Phane�Gontact for Permittin �s l �-- � }
<br /> �u.. G �}, /`� :
<br /> Owner's Name �� ��� Owner Pfio»e Number D � ��i�Vl ' ,.
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<br /> OWtt9f`8 Add�ess � �� Owner Phone Number '
<br /> � � : _ � �;
<br /> Fee Simple Tlklehaider Name � I Owner Phone Number � �
<br /> Fee Simple Titlehalder�lddresa �
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<br /> J08 ADDRESS � LOT� � .
<br /> 3UBDIVIStON � � F'AR�IEL.l�# .
<br /> (087AlNED FROM PROPERTI!TAX NQTICE� ;
<br /> WORK PROPQSEp •_.NEW CONS7R' ADDlALT Q S{GM' �Q C] pEMOLISH
<br /> '�e. INSTALL 8 REPAIR
<br /> PROPOSED�USE Q SFR• Q COMM �� OTHER : '
<br /> TYPE OF CONSTRUCTION - Q� BLOCK " Q FRAME Q STEEL Q !
<br /> DESCRIPttON OF WORK ' y� ��'�C �L�.C� L� ,
<br /> BUILDING SIZE � �`SQ FOOTAGE��; _ _HEIGHT}.��,�� i
<br /> QBUILDING $ VAt,UA7lON`OF TCITAL CONIS7'R4JCTION" ' '
<br /> . ��d.�� _ � ,
<br /> QEIECTRICAL $ - � AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. j
<br /> o , � � ��j�� ��;,���� '
<br /> PLUMBING �p___.� - '��'" �/+ �� ,
<br /> � '2�
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<br /> QMECHANICAL $ VAk.UATION OF MECMANICAL INSTALLATION � ,
<br /> QGAS Q RtZOFiNG .Q SPECIAL'iY �] OTWER ,�2�� ���e"��'' �
<br /> �'���sf�`�p�.c( .
<br /> FIi�i1SHED FCQOR ELEVATIONS FLOOD zOtdE AREA QYES. NO ��,�� ���� �
<br /> �
<br /> BUILDER �,.{`� (1 , �� COMRANY� l7DS�'L�C'�.�� � ,
<br /> SlCyNATI}i2� � ���' �lV��---"' REGISTERE Y/ N ��E cuRaEn Y/N
<br /> , � �
<br /> Address ' � 1,Icense#'�_.,. � �
<br /> �
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<br /> ELECYRtC1AN:: ,. COMpANY � �
<br /> StGNAfitlRE � REGISTERED Y J 1�1 FEE CURRE�' ' � li'Y/N � ,
<br /> Addre8� � . I.ICet1Se�#'.� r �
<br /> Fi.UiVIBER ' � COMpANY ' �
<br /> $lCaNATU12E� ; REGIS.TERED, Y/:F1. . ��.FEE CURREh Y J IV
<br /> Address � _ � .L.Icense,#.���� ��.
<br /> MECHANiCAi: � - ' . . . COMP/WY, '
<br /> S!(�MATURE ' R��ts7'Ei�Eo Y./ hf . � ���Cu�'t�n Y-!N
<br /> ;,.: .. .
<br /> Address ' . ' - , . - f` � Licenss#,� , �� -
<br /> OTHER ; ' ' ' " ,COMPANY .,�.�
<br /> SIONATURE --". - ., .�,, , . ` . . .` RE��s=�ai�o - Y 1 N:.: . ��ctiRtt�i� - Y!N.
<br /> Addresa ' � . , ' Clcense#'� I
<br /> ° . .. ._ ,�;x.<: :..: .
<br /> ., _N`:,„y... .,,q,.,:r-:;:�� - � . . F:: };.F._="rl�. '-v. / ,
<br /> RE3IDENTIAL�: Ai#�cti�'(2}„P-.1at•Piaiis;��:(2)'s'ets;of:BuilBingi Pians;t1)set o1�=Eiiergy+�Forms;,R=O�W�Perrriif far.new construcUon,, • ; ,
<br /> .. :��Mlnlmum�ten�(�1A);worlcing�clay,s;atker;subm�ttal"datia:a Requli�if onslte;:Gan�truc8on'Rlans;=Stormwater Plans�w!Si1t Fence Installed,
<br /> . �� SaniteryFacllltles:&�1,dumpster-�Slte�;Work}P�ermlt�otsutidivlslonsAarge:qtojects'�=_ :."z:;; "
<br /> COMM�lt�iAt:•`= Attach(3)`c6mplete�sets`bf'Sullilie�Flans ptus a Life Safety Pege;=(1j set of Energy Forms.R-O-W Permit far new construc�tlon.
<br /> Minlmum tett{1�)worlcing d�ys after subml�tal date. Requ3reo onsite,Gar+s'vuoiic�n Plans,StareaM�ater P1ans rnrl Siit Fence instalted,_ ___. __ _
<br /> SaMtary FaclliNes&1 dumpster.Stte Work Permlt for all new.projecfs.All commerclal requlrements,r�i+st meet compllence � �
<br /> SIGN PERMi7 Attacfi"(2)§et's of�Englneered:Plans:;� ..,�;�- . .,, , � .
<br /> "•**PRC?PERTY SURVEY regulrec!for_atl,NEW constnacBon.. ,. •
<br /> Dtr`ections: .. , . .
<br /> Ffl1 out appllcaUon comptetely.
<br /> Owner 8 Conhector slgn back of appllcatlon,notarized �
<br /> If aver�2500,a Notice of Camm��acem�nt la requlred. (AIC upgrades aver S7S00)
<br /> ..,.-r.•.-n,.::
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<br /> qgent(for th�e contractorj'or`Pqwet of Attomey(fbr flie owner)�wauld�be som�one�wlth natarized letter fram awner authorizing same
<br /> aV�RTHE CdUNTER:PERhAiTTING. -- .(.Front of�ApPllcatton_Only)�.. :_-: �J....s�,� �� "' ��C� �
<br /> Reraois If&hingtes Sewers Service.11pgrades AtC Fences'{PtoUSuroeytFootage} � � '
<br /> . .. .. .. .. ._ ._.. . ' � � CS_.�t�-c�r-��:.�``"^e'�' ...
<br /> DrOvevaaya-Not over Counter lf on publlc roaiiw'/ays;.rieeds ROW `' �A�4UE�tiNE��� S �� - - ••
<br /> �.,,, ..
<br /> ' ., s�,�,�Y rvB`•', mmission#FF 15042z_ ��
<br /> =`r.�.t '�"= Expires Dacember 12,20180 ,; r�6'-��'7 (j+-/�
<br /> �r �o�" Bor.dadlf'mtroyfaminwre a800�985' , '�` f ;,`,
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