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s�saso-oozo � City of Zephyrhills Perrr�it Application Fax-813-780-0021
<br /> . Building Department
<br /> Dat�R�ceived , �'� I ��( I� ' Phone Con4acg�or Peemi�4ieig •` <<.J ��� -- �V�
<br /> Owner's�1ame �f"�"T l.u�(� O f� Oweeer�hone f�umber 13'�� + �� `�
<br /> OwneP's i�+ddress. 1919�l I � �� �-� � (�( ��s t' Owner Phone Rlumber
<br /> F�e Simpl�Ti4lehoider'Nam� OWP1�P�FIOY7�El14APIl��P
<br /> Pee Simple Yitleholde��,ddeess (�
<br /> �o��D����S (o��I n 6� C-� h (h�I�S �( 33 5 L(I Lm,�� ��
<br /> �
<br /> su�oivisio� �,�aac��i�� �07- -a� -(�a I v � 66(�C�(� � � c��
<br /> i (OBTAINED FROM PROPERN TAX PlOTICE)
<br /> WOR�L PR�POSED � NEW CONSTR ADDIALT � SIGN Q � Q DEfVIOLISH
<br /> � B INSTALL e •REPfAIR
<br /> PROPOSED USE i 0 SFR� . Q COMM 0 OTHER
<br /> 7Y�E'OF COPdSTRUCqIOfV j Q BLOCK • Q FRAME � STEEL Q
<br /> � R3 S ' F-T(✓nb� � � le
<br /> DESCRIPTIOPf OF.W09i6C '! e� Ut-1' �'e'IUU� CI �� -,' S
<br /> ' ��' Q . 1�C
<br /> BIJIGDIP�G SIZE � SQ FOOTP.ts�� F�EIGFET U(1 f LQ �/��
<br /> �UILDING � $� J ��' 6 0 VALUATIOfV'OF TOTAL CONSTRUCTIOIV
<br /> ; —1
<br /> - DELECTRICAL � $ AMP SERVICE 'Q PROGRESS ENERGY Q W.R.E.C.
<br />� i .
<br /> QPLUMBING � $
<br /> � s�
<br /> I OMECHANICAL '' $ VALUATIORI OF MECHAiVICAL INSTALLATION ,
<br /> OGAS Q ROOFIIVG Q SPECIALTY � OTHER � �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZOfVE AREA DYES NO
<br /> �UILDE@2 COfIflPPddY
<br /> SIGPl9AYl11�� REGISTERED Y/ N FEE CURREA Y/IV '
<br /> ��o9Pess �License#
<br /> �
<br /> ELECYP3I.CIAYd COf�iPAftIV
<br /> SIGINi�7Uf2E REGISTERED Y/ N FEE CURRE� Y/N
<br /> alc➢dress Cicense# -0
<br /> �L17�lJJ��R: , CO�Pt4P9Y- ,
<br /> 51GI\94A'9'U92E REGISTERED Y•/ W- � FEE CURRE� Y/N
<br /> �,ddress License#
<br /> i11EC0-Ii4R�ICP,L' � COMi PR��Y
<br /> 59GiVP:TUFiE� � REGISTERED Y/ �1 FEE CURRE� � Y/�IV'
<br /> Ai3�9Pess Lic.ense.# �
<br /> �, .
<br /> OTIiER� . ; _ COMt?RJVY m� U(� n �n.�
<br /> SIGP914T1143E:� ., REGISTERED Y/.N FEE CUR � /iV
<br /> �c9c9ress _ UI�J'l�� �l� ,:Sy � h l���� F� License# C i 3 a 5 5 o S
<br /> FdESIDEFlTIAL;�; Qttacfi;:(2);PIot�Plans;�`(2):sets�oftBuilding�Plans;�:(1)'set'of'Energy"Fotms;'12-Q-VU,;Permit.fornew.construction,.
<br /> • . - -_ �.Minimum;.ten,(r1'Q)_w,o.rking;�days after,-subrriittal�date.`Requiretl�bn`site�'Gon'struction Plans,.Sto[mwater Plans w/Silt Fence installed,
<br /> � ^' Sanitary,;Facilities�:&ry.1��dumpster;Site� ,W.orkP.ermitfor<:'sutitli"vis'ions/large.projects
<br /> COIUiHfiERCIA� Attach(2)�coriipl'eCe'sets of BuilcJing"Plans�plus�a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)woricing days after submittal date. Requf�ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit fd��all-new p'rojects.All commercial requirements must meet compliance
<br /> �SIGN PERfViI'f Httaoli(2}sets of�Engineered Flans.
<br /> • **"*PROPERTY SURUEY required foc.all.NE1N construction.
<br /> Ui�eaQions: . �
<br /> F(Il.out application completely. '
<br /> Owner�Contractorsign.back of application,notarized
<br /> o�.o�eP z�oo � ' �
<br /> $ , ft9o4ic�of�Comm�nc�m�nB as r�igaeiP��. ��4IC U��P�tB�S QV@P$750OD •��
<br /> *" Agent(for tFi`e'cont'�ractor)•orPower of Attomey(for'tfie ovuner)would tie•someone with notarized letter from owner aut}iorizing same
<br /> •OVERTFiE'COtD,i�l'ER'PERfUi1�1�8G. (copyof-contraet�reGuired)
<br /> i Reroofs if shingles Sewers� Senrice Upgrades A/C Fences(Plot/Survey/Footage) :
<br /> =� - - -(,...._. ._: ,
<br /> � i--- . - ._._. - - - -
<br /> ' Dripeways-Not;over,Counter�i��on�public roadways..needs ROW ,- _ -=-- -- --,_ , - � � ,
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