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s�s-�so-ooza � Ci�y of Zephyrhills F'�rmifi Applicafion Fax-813-780-0021
<br /> . � Building Department
<br /> Dage Receiv�d , I � _.(D V `
<br /> �. � � � Phone'ConfacC�oa�PermiQQing} � •��� ! V
<br /> Owner"s illaene �. , ��-Q. �l i(}(� "' { (�2�� PJwn�r&�hon�AIumB�er V�� ' t r� � ` t��
<br /> OwneP's&ddr�ss. ���•V;� �O�r" , �. Y 1 t�v+t��!S Ouun�r Phon�t�oertbec
<br /> F��Sim�t�Ti4leholder�Rlam� d�wneP Y'G�ou►e R9wen9��e ,.,_,,,._.,,. ,�._,
<br /> Fee S9mple T6tleholdeP At9dr.ess �
<br /> �o�������s 3 8�r�a svv�, �J� �, { �,��ft s �� �3��a �.�T� � C�
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<br /> sa��o�vis�a� �C►t��es ��'� ��i-4-ia�'1 �,��ac��.«� 1��a�,-�� - (�U I(�~�a Od- ���0
<br /> {OSTP,iRIED FROPdi PROPERTY T,4X�tOTiCE}
<br /> t!!lpR�C��Q�pS�D � NEW CONS'iR AOD/A�T (� SIGN Q � Q DEMOLISH
<br /> f B INSTALI. 8 •REPAIR
<br /> Pt30POS�D USE � Q SFR' �] COMM � OTMER
<br /> YY9�E�'OF COPdSYRUC'PIdNI i Q BLOCK • Q FRRME � STEEL Q
<br /> ��sc�iPrio�v o�.wo�c� ! t�f�..T b�' ��'(�bo� �t�S ��-� 1 i �e��i�lQ� hC.t-�- S i �� S �1'�u�. ��
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<br /> ���������»� ���d�~� ��������� . ������ ����
<br /> �BUIl.DlNG i $ ��J ('I �� }/ALUATIOR!`OF TOl'AL CONSTRUCTtQ�I
<br /> l0'1
<br /> QELECTRlCAL ($ � �� AMP SERVlCE � PROGFtEBS Ef�ERGY Q W.R.E.C.
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<br /> QPLUMBIPVG ; �� ���~j
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<br /> QMECHANICAL ' $ VALUATlQN QF MECHAP�ICAL INSTALLATIOf� �`
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<br /> QGAS [� ROOFIfVG Q SPECIALTY �,� OTMER
<br /> FIfViSHED FLOOR ELEVATIOIVS �� FLOOQ ZONE AEtEA QYES NQ
<br /> SIGtd�a"P�DFYE �_� � R��IST�R D Y/ 11t . FEE CURREh Y i lU ' .
<br /> ,�c9�c+ess -Lieense# �^� �
<br /> EE.�GYRICIA� Cm�fPAft1Y
<br /> �IC9WE�,TUF�E REGISTERED Y/ N FEE GUt2REA Y I(�I'
<br /> Ac9dress Gicense# �i 4' �
<br /> ��.U�!l�IE,F`s. , �O�f4i�dift�Y'
<br /> �ICift9�4'TU�E F(EGlS7ERED Y�/ lV� - FEE GUftFtEP YI N
<br /> P;ddP�ss License# �i �
<br /> t�EC�0i4l�itG,4i: � C43�1lB��,4�Y
<br /> $8CR9�TURE' � REGISTEREQ Y! �1 FEE eu��En Y!•N
<br /> �:�9�9c�ss License.# �� ^i�
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<br /> a�Tw��- .. cor�p�� 'YIG.�l b0 r� ��C.
<br /> SIGPd�.TUR�-:, :; REGIS7ERED / N . FEE GUft I+ N
<br /> Add��ss,. Uj c� t �Y 1(r1�� �t �J�5�� L.icense# C,e.c t 3a 55aS �
<br /> RE�IDEflfT1AL,�;. Attacq�!(Z�:Plat'�Piansw:`(2).sets�of=Building%PEans:{1)'set'of'Eitergy'Forttis;'f2-0-1IV:Permitfor new.construction,
<br /> • �;Minimum::te��,(�1'U)yv,o.rking'�i�ays�after�sqliirfittalfdate. 'Required�on'site';''ConstrUction Plans,.Storrnwater Plans w/Silt Fenoe installed,
<br /> �� � Sanitara!;FacitiGe.,�:8�k1,dnmpst$r;S„i#e� ,W.or,leP.er.m(tfor:'sutidi"visions/large.projects�.
<br /> �COIUiM�RClA� Attactt�(2)�cosriplete"5ets of'BuilcJing'Pians plus a�ife Safety Page;{9}set of Energy Fasms.Ft-4-W Permit for new canstruction.
<br /> , Minimum ten(10)woridng days after submPttal date. Required`onsite,Constructian Plans,Stormwater Plans w!Sift Fence;insta{led,
<br /> Sanitary Facitities&1 dumpster.Sife Work Permit for�all�new pro)ects.A�l commercial requirements must meet compliance
<br /> ��IGM�'ERi�IT Attach(2}sets of�:Engineereci Rians._�..
<br /> *""*PRO!?ERTY SI:1R1/EY required for..all,fVEW constr•uction. .
<br /> DirecYions: -. ,
<br /> F(II':out application completely.
<br /> Owner�Cantractan sign.back of.application,notarized
<br /> If.over$2504,�i�o8ic�of�Camm�eic�m�ee�f is r�qvia���. (k41C up�gr���s ov�r�T500} _, _
<br /> *" R ent for'fh`e�coritcactor'or-Power ofi'FCttoTne far'ttie oinlner woutd 6e sameane wi#Ft natarized Eetter from awner autfi�orizin same
<br /> 9 t .... ) , Y� } 9
<br /> QVER:1'F9E'GO4D,l�1'�RRERl4f1071'YI�G, (copyof-canfract=required}
<br /> Reroofs if shingles Sewers' Service Upgrades}A/C Fences(PlotlSurvey/Footage) _ ,_ _ ,..,
<br /> �eiveearays-�tot over'Couriter if�oiti publie.roadways:!needs ROW - . "``''`� •. -'_" ' - ` '�
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