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� 813-780-0020 Ci�y af Zephyrhills Permit Applicafion Fax-813a8a-oa��
<br /> F 8uitding�epardnent
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<br /> Date Recelved ' Phone.Conhact for Parentttin � "6 I � `
<br /> Owne�'s F2ame � mwrner F�hone Fin�ber
<br /> OwnePs Address tQ�i� ��(`���S - �(i 1m�"'"'` �wmer Phon�Numiser �— ���
<br /> Fee Sim�si�Tttlehatd�r Name �_ � f�wner D�hone Numiaer � �
<br /> Fee Simpi�Titiehoider Address
<br /> ao��oa�ss �J ��� �,zJ! �� � t - a.o�r# �
<br /> �u�oru�s�a� c, � ����C�� �ar�c��.�� C��-a -o�?S-t�C�"10-C�E�fl-C���Q
<br /> (OBTAINED FROM PRdPER1YTAX NOTICE)
<br /> WORK PROPOSEI9 � e NEW CONSTR� ADDlALT C] SlGM [� Q DEMQLISN
<br /> INSTALL REPPiIR
<br /> PROPOSED�iISE Q SFR Q COMM Q 07'HER
<br /> TYPE O�COTdSTi3�iC'PtQA1 Q B�OCK " Q FRf�ME C� STEEL Q
<br /> DE$Cl2tF�1'tQH OF WtaRK ��i t ��i D� 1 !�1(�1� . -
<br /> BUILDING SIZE "SG!FOi3TAGB��. H�tGtiT ��.�
<br /> OBUILDING �� VAL.UATION"C1F TOTAl.COAlBTftUCT`!ON -
<br /> QELECTRICAL �� Ahflp SERViCE Q PROGRESS EtdERGY [� W.R.E.C.
<br /> QPLUMBiNG- $ }�,�,` � � ��
<br /> 1 t;✓t,.} ( ll
<br /> QMECNANIGAL S � . VAi.UA"i{03�7 OF i�ECi-G'�NiCAi.i9YSTALLATiQN �
<br /> C]ras � 0� Roo�r��..[�� s��c�,aLrr C'] o-��� ;
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<br /> �U1L�1�6d COMPAP�Y � . .
<br /> SiGNA�'URE REGiSTERED Y/ N F�c,uRtz� Y.I iv�. -
<br /> �iddress _ _ : Ltcense� � . . —� , LL-
<br /> ELECTidICliiAl; , COl1N�'�tdY . _ � . ` .
<br /> �IGNIA'Y'11R� �' REGISTERED Y/ N .- �e Cu�== :-Y J�N
<br /> Address • � , .' ; - ,. _
<br /> Ucense# � " :: �
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<br /> ��urwa��, cc►���wv Y I �'I 1� .
<br /> SIGPI�►7'URE , REGisI'EREv V./-td . EEE Ct1RRE� I'N,;._ -." . .
<br /> �dd�� c� u�rise# �����-�=og a��: _� - ;
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<br /> ��cr��tcdtt c���nwv _ !
<br /> �1GPfATURE R�GIS7ERED Y./ N . - �EE CURitER. . Y GIV `��
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<br /> Addr�ss Licsnse# �� ^...._. I ,,
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<br /> OY�iE� � �CQM��IY � _
<br /> SlGPlATUR� _- . RE�iS7ERED l'! N:.. ��CtiR�t. Y/N. . �
<br /> �lddre� _ Ucense#��— ..^...—� , �. �
<br /> RE�ID�A1'fiAL' �Attacti-(2);Ptof�:P.,taris,.t2)'sets of Building�Ptans;(1j sef ofiEnergy_Foims;�Fl=O�W Pertriif for new construetian, .' �
<br /> Minlmum:tenF(10}�warktng,days�a(terrsubsnikkaf"i!"ate.`:Requf�oris{te;.Cons#ructlon-Plans;�S#ortnwater Ffans vr1,S"ttt Fes�r,e�s~t�ed. '
<br /> Sanitary Facil(tles.&:1:,dumpster�Slte Work:Rermit#or subdivls[pn"s/laige-prnjects `_-. <� ' " - �-• �� - ,
<br /> CO�lINAERGIAL Aftach(3)cbmpteta�sets of Building Plens plus a L1fe Safeip Page;,(1)set of Enercjy Forms.R-0-NV Permit for naw�.� �' ,
<br /> Minlmum ter�{9Qj wa�cing days aRer submitta!date. Required ansite,Ganstsuct�an Pians,-Starmwa#ar Plans t*rl St�t Fencss ins`-�3ie.i,
<br /> Santtary FaclliHes&.1 dumpster.Site Work Permif for aU new praje"ds:A!!cammercial.;equiiemerrts must ssteet caznpI'rance - -
<br /> SIGN PE�IVIIT Rttach�(2)`sets af Eingineered�Rlans: = . � � . ' ` � �
<br /> °"'PRt?PER1Y SURitEY reguired far ati NEW.canstrucfian. - _� � � < ;
<br /> Dir�ctlons: � . , _ - � . , . �,
<br /> F1tt oat apptica�or�complefely. ° - , t . . .
<br /> Owner&Contcactoe siga back of apptiqSon,.nctarizetil.'• ' - . - `
<br /> if aver g2500,a i�ottce of Commen�eQn�nt is required._(NC upgrades,oyer$7500) �
<br /> `� ��.��;s�e c�ntractarj ar Power of A4tomey(for tiie owner)�would be someone with�notarized letter from owne'�authorizfng same - ,
<br /> ,�i�c:,��:�c'�.F=�IITRIVG -(Front of-Application Or►ly);- �
<br /> �..;.:,., ' � ` _� Service Upgrades l�lC Fences(Ptot/Survey/Faotage) ,
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<br /> a.� �.�^s'e'� ��.:�'x.�-�.-�-':SS.B�lS RdW : _ _! -, � .3f
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