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<br /> ` -��ea-oo2o City of Zephyrhills Perrnit Application Fax s�s-�eaaa2t
<br /> ,_�� Buiiding Departrnent . ��
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<br /> Da#e Received � PhonatCantact foc Permlttin
<br /> Owner'�Name /� i �� �l + 1 �t,�, �.� Owner Phane Humbe�r �����C�( �""b t
<br /> Owner's Addrass �J��� /� : ,,�i�T Owrter Phone Number . �� �� ,
<br /> ._.. _. � �
<br /> Fee Slmple,Titleiiolder Name �� � Ow►ner Phone'Number
<br /> Fee Simplef Tltleholder Addr�s�
<br /> JOBADDRESS � () � -ML� l,OT# ��'�' �/
<br /> SUBDtY18l�N PARCEl.1t?# �i �.(�i,� �� ��j� ( �/�i�� O��
<br /> ���_��.
<br /> � . . .� (OBTAINED F:RpM.PROP6RTY,TAX N0710E)
<br /> WORK PROPOSEQ .NE1AI C4P15TR ADplAl.T C�` SIGN`� [� � [� DEMOLISH
<br /> ; �� INSTAI.L e , REPAIR ~ -
<br /> ; RROP08ED'rUSE � � [� SFR� [� -COMM � "Q �OTHER � �
<br /> TYPE OF CONSTRUCTION Q� ' "BLOCK " Q FRAME `;�' 'STEEL Q
<br /> DESCRiPTiQN OF WORK. .LL ��"� t 11 �, J�f`�i j` . , " ` " . �
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<br /> ' �� HEItiHT . ! .�"'f !�l
<br /> �tlILDlNG�IZE , , . 84�FOOTAGE C�i -= � : ;, .�,., �
<br /> �BUILDING � �uQ� � VALUATIOPI�OF``f0"fAl.CQNS'1'Rl'JCTlON �
<br /> 1 1
<br /> QEI.ECTRICAL $ AMP SERVICE [� 'PROCnRESS ENERG`( [� W.R.E.C.
<br /> P � �f � ,��t, � ! �{�f
<br /> QP4UMBING , $ -. V"'���� �.�'�- l V ( ��"
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<br /> OMECF{ANIGAI. �!� VALCIATIONOF,MECHANICAI.INSTALLATION � � ����
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<br /> QGAS � ROOFING .Q ,, SFECtALTY C� OTHER �C 2�Y,�p�-.
<br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA QYES. Y kNO
<br /> }, N_ , ; �p^�
<br /> 8UlLDER ; �� COMPANY= � v..6��Y�� ���"�Yl "�f- �'if �� roc�,'r
<br /> SIGNATURE REGISTERED Y/ N FEE CUR ' ' Y'/N
<br /> �dare�s ��z�� S t,. v v2. �tcecise# ��'cc,f`�3,o a`� (
<br /> ELECTRIC!%W; , � ::�COMPANY ,
<br /> SIGNATURE � REGISTERED Y J N FEE CURRE� ' ='•`'Y/-N�
<br /> Address " � ', _ , Llcense# (• '. �. ���
<br /> PWMBER` � .CQMPANY. . - +►� �
<br /> SIGNATURE` � ' ' �� ���,REG�sTJE�RED.. � Y J,•N.. , ,,FEE CURREi�. Y-1 N:
<br /> Address ' �. - , -. . � ` .Ucense,#��.._.,�..�._...._,..�'
<br /> - _� � _ ?.,} _
<br /> iNECHf1NIGA1: ' . ` • ' ` C.OMpANY _ , ' � , ,
<br /> �.;r.:.
<br /> SIGNATURE � ` ' . , ' � ' � REGis7EttED, ' �...Y./ N ~ : FEE Cut�tsi� . Y./-N .-
<br /> Addre� : _ � ' _ � �� .=`- ' , ' � � . - � ° ;�l.icense#�1 � .
<br /> OTHER �- _ � - _ ; , - , . ,. �C�.1MN'ANY' � � _ .... � ,
<br /> SIGNATURE .. �'�� ��� t3�' f' � • -°� ' � REGI8TERED' ' Y/ N..,: �eCu�h Y!N-
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<br /> Addres� °: -„>..r.;. F,.., � rt-_,.,,,.," � - . . „ - �� . . cense# " . .' ' '
<br /> _ ; ,,. ,., .., . . .,..
<br /> ut . ,u'.. � �'
<br /> ' - , : � . 4._,::• .': -.. >.i .;y._';..«. ..`" f." . E . , a .. .,_. . . �
<br /> RESIDENTIAL.�� �Attacfi"(2),,Plo.t;Plans;;_(2)sets:of�Buililing`Plans;°(4)set of-Energy�Fo`rrns;,yR�O�UV��PeriXilt far new conskrua#ion, ' `
<br /> - •. r,,;>MinimumatenT(10)�,worklrig;daystafte.r.;"subrititEai'date::R`equireii orisfte,::Con§tivcBon-Riaos;'Starrnwater`Plans wi Si!#yFenrs instailed,
<br /> �... t .�.� ., _
<br /> ��Santtary Fadtitl�&,&:�'l,,dumpsterv3lte_Workl�esmik;far„subdiv(slonsllarge=proJects:_ yn�:,..-• . � ., _ . , _ ,
<br /> COMMERCIAL Attach(3)complete'sefs�of Building Plans plus a l.ife Safety Page;(1)set of Energy�Forms.R-O-W Permit for new construction.
<br /> Minfmurim ten(10)work(ng days'after subinittal date. �teqatred onslte,Construction Plans;Stortawatar Plans w!Sitt Fence instalted;� - �-
<br /> Sanitary Fa#i�tles 8�1 dumpster.Slte Work Parmit for aN neuvrprojecks:.Afl oamme�ctal requt[ements..must meet campllance '
<br /> SlGN PERMIT Attach"(2)sefs�of`Engirieer,ed�Plans:.,;;. '. ..�` .. _ _ ,` �
<br /> ""PRQPERTY SURVEY requirecirfor at(NEW ycanstruction._.
<br /> Dlrectlans: ,. ,���,: ,� ,
<br /> FIII out applicaUon wmpletely,
<br /> Owner 8 Contractar sign back of application,natarized
<br /> If aver�2500,a Natice af Commencement Is requlred. {I4IC upgrades ovsr�7500)
<br /> ;,;"'na'C.rasr�:'"+ .
<br /> " Agent{for thervcontractor)�or'Powes:of attomey{fcr ttie cwner)wautd be someone with'notarized letter from owner authorizing same
<br /> DVER THE�CQUNTER PERMITTING;-, ----{�ront af�ApplicaUon Onlyj �
<br /> Reroofs if shingles Sewers Service Upgrades ,A/C Fence�s(Plot/SurveylFootage)
<br /> Driveways-Not aver Gounter{f on.publEc roaduJays..need"s=Rt3W � �
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