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a�aaso-oo2o City of Zephyrhills Permit Application Fax 813-78Q-0021
<br /> Bulid�ng Departme»t ` " . ;
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<br /> Date Received t � l
<br /> t� � Phane Caetac#'for�Permt�3n ' ' ��t � � . r�t �
<br /> Owner'�Name �Z�. �OL.T!(/�1G� '�'Q.Y� Owner Phoae htumber ` . , ,
<br /> Owner's Ad'dre�s 3' 3 � � /us�c� . � Owner Phone'Number - - ��
<br /> Fee Simple�Titleholdert Name Owner Phone Number �� �
<br /> Fee Slmple;Titlehalder Address
<br /> JOB ADDRESS �/�% � ,.,,5 � LOT# ��
<br /> sueo�v�s�o�v �_ � PaRc�G ia# � -��` -.Zl�-D�.G d—�1G10�'-D 7�
<br /> i , (OBTAINED FRpM PROPERTYTAX NOTICE�
<br /> WORK PRQpOSEO NEW CpNS7�t ADDlALT C� SIGN� [� C] DEMOLtSH
<br /> -.e. INSTAI,L 8 REPAIR �
<br /> PROPOSED�U$E � Q SFR Q COMM �� OTEiEFt � ` �
<br /> TYPE OF CQNSTRUCTION < [�'y� BLOCK ' '�] FRAME � �� 'STEEL Q ,
<br /> - e ,p,, /� �/_ �y
<br /> dE3CRIPTION OF WORK� ��,�."'fC-!/�r�/t�O-� �i��Z%1"" �IG%��� 2 � � � �!�
<br /> BUF�qING SIZE � _ � SQ FOOTAGE,��: • HEIGHT.,�, �
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<br /> QBUILDING $ . - � ' ' .
<br /> i I �o� VALUATION.OF�TOTAL CQNSTRUCTION
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<br /> QEI:.ECTRIGA� $ " � AMP SERViCE Q PROGRESS ENEF2GY [�� W.R.E.C.
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<br /> [�PLUMBING $ _ V( ~�-�
<br /> ` � 1�
<br /> Qf�ECHANiGAI $ VAt;UAT10N OP'MECF{ANiCAI li�lSTA�UiT10N
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<br /> Q�5 [f�ROOFiNG Q SPECIAl.TY � OTHER
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD 20NE AREA QYES NO
<br /> BUIE.DER � COMPANY -
<br /> SIGNATURE REGISTERED Y/ N 'FEE CURRE� ' Y/N
<br /> ' Address � Gcsnse# �- �
<br /> E�EC7RICIAN� COMPANY
<br /> �� SIGNATUitE � REGISTERED Y I N FEE CURREk' ' '�Y/N
<br /> ���s ~ � , License# �� �
<br /> PLUMBEI2 j , COMPAFlY . ' -
<br /> SIGNATURE , REGI$.TEREp , Y./}N.. � FEe CuwtEn- Y�/N. •
<br /> Addre� .License�# �� _ .. �:
<br /> �f -
<br /> MEGHANICAI: COMPI�NY ' -
<br /> SiGNATURE " ' REGISTEReD Y.,/ N . _; FEE CUwtEn Y/-N
<br /> Add�s ' - '� '" " License# �- �
<br /> F - ,
<br /> o�M�R " • .`���,�., � �' �� '�co��i�r r�rl�.� j2p��i;¢/`�
<br /> SIGNATURE �.� � ' 'REGISTERED Y/ N;.. ' FEE CURRE� Y/N
<br /> Addres$ ��.}�, '.3�:�. r��1�--~'��t:'� _ Clcense# ��-40�e��L�` I
<br /> .,�,.�,_ - .� ,;,.:. � - .
<br /> RESIDE�1'1'U41:,: �•Atta�cfi'"{2}�P-.I6t:Plans;•:(2}se#`s�:of:Bult"ding�`F'laris;(1)'sef of'Energyr�Faiins;�R-O=Vtit;Pennif far new consUuctian, ` ` '
<br /> -; t._r,;.;11Ainimum�ten-(:1,0)kwortiing;days_after,ry"submittal`date.�:Requl�ed onslte,:C�b'nstrucNon'Rlans;Stormwate�'Pians w/Siit'Fence Installed,
<br /> . �•Senitery Facilfdes;&_,1:dumpster,-Site°Woric,;Perrnit for subdivisionsparge:prajects,, ,._�. ;.• ' ' -. ,
<br /> CQMMERCIAL A##ach{3)cciiriptete sefs'of Biilldiiig�Plaits�plus a�Ufe Safeiy Page;(1}'set of Eitergy Fomts.R O-W Petmtt for new canstnsction.= -
<br /> Mlnimum ten(10)working days after submittal date. Reputred onslte,Canstructlo�Plans,Stormwater Plans w/Silt Fence installed,
<br /> 3anttary Facifltles&1 dumpster.Site Warlt Permlt for all new proJec�..Alt commerGal requlrements.must meet compilance �
<br /> �SE�N'PERMlT Attac.�"{2)"set�df'Eiig�neeied�Plaris.;;�_:;; - : , s. �
<br /> """PROPERTY SURVEY reyuirecl for all IVEW consUucUon.
<br /> Dlrectlons: . ,. , • ,
<br /> Ftll out applicadon complately.
<br /> Owner&ContracMr sign taack of applfcaUart,noNadzed
<br /> If aver a2S00.s Notice of Camrnencement is required. {A/C upgrades over gT580j
<br /> .".?�.y.N''�,.'
<br /> " Agent(fpr the conVa'ctor)or Power of Attomey(fo�tFie�oJmer)would be someone wikh+natarized letker tram owner autho�izing same
<br /> QVER THE CClUN7EI2 PERMl1'-Ti1VG-� ----�(Front-af-Appllca#tan�Only} -
<br /> Reroofs If shingles Sewers Service Upgrades A✓C Fences(PIoUSurvey/Footage)
<br /> Qriveways-Nat over Counter if an pubtic roadways'..needs ROW '
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