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<br /> 813-�so-ooao City af Zephyrhills Permit Application Fax 813-780-0021 i
<br /> 8uiidin¢�Department
<br /> Daes Recetved ��7. �� f�" , � phane-Contact for Pernilttin SvZ � ��
<br /> Owner's Name � (� " Owner Phone Hurnbsr �� - • �7�`
<br /> , � �
<br /> Owner's Address 3 yy..� �' �^ � Owner Phane:Number �
<br /> Fee Simple Tltleholder,Name � Owner Phone Number �� � -�
<br /> Fee Simple Tltleholder Address
<br /> JdB ADDREB$ �7 �,Sr " LOT# ��
<br />�I SUBUIVlSION , �y2ck� p���{.: PARCEt».1D# � � O D 0 D D � a 6 O
<br /> , , (OBJAINED FROM.PROPERTY,TAX NOTICE)
<br />( WORK PROPt3SEQ _NEw CONSTR� ADDlALT � 31GN Q• Q DEMOLtSH
<br /> �•���. INSTALL ��_� �-REPAIR - � �
<br />� RROP{SSED:USE � Q SFR Q �GOMM '- � OTHER � '
<br /> TYPE OF CONSTRUGTION - Q` ' BLOCK ' [� FRAME .��] ;STEEL' `�]
<br /> DESGRIPTION OF WORK C � ��` / i '��,, U .%/' � �i
<br /> BUICDfNG SlZE" �w �'$Q`f08TAGE��: . HEIGHT�..
<br /> QBUIGDING , �^� ti/AIUATION:OF`'t'OfiAL�CONSTRUCTION ' � �
<br /> QEIECTRIGAE. �� AMP SERVICE Q 'PRO'GRESS ERIERGY Q W:R.E.C.
<br /> QPLUMSING. -� �
<br /> [�MECHAt+lIGAL $ VALl3ATlQN OF.MEGHANICAt.11�tSTAl�,4TION � o��
<br /> / t .��� ' j���
<br /> � • t�
<br /> QGAS Q ROOFlNG :Q SPEGIALIY,-C� • QTHER,
<br /> FINISHED FLOOR ELEVATIQNS r�� FI.00D ZONE AREA �]YES. :NO
<br /> � � - . .,
<br /> _vBUlLDER____ ._-___ ; =- - -- - ---- -- __�.- _ .__ �__.---
<br /> -- --- --�--- --- - -- - - C�AIlPANY=: _- �n - — -- =
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�s ' License# �— ��
<br /> . , .;.
<br /> ECECTRICIAN� .: ._COMPANY �
<br /> SIGNA7URE � REGISTERED Y/ N FEE'CURRE�`"- ' '=-Y/N �
<br /> Actdre�� _ � . ._ : � , ` . License#;(: � , �
<br /> PLUMBEE� " � . .,f.COMP=AtdY . , , , ; . � � � � � � '
<br /> , SIGNA7URE� � "- � � " _ , ,REGIST.ERED- : Y./�N�. =; <FEE CURREA Y-/N. ' '
<br /> � Address ,.Ucense#���: , , . , �
<br /> � MECNAN1CAt:' � - COMPMtY. L �
<br /> .4,F."
<br /> SIGNATUP2E REGISTERED; ,_ N. . , FEE CURREA. /'N .
<br /> Address�'' �fc�� (/:� �v�it� . - (J ,. , license# . .:� ,
<br /> pr � . .. . .. . r . . .. . ,. . �
<br /> OTHER = ` '` _ .z . , _ _ -. �.; . . , _ . , �_ ,
<br /> ,CONIPANY. �.,
<br /> SIGNA7URE �j=: , ��r��r" ��'''` ''� ' " '' ' � `REGISTEREDr ' Y/ N�,. FEE CURRE� Y/N
<br /> �C��68$r, . ( ..._ ^,r(fV . Rv'. ' . .t' , , r r .�:�C$�!$8� � � .
<br /> ' . ,� ..�:,. .. . , _ �iE3 '- '�;fl.��,.yrn. ' t.; . . », . :.. ` . y . , ,. ., . "
<br /> RESlDEN3lAL<„<�Attach;('2),P!o#%€?laris;-:(2}"sets`_.of�Bultili'rig�`Plaris;�(1)sef af�Eriergyr'FF'oiins;R=0=1tU�Per`init for new construct�on, -
<br /> <<�Minlmum,ken;(10);woricing�days;:after.;submltf`al`dat"e.'�Requi"�red onslte,�Gon"stiucNon Blans;$tortnwater Pians w/Sii4'Fence installed,
<br /> x�;`".��•� Sanitary�Faciliyes,&�1f;dumpster,ro5lte�Woric:�;Permit,forsutiidivisions/large:projects.^....'>'�" " - ` � ' :+ . ' ; ,_
<br /> COMNlEEtCtAl. Attach{3}`complete sefs'of Bi�l(ii{ifig Plaris plus a l.ife S'afety�Page;{1)set of Energy Eotms.R-O-W Petmit far new c8nstru�on. �
<br /> Minfmum ten(10)working days afker submiRtal date. Required onsite,Canstruction Plans,Stormwater Plans w/Siit Fence installed,
<br /> Sanitaey FaoiliUes 81 dumpster.Site Wor1c Permit for all netirpnojeofs..All commerGal requhements.must meet compllanca '
<br /> �:StGNPERt�tl7 AttacFS"{2)'s`efs'of"Einginee`r,ed:F#aiis:,,-:.:_�,'. �. � ,
<br /> `•'"PROPERTY SURVEY reGufred„for ail,IVEW consWctlan.
<br /> , 'Direetian�: �.� , • '�
<br /> FIU out applicatlon completely. i
<br /> Owner&Cantractor sign back of app!{caflqn,notarlaed �
<br /> tf over 52500,a Natice of Gommencement la required. {AtC upgrades cver.�7500)
<br /> ;_..:;;•: �
<br /> '" Agent(for tlie-con'tractor)'or Power-of Attomey(for the owner)would�be someone with�notarized letter from owner autho�izing same
<br /> i .. -
<br /> � DVER"THE COUNTER,P.ERM17"fiNG-'.--- •(Front-af-APPIicaBan�Oniy)-. ._j , ... - , +
<br /> Reroofs If shingles Sewers " Service.Upgrades A%C, Fences(PlobSurvey/Foatage)
<br /> Driveways-Not aver Counter if on public roadways..need"s•ROW�'� `
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