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s�saso-oozo , City of Zephyrhills Permit Applic�tion
<br /> Fax-813-780-0021 l
<br /> , Buiiding Qepattment
<br /> Dat�Received `���� � ��one Confact�or PermitQ�n� ��� � ��-- -- ��i`�'� '
<br /> Owner's?dame �VV�t.Y� l.U'dL.°r'��Ui.� ���� --4,/�[., Own�r PF�on�lVumber ���� [��-���u��J"
<br /> i i `f (,, �� �
<br /> Owner"s�Addr�ss � �'l 1�s'� �� � �1 Z.Q " � f����S F�' '"f��, Own�r Phone i�umber
<br /> F�e Sirople Titl�holder Nam�i �— � OwneP PG�oc�e Muenb�a� � ' �
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<br /> Fee Simple Titleholder AcBc➢re�s I
<br /> JOB�4DDt2ESS � G'C�+�v � � L07'� ��
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<br /> suB�:visia� l�r�.��-u���c�� �,a�c�c.�a� �3 - � {� -a.�- C�3 c�� �-o��d~-�5,�.
<br /> � (OBTAIPlED FROM PROPERTY TAX NOTICE)
<br /> W4RK P'ROPOSED NEW CotVSTR ADOIALT � SIGN Q [� DEMOLISH
<br /> + � INSTALL 8 F2EPAIR
<br /> °ROFOSIED tlSE � 0� SFR � COMM � OTHER
<br /> 'fYPE'OF CONSTRUCT.IOYU � �"'` BLOCK • Q, FF;AME � STEEL Q
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<br /> DESCi21PTtOW OF UflORSC ' ���i �S1,S�f��L..C�-:v fi1 — �j ���"-}Z'
<br /> �Ut�Dl�l('s S[�� �� � SC2 FOOi'P.CsE 1 t'� �� F9EtCsF�O'i" �j�
<br /> ��"�«d��� ' � � f� r DC>�� VACUATtON'OF TOTAL GONSTRUCTION
<br /> DELECTRICA� ($ � A{U1P SERVICE 0 PR{}GRESS EI�ERGY Q UV.R.E.C.
<br /> �_....
<br /> [�PLtlMBING $ �� �`(}� � � c�� ��.�S
<br /> OMECHANICAL �; � VALUATtQN OF MECHAf�lCAl.INSTALLATION � �C/��
<br /> � ,�u� � c�-1,���
<br /> OGAS � ROOFING Q SPEGIALTY �� OTHEFt
<br /> FINISHED FLOOR ELEVATIOfVS FLOOD ZC1NE AREA DYES �NO`✓�""�
<br /> _.,_,�...
<br /> �UlL�}E� � GO�P,4�Y � ��i� �l�7'ti..S-�-�r'`1�,'�`� "Y1 �t��- -
<br /> SIGiu1PoYU03� REGISTERED Y N FEE CURRE� Y/N
<br /> Rc9c�Pess �, �Za ��.. 5 �f�+1:1�5 3`�°J�� � Licerise# ��� 1.t..J"' � � ��t�
<br /> �L�cr�tc��t con��a�v ��s�k -1�- r�.�cc� �l�.c,-�fi�
<br /> SIGWdlTURE REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Adc3ress � License# ����j����lf��
<br /> P�.U�11t�E�2 - �OtU1�,�dY '^� �i,5 ��tx,`+"ti�i �-.
<br /> �"uIGi�I�4TURE - REGISTERED Y/ N FEE CURRE� N
<br /> ,4dc�ress License# � �
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<br /> �t�cx��c� car�p�at�� ����� � �}L.
<br /> SIGP�ATURE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address License# � —�
<br /> „ _'"�. ✓�'ifs�.- �P t
<br /> 07HER �� CQMP,QV�Y
<br /> SIGi�1P.TlTP2E:• REGISTERED Y I N FEE CURFtE� Y/N
<br /> Atldr�ss �.�a� , r �+�� l�(.� 3 �-l! License# ��L[��.�tij'd� �
<br /> P2E�fDEtVTIAL �, Attach�.(2)':Plaf Plans,:(2}:sets af8uildirig�Plans;�{1j seYof Energy Forms;R-O-W Permitfor�ew.cansfsuctlon,
<br /> Minimum,wten=(10}yu,orking.days aftersubmitfal•�date. Required onsite,`Construction Pians,Sto[mwater Plans w/Silt Fence instatled,
<br /> Sanita.ry.;Facilities�,&.1�.dumpste�;S1te:W.ork Permit for.sutidi"visiohs/large projects
<br /> GOAtiMEl2G1�4L Attach`(2)camptete sets of Buii'ding Fians pius a Ltfe Safety Page;{1}sef of Energy Farms.R-O-VY Permit for new cansfrttction.
<br /> Minimum ten('!0}working days after submi#ta(date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commerciai requirements must meet compliance
<br /> SlG3�PERIYIli' P.ttach(2}sefs of Engineered Ptans. �
<br /> "**PROPERTY SURVEY required for ail NEW construction.
<br /> i7irections: •
<br /> ' Fiti out applicafion comple#ety.
<br /> Owner&Cantractor sign back of appiication,notarized
<br /> If ovee�$2500,�Ido4ic�a��or�em�ncer�ent is r�quir�d. {,�lC u��rad�s ov�r$7500}
<br /> "� Agent(for the contractor)�arPower ofAttorney(for'the owner)would be sameone with nptarized letterfrom owner authorizing same
<br /> OVEia Tk9E COUl11TE�PERiUi!'9:Y'1114G {cogy of contract required} - ,_;.x,;,:. :.;.,:_.�.°.-.-R�.�...:.
<br /> Reroofs if shingies Sewersa _,,. Ser.vice Upgrades A/C Fences(P1ot/Survey/Footage} �r�:_°_ `�" ";" �� ,�;:� �
<br /> Drivewa}�s-Ptat over Gounter if on public raadways..needs f20W ' _' " ` _
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