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<br /> � 813aso-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> , ' Building Depactment `�
<br /> Date iteceiv.sd _ � Phone:Cantact�far Perm3ttte '
<br /> �:-
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<br /> Owner's Name L..ci� �—a!�✓�a�(? Ownar Phone Number c/�� ���.� ��� .
<br /> Owner's Ad'dress .� �! 7 7 `� '�`��. v� Owner Phane.Number �� t� '
<br /> Fee 3lmple�TI#Ieholder.Name �� ' � Owner Phone Numbe� '� �
<br /> Fee S(mple 7ltleholder.Address �
<br /> JOB ADDRE$$ � 1 J� l� '7! �� LOT# C�
<br /> SUBDiVIS10N , � � PARCEI.ID# ` 1 l` �l� ^ �'I '!J O I�J ~— l�,d GDD �C,D�ot
<br /> j , , , (OBTdINED F.ROM PROPERTY7AX NOTICE)
<br /> WORK PROPpSED �NEW.CONSTR ADD/ALT Q` S1Gi3' �Q � [� DEMOLISH ,
<br /> -e. INSTAL:L � , -REPiAIR •. , •
<br /> � •
<br /> REtOPOSED.U$E .. . Q= SFR; � 'GOMM 'Q .OTNER , `
<br /> TYPE OF CONSTRUCi'ION Q✓ " BLO'CK " [;�] FRAME ' C] STEEC C]
<br /> DESCRIPTICIN OF WORK� f /G lj�q� U'2� U"(a(1 ��/'�` �{ ��� .
<br />; �UtLDING SIZE� � �'SQ FOOTAGE*��: . ,,,HEIGHT YC�,____r��
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<br /> QBllII.DING $ VALUATiONaC1F�T01'AL'CONSl'RUC'i`ION t�� �� '
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<br /> i ELECTRICAL. $ AMP SERVICE
<br /> Q , Y-� � Q 'PROGRESS'ENERGY Q W:R.E:C.
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<br /> QPLUMBlNG� $ `
<br /> i ��.� � �
<br /> �MECHANIGAL �j'� ,r��. YAIUATiOM OF;MECHANICAL INSTRLIATIQN ''��(�yr /���� , .
<br /> (/� y�L,r ri�
<br /> ; _%� �
<br /> �c,As , 0 F2QOFiNG _Q s�Eciat.rt .� orNE�t<
<br /> FINISHED FLOOR ELEVATIONS ��� F1,00D ZQNE AREA QYES. yN0 . .
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<br /> BUIZt1Eit ; CONIPi4N1f� , . .�_ , ^ � .
<br /> SIGNATUFtE REGISTERED Y/ N `FEE CURREI: ' Y/N ,
<br /> , -,� .
<br /> ARIdr68S LIce11Se#w'� �
<br /> E�ECTRICIAN.; : _, .�GOMPANY .
<br /> SIGNATURE � REGISTEREO Y/ N FEE CURRE��' , '� ^Y/N" '
<br /> Address ` ., � _ . - � _ � � � � License# �.— ��
<br /> .. _ �, �ti _.r
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<br /> PE.UiY1BER °, ,.CO.MP,AElY � � .
<br /> SIGNA'TURE' ,REGIS.T.ERED Y�/,-N,e �;FEE CURRE� Y./N. -
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<br /> . . . . �.. ;-,
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<br /> /►+d�drass . � ' . _ .
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<br /> . , Lii�n`se;# .�:
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<br /> MECHANICAE: I��/// ��,'.�/j�"_ ...._� ' C{1MPA1+tY, _.,t.tA�r� .���G1�i G ; . .
<br /> •!{t\w/ �-Y ti!• "'f'r:�ST:::� � �.
<br /> 51GNATURE• ��.. ,� �REGISTERED.,� Y�/ N . � FEE�CURF3EP;� Y./••N •- - , -
<br /> Address�" °`' . �. :^' 1- . , , _ rv Licanse#�.� .,� . . � .
<br /> 03HER - ' - � , , ., . .+. , �_ .. . - .,
<br /> ` t GOM,P'ANY
<br /> SIGNATURE � "z�y � � �' � ; • ' � ' " � REGIS7ERED' � � " Y/ N.w, � FEE CURRE� � Y/N
<br /> Address ���.;s, . . _ .� q ' ..Cic�nse#-�� _...� �, ,
<br /> RESIDENTIAL: �.A ' . _
<br /> , ttacfi:(2)=PJot Pla'ris;;,(2}set's'�of3B�t11d1ng�Plan's;(.'t)'sef of:En=ergy:Fairns;R�1N='Peririlf hir r�ew�nstruc6an,, ,`
<br /> �; ;,���,,:.Minimum�ten°(1.0);�vvorlitng�days:afte�;subm�ttal-date u'Requlred onsife,:Cbnstiuctlon�Rlans;'Stormwate�'Plans w%311t-Fence installed,-_
<br /> W.._ r.w,;�,,,� . . -
<br /> `��SaniEary Facillyes;&;1�,du,mpster�Site•Work}Perr�it,for.subdiv,isions/iarge..projecYs�_v =_:�:�" . �'a.- :" ::=. '. �• � ,
<br /> C4IYIMERCFI4l. A##ach{3)`aoinptete"sets of Biiililliig Plaits�plu5 a.l:ife 9�afet}f Page;�{'I)set of Energy Famts.R-L?-W Petmli for nerii'canstructlon.-
<br /> Mintmum ten(10)v✓arktng days afker submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all newsproJiacts.All commercial requlrements.must meat compliance
<br /> SI�N PERMIT AKacFi{2)sets of"Ei►g[nee�ed�Plans�;, �,.� -: °.�: ,- , . , -
<br /> •'*"PROPERIY SURVEY reguired for all,IVEW_construcNan.. �
<br /> 0lrectlons: ... ..-., . �. _. . _ ; {
<br /> FIII out applicadon completely.
<br /> Owner 8 Contractor stgn back of applEcattan,notarized
<br /> if over�250d,a NoHcs of Commencement 1�cequired. {A/C upgrades aver�7500}
<br /> ., „�:.�;,;..,,,
<br /> '" Agent(for the co�ntCacto"r)ar Powe'r of Attomey(fo`r the`owrier)wrould be�someone with notarized letter from owner authorizing same
<br /> DVERTHECOUNTER,PERMIT77NG-_. ...-:..tFront�afAPRilcation•On{y)-.��� :: :" .., ,
<br /> Reroafis if shingies Sewers Service Upgredes A/C Fences(Piot/Survey/Footage) I
<br /> Driveways-Nat aver Counter if on publEc roadways:.needs ROW
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