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8�3-780-00,20 City of Zephyrhills Permit Application FaX-B�a-�aaao2�
<br /> , v BuElding department '�
<br /> Rate Receiqed — �'� .- Phone=Cac�tact for PerniitE�n ' -
<br /> Qwner's Name + r�rr` t_G�w-�G�"" . Owner Pho»e Number /J�".�T�'"^ l�.�2-
<br /> Owner's Address. ���� �r'Gl�t�rvc ty'�(le G/r' Owner Phane Number �— „�
<br /> Fee�Simple fTItleHolder Name �� � Owner Phane Number '�— �
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<br /> Fee Simple 3Tltleholder Address
<br /> I JOB ADDRESS ���� ��E''" �v4�ir�lf� G�/" LOT# �✓�7
<br /> SUBDiViSlON �rGS�1/!�'� !7�`t j„� PARCEL ID# � �
<br /> � (OBTAINED F.ROM.PROPERTY.TAX NOTICE)
<br /> WORK PRQPt}SED NEW COt�iSTR°-. ADQIAlT [� S1GN Q ° �Q DEMOGISH
<br /> ` . �•8. INSTALL 8 , REPAIR • -
<br /> i PROPQBED�USE � � , � � SPR- Q GOMM `'� OTHER .. , .
<br />�� TYPE OF CQNSTRUCTION [y� BLOCK " [� FRAME [� STEEL "Q�"
<br /> i DESCRIPTION OF WORK . R� l��e ITo� �,,l��e/�' ���`�� -
<br /> �Uli.D1NG SIZE' - ' � SQ FOOTAGE '18�t� ; HEi,GMT �____,:�� ,
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<br /> QBUILOINC''' �$ � VALUATION`O�F TOTAL-CONSTRUCTION
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<br /> QELECTRICAL � .� AMP SERttICE Q PROGRESS ENEftGY Q W.R.E:C.
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<br /> Q��.�M����7 '.�� - � v�J
<br /> � ° , � ' � , l �1� �
<br /> , QMECHA[VIGAI $ VALUATlQN OF MECHAi+31GAL tNSTRLLATION �
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<br /> QG�S Q 12QOF{NG .Q $PECIAI.TY Q OTHER 3
<br /> FINISHED F�LOOR ELEVATIQNS ��� FLOOD 20NE AREA QYES NO . ,
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<br /> BUIE.DER � COMPANY� ' - - ` `
<br /> SIGNATURE REGISTERED Y/ N ' �FeE cuRrtEn ' Y/N�
<br /> Address � � �License# � �
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<br /> ELEC7RICIAN . - =C'OMPAFiY .
<br /> SIGNATURE � REGISTERED Y/ N F�cuRRe�`• '' 'Y/N '
<br /> Address . � • , , _.'LEcense#�� 1
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<br /> PLUN6BER ? '��'"'..�L�,�� - COtWPANIf � � 1 �'lm�'�,.�,r.rJC�t S.�" _
<br /> SIGNATURE ' �?�'" ;. _REGISTERED.. � Y/�.N� „ .�FEE cu�ten_ �." Y l N. _ �
<br /> Addres� . '_ _ . . . �license# � -. , .� _
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<br /> MECHANtGAl: � � �pMp%�! : � ,_ _ _ • .
<br /> .;,:. . ,...-_, -. _
<br /> SIGNATURE � '"� ' ' REGI$TERED ` ..Y,/.N, �F�E cu�n..: Y/�N
<br /> Address' , � • • . , : _ ` � ' - _ - . ;Cicense# �. �
<br /> OTFiER ( � '��C014(IPANX ,. ; . ` �
<br /> SiGNATURE ' - - - ' " �` ` ` �rtEGl'87EiiE� ' ' Y/ N;.. 'FEE CURFtE� Y/N
<br /> Address� . ° Llcense# � � �� `
<br /> .:..,.......„...�. �„ ...., .. . �-, ,. ..,.: ...,: �.� ,, ,,.,,�; .,.. .. ,r� . •
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<br /> r . 7 � .. . k,-�, ,,. �, .�:,. _ ' . , ^' '.
<br /> RESFDEN'�AL:,;^ Atta'cti"(2j„Plot<Plaiis;_(2}sets�of'8uilcfing�lans,�{i)sef of-Energp�ForrrWs;.AR;O=W'Perr_�lt for-�ew constructEbn, .
<br /> �ti ,, �;�. Minimum�ten�(;10)zworking;days�after�submlttai-date:�.Repuired onsife;:ConstiucNon=Pians;"Stormwater=Pians W%Silt'Fence instatled,
<br /> �" ��SanitaryFacdliUes�&��1�,dumpste_r,�Site-Work;.P,ermitforsubdiVisionsAarge',proJects;•.;'.. -�- '� " � ' ` ' ' '
<br /> - -GOP�II+�ERGIAR. Attach{3)•ebsiipiete�sets'of Bulidfng Plaos pius a'�ife Safefy Page;{'1}set af EsiergyFar'ms.R-O-W Pesmit far new canstsu�tton.
<br /> Minimum ten(10)wo�ictng days afker submittal date. Requlred onsite,ConstrucUan Pians,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilidas&1 dumpster.Sfte Work Permit for all new:proJi�cts:All commercial requlraments.must meet complia�ce � �
<br /> SlGN PERMIT Attac;�{2)'se�of Englnee�;ed=Plasis:;,-.:;-., �, , � . �
<br /> `•"'PROPERTY SURVEY required for.all IVEW constructian.. -
<br /> Dlreetians: , .. ; ., .
<br /> Fill out applicatlan completely. ,
<br /> Owner 8 Gontractor stgn back of applicat[on,nota�ized ,
<br /> tf avar a2500.a Notice of Commencemerit is required. (AtC apgradea over�7500)
<br /> �' rir, "
<br /> ' " Agent(for the iwntractor)or Powe�of Aktbmey'(for the owner)would be someone with natarized letter from owner authorizing same
<br /> 4VER THE�COtiNTER,PERMITFFNG. ..._..{Front-of-+4PPIIcation{}nly}- ` " ,
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Foa#age)
<br /> Orivaways-tVot aver Gounter�f on public roadways..needs ROW � �
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