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s�s-�eo-oo�o City of Zephyrhills Permit Application Fax-813-780-Q021
<br /> 8uilding Department �
<br /> Date Received phane=Gontact for Permittin
<br /> Owner's Name • � Owner Phona Number �� sd y' ��7�G... '
<br /> Ownar's Address -3��20 /Y+�7�v1 �.V 2�. Owner Phcne Number �� �
<br /> Fee Simple TltletiolderName �����'V ��"V•Ir^ � Owner Phone Number � —�
<br /> � •
<br /> Fee Slmple 1'Itleholde�Address
<br /> J08 ADDRESS ���2�1 '�..-t? �b'Y� �}V'� z„ '7jYNI/.S L07# �_��
<br /> suso�v�siaN 1 � Pb►�c��.i� � �f�-�/—1�71b�-a��� �_ �b l�
<br /> , - , (OB,TAINED F.R4M.PROPERTN.TAX NOTICE)
<br /> WORK PR4POSEt? NEW CONSTR ' ADDlA�3' � S[GN' [,�. C] DEMO�.lSH
<br /> � e INSTAL,4. 8 : REPi41R
<br /> PROPOSED=USE - Q SFR Q COMM C� OTHEF2 '
<br /> TYPE OF COPISTRUGTION � Q BLOCK " [� FRAME � STEEL Q
<br /> DESCRIPTICIN OF WORK ', 't V�^ �G1'�-{/ti�- ��1 pvl� 3� >�,
<br /> BUIt,DlNG StZE' � � . � - :
<br /> `SQ`FOOTAGE C,_�, .,,HE1GFiT .�_�
<br /> + ,,,_„ , -
<br /> QBt1t�DiNG � � m a �:.....�._y- ` .
<br /> t j�jQO �'"''� VAlUAT10tV:OF�TdTAL'CONSI`RF:ICTIOtd
<br /> ,_ �J
<br /> QE�:EC7'RfCAI �a� AMP SERVlCE: °'[� PROGRESS ENERGY Q 'W;R.E:C.
<br /> , � ,
<br /> OPL'UM81NG $ ' '
<br /> � �..� - '
<br /> OMECHA(VICAL $ VACUATION QF,1iAECHi4PtiCAL tNS7ALLATlQN
<br /> � �.. .� . - ,
<br /> QGAS Q ROOFING CJ , SPECIA�TF.��_ OTHER� -
<br /> FINISHED FLpOR ELEVATIONS �� FLOOD ZONE AREA QYES. ,NO
<br /> "..�. .ir. ' i
<br /> BUIE.DER i C.OMPAl+IY' �YI'� Lt?J�►L/Y !
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre� � , , Ltcense# � �
<br /> ELECTRlClAN . CO{VtPAt+1Y
<br /> SIGNATUitE � REGISTERED Y/ N FEE CURRE� ' -Y/�N
<br /> Addres� ` , , , . _, 11C8T1sB# �� � �
<br /> �LUMBElt '� • C�MPANY �,; .'. • ' ,
<br /> SIGNATURE � ,.REGI9TERED � � Y./,.N,� -,�' FeE,cu,RrtE� Y�/N.- , �
<br /> Address , • .. . . ;Llcense#'� „ . � .�,�.
<br /> ; . ,t
<br /> f. ` ' "
<br /> MECHANtGAI: ,COMPANl! ^ � �- - '
<br /> SIGNA'�URE �� REG„IS7ERED . ..,,Y/N , ,.FEE CURRE�:� Y-,/N - •
<br /> � � . ., . , �
<br /> ' r . „ . .
<br /> Addre�s' � ' �� 4- . ` � � License# � �
<br /> OTH�R F' � � ';GOMPANY � . ; � �: � . '
<br /> SiGNATURE � •. ' = ° � RE�is7E�" ' ' ' Y/ Na� 'FEE CURRE� � Y/N
<br /> Address �� - s� � � � , , - - ' ' � Licerise# � ` � ' �
<br /> RESlDENitAI;,� •Attacti'(2)„Rtdt�P.lans;,{2}sets=of<BuiidFngj`Piarts,'(1)sef of-'Energp=Fa'rrn,"s;�f2A�W Fermit foi new constnrction,,_,
<br /> -.; ;.,4:Minimum4ten,(10)�worliing;day,s;after;"subinHtal'date.�Requir`ed onsite;,Ganstruc�on"Pl�ans;StortnwaterPlans w!Silf Fence installetl,
<br /> `�� �Sanitary'Faciitdes�&;.1;dumpste_r,�,Site.Woric;.P.,ermlt for su�divisions/large prn)ects�'_- , � ` � �
<br /> COMMERCIRl. Attach{3j���plete sets of Bulidiog Pians'plus a�ife Safeiy Page;{1}set of Energy Forms.R t�-W Petmif#o�new.canstru�lan.
<br /> Minimum ten{18)working days after submittai date. Requtred onsite,Constructlon Plans,Stormwater Plans wi Silt Fence installed,
<br /> Sanitary FaGlides&1 dumpster.Site Work Permit for all new proJects..All commercial requlrements,must meet comptlance '
<br /> StGN PERMIT Attach"{2)'sets of�nglneer'ed:P#ans.. - :�- = . ,
<br /> ""PROPERIY SURVEY reyuirec!for aii NEW aansfrucUan.
<br /> Diree#1ans: - . , .
<br /> Pill out applicaUon compietely. �
<br /> Gwner&Contractor sign back of applfcatlan,notadzed
<br /> If over�.2500,a Notics of Cammeacement ls required. {A!C upgrades over 57500}
<br /> Mt � -<�...r�.,
<br /> Agent(for the contractor)'or Power of Attomey'(for tFie owaer)would be someone with natarized letter frram owner authorizing same
<br /> d1tER THE COUNTER.RERMITFiN� - {Frant of�Appllca#iamOnly}-�
<br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Foatage) ,
<br /> Drlvewaya-Not over Counter(f on publia roadways..6eeds ROW '
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<br /> i � �}Jy' .�`c.,. . ., . .-s e =- . . .. ,n. � : _ ... -
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