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893-7$o-oozo Cifiy a�f Ze�hyrhills ��rmit�pplication Fax 813-780-0021 <br /> Suilding[}epartment <br /> Da¢�R�ceiv�d 4� �(� �� - P�tcse���ct�Cact fop���cnt4ttn ��� <br /> Owrn�r's R1ame � � L. � Oenmer Phon�kYuer�bor <br /> �r � � <br /> Owner'�&�dress ��� � G'i� 5� } ���� I� �wrner Phon�tdumb�r � �� <br /> �se Simpi�Tlgl�holder{da�me �! � Owrn�r Phon�R9umber � � <br /> F�a Sir�pl�T'141�holder Adde�ss <br /> 30��7�RE�� � �( 1.J� ' LOT# ��� <br /> ���Q��m���� ���� ��-e�] �����,�� � -a�-�}- -��a� -�a�c� <br /> (OBYAIPIED FROM PROPERTY YAX PIOTIC� <br /> tf�0�#�P9��I�Q��� , e tv�Vtt COtUSTR 8 At3DL�T [� S1GlV Q Q L7EMOi.fSFt <br /> INST,4LL FtEPAIR <br /> ��apo���a��� 0 s�R � co�n� [� oz►�E�t <br /> TYPE CAF C0�9aTRUC710R9 Q BI.00K " Q FRAME [�� S7EEL Q <br /> ���c������a�v�ro�� � 1(�1�1 , ��" � � ��t <br /> �u�i�tr������ �Q�oo�a��� �Er�w�r �`� <br /> QSUlLDIlVG �� VALUATIOftiI OF TOTA�COiVS7'RtJC174R! <br /> [�]ELECTRtCF14. �� AIv1P SERVICE Q PROGRE3S E�IERGY Q W.R.E.C. <br /> I �LUMBING $ �-y ` <br /> '� � V� <br /> QMECHANlCAL 5 1'A�U;,'TiOh OF?�#�CtiA3�lICAL 1iVSFALLA3tQN "" � r I � <br /> C]�s 0 RQOF��u� ��" S�cc��� [� o��a <br /> FiNISHED FLOOR ELEVATiONS ��� FLOOD ZO�E AREA QYES NO <br /> � �UlL��R � �flh9P�lidl' <br /> SiCxP�A9'URE REGISTERED Y/ N FEE CURREA Y/hl <br /> �d�res� License# � �� <br /> �L��T�tCl�t9 C0�9PAI�Y - <br /> il �;������� � REGIS'fERED Y/ Pl .- F�cuRt�En Y/iV <br /> J��R.�P�sB �.ICBTtS@# �!! � <br /> �L����� cc���a�Y � �'V �Y t�1 Cd�-1 P� <br /> SlGR1A1't�F3� REGISTERED Y/.N. . F�e cuttREn /N <br /> At�c�rs�s 1�t "�� � �� {� l.icense# 1.����r��,�,� � <br /> I N1i�C�1�91C�sF. �C�i1�P'A1dY . <br /> � �{������� REGIS7ERED Y/ i�! . FEE CURREP Y/iV <br /> s�ddr�s License# � � <br /> ClY�i�� .C01U��AAPdY <br /> �;������� REGISTERED Y I 1V., FEE CURRE� Y 1 N <br /> ,�U1S�PQS� [.1C8t1Se#-� � <br /> R��ID�R9�'lI�IC� AtNach(2)Plof Plans;(2}sets of�uJlding•Plans;{1)set of Energy Parms;R-O•W Permit for new constructian; <br /> Mtntmam ten(14}workEng deys a#ter submittal date. Required ons{te,Construatlon Fians;Stormwater Plans��:!Si:t Fence instailed, <br /> Sanitary Facilities�1 dumpster Sfte Work Permik for subdivislonsflarge prbjects <br /> C�QflHPA�12Cl�l.. ;4ttach{3j comptete sefs oE 8uitdirig Pians plus a l.tfe Safety Page;{1}set of Energy Forcns.R-O-W Pem:t�r�°x canstrvcfion. <br /> Minirnum ten{10}warking days after sUbmittat date. Reguired onsite,Construcdon Pians,Starmwa;zr Pl�.-�s 1r,'S"ut Fent:e instailed, <br /> Sanih�ry Facllities&1 dumpster.Site Work Permit fur all new projects.All commercial reGulremsnts nu�+r;��:compIiance <br /> ulGA�PE��IiT Attach�(Z}sets of Englneered Pla�s. <br /> ""PF30PERTY SURtlEY required for atl NEW consfruction. <br /> ', �Ic�cgi�eas: - . .. . _ . . _ . <br /> FFii out apptication completely. <br /> Owner&Gontractar sign back of applicatlon,notarized '• <br /> � ro If avsr�2�00.a�t�o4��af G�mm�nc��tan4 is reqalred. {��upgrades over$7�04} <br /> =>�:��"t(Eer the contractor)ar Pbwer of,4t4amey(for the owmer)would be someone with natarized letter from owner aufharizing same <br /> =���===.���4=u�..".-tT�R P�Rhl1'1'�lt�G {Front o#Apptication Only} <br /> � I '�'=�»�,�';'":-w _ � �s.��,.5 Senrice Upgrades AIC Fences(Piat/Survay/Faotage) <br /> •�*�•.�=�_ -�..�..:.:�":_ �s-:�.:-�-���,s._re�is ROW <br /> , � -- <br /> � <br /> y , -,�. <br /> d`` - _ � _ .._, -— -,-� _________ : ._..._ <br />