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<br /> 8'13-780-0020 Gity af Zephyrhills Permit Application F�-a�s-�eo-oo��
<br /> , Buildi��g Department
<br /> Date Rece9ved ' ,�"'I;;7Y'"',,��.r`,�i�7�o,fFrF"'� � �"" `� U'��`����
<br /> • Phone Contact for F'ermitting
<br /> _�.-1-['1T(-1-� C- (�
<br /> Owner's Name �, � f.� r,� ,-. , k= Owner Phone Numl�er �� ...1 �'e��'i • �- �� f1
<br /> �� � �
<br /> Owner's Address ���'���'�-�'� �-"� '"" �''r T�-�^t°��j?� �f Owner Phone Number
<br /> Fee Simple 7itleholder Name �_-��,.��• '� � Owner Phone Number �---_ n �
<br /> .Fee Simple 7itleholder Address
<br /> � �4`� . -�~f _ lt r �" �// 1 C�
<br /> JOB ADDFiESS ' ^t LQT#
<br /> sUBDlVlsloN ��t t V���'� �ca PARCEL ID# '�-r-���`��r �"�� �G� "�C��°
<br /> (OBTAINED FROM PRQPERTY TAX NOTiC6)
<br /> WOFiK PROPOSED • �NEW CONSTR 8 ADD(ALT � SlGN 0 � DEMC}LiSH
<br /> lNSTALL REPAIR
<br /> PROPOSED USE � . �'"� SFR 0 COMM � OTHEFI
<br /> TYPE OF CO.NSTRUCTIC7N �� BLOCK 0 �RAME � STEEL � �
<br /> DESCfliPTiON OF WORK �1��"-'4� ���/.�.���•�'�rv.-� �, �'�'-5�a�c��.zC:z't ,,� �G c� � �:��:'�-},..t �,,,��c,-�c�:
<br /> BUILDING SlZE � � St�FOOTAGE � �� HEIGHT �_______�
<br /> TQ-"r`�"r-r-v�'rrre-w-�r-T-e'z-a-rr-r-p-e-rr�s-rr-r'x"e"s"�-c-�"fl"'rr'-e-rv"`ri"►-a-r'�-rc-rs-r-a'-v-c-r�a-a-G-v-o-4^-e-e�--9-R"u-�..
<br /> �-��UiLDING $ 1 � � �� VALIJATION OF T07AL CQNSTf�UCTIdN
<br /> !
<br /> 0'ELECTRiCAL $ ,�/��� AMP SERVIGE [� PRQGRESS ENERGY � W R.E.0
<br /> `Y
<br /> �PLUMBING $ ��L�a� �
<br /> � �q� C�
<br /> [�MECHANlCAL $ �, VALUATION O�MECHANICAL INS7ALLATION �� .
<br /> �r,
<br /> �GAS �� FtOC}FING [� SPECIALTY [� 07HER
<br /> FlNISHED FLOOR ELEVATIONS FLQOD ZONE A(�ER �YEB NO
<br /> I�-!; ��� .
<br /> �-C�-G-G--i--0-1-il-�i-F�-i--6�-4--i--➢-Fi-II--7-*�'-0--k-{I-�-➢-�'v�-9��-G-�--�-C-�-�'-6-u--�u--b-8-�5-�-F�-�u�-'v-i-6-$-E�-'n-i�6�-'v-:-0�-t-•°wbaE�r-�C--a--9�-4-`1-'�P-'�-
<br /> BUiLQER -�'"�__� COMFANY �.. � .. �--� �-J.�--�'d-r'��-�, ��ti�
<br /> 51GNA7URE � ,f��'"�� � REGISTEREd Y( N FEE GURRER
<br /> Address ����ra� /�'jt"CC�.�i .� r�' ��'r�� �" License# ' , �-G�T��Q�� '�
<br /> .���cTRic►�,N ��,..--a�,-��" COMFANY '��,�`1�,��n�,.�'"�,� ,�.�- � � �.. ,,�� � ���• 1
<br /> SICNP+TURE � REGISl'EflED Y( N F.EE CURFIEf� Y/N
<br /> Address P'��.;?`���`��,0'��`" Cf,� � ,�-7'�' :'�1� Llcense# �(.:.-�-������/ "�,�
<br /> _._. e
<br /> PLUMpEB �� COMPANY � 1''"' /j'�.F�i,G7,f. •.�A�'��-�s{',��'�!�..r� ���'�;�?F�'� �
<br /> SiGNATURE "�������'J /
<br /> REGISTERED Y/ N FEE CURAE� Y/RI 1
<br /> ._r
<br /> Address f ,=��� �c��ll�-�Q'" ��'-Q•�'� License# {��,` �"�+� +L.i F,�! • ,u�` � .
<br /> MEGHANICAL �) s� ,� � ���"�-�
<br /> SiGNATtYRE �,/��`l..�'` ".-„"'�,�.� COMPANY ��i�,rt���`�,� ��'�' �°"� ,,,a' .. .�+
<br /> �� ��-""°-^�^^^----REQISTERED Y�/ N FEE CURREA Y/N ��',(��/[
<br /> Address ����� �G���'.� ��' ��ca,,.��"`�f-tr�,Lf/`��!< <���
<br /> _ f' License# ���� � p�!�
<br /> �-, .-,-a�� ,,t� �`
<br /> OTHEfl - � .�w�::-���_._,_.--�r--�-^^�, COMPAfVY f./!��~z"�'� fi!'�!�=.v�(?f7��O�'� :''r��(��-�,,(`d•�'
<br /> SIGNRTURE r REGISTERED Y j N FEE CUARE� Y/N ,/�
<br /> Addi'ess 1����fif-� '� ���n� 1�'��rb�.-`�`
<br /> License# � y �
<br /> 1 1 p 1 1 1 ! 1 i i I 1 1 � 1 i t / I i ➢ i 1 I II I 1 1 1 ! � d ! 1 H d � C 1 a 0 1 1 1 i 1 i 0 i i .9 � 1 0 M 9 o fl 9 9 0 � & 9 ! 9 7
<br /> RESiDENTIAL Attach (2) Plat Plans; (2)sets of Buiiding Pians; (1}set of Energy Forms; R-Q-W Permit for new construction,
<br /> Minimum ten (10}working days after submittal date. Required onsite,Constructfon Plans,Stormwater Plans wJ Sllt Fence insYalled,
<br /> Sanitary Facilities&1 dumpster,Sfie Work�Permit far subdivisions/Iarge proJects
<br /> COMMERCIAL Attach (2)compieie sefs of Buiiding Plans plus a�ife Safety Page, {1)set of Energy Forms. R-O-W Permit for new constructlon.
<br /> iviinimum ten (10}working days after su6mittal date. Required onsite,Gonstructlon Plans,Stormwater Plans w(Silt Fence instaited,
<br /> Sanitary Faelliiies&1 dumpster.Sfte Work Perrnit fpr ail new proJects.A!!commerciai requirements must meet compliance
<br /> SIGN PERMIT Attach(2)seis of Engineered Plans.
<br /> � *"**PROPERTY•SUAVEY required for ai!NEW construction.
<br /> -a.-�-G--�-i-t-�-e-.D-i-i-i--i--f-�D.-i.:i.-3-8�-�-.4-a.-i-0-3-�..i--0--�-E--a.A.-�-�--�-a-&-3-�-�-�-.�-�--�-4-�-�.-8--0-9�-G�-&..F.�_��➢-��oEd-@o4�.4el�S--A-�t-G-.
<br /> � Dtrections: �!d
<br /> FIN out appifcation completely
<br /> Owner�Contractor sign back of appiication, notarized
<br /> !t`aver$2500,a Notice of Commencement is required. (AJG upgrades over$7500) � ,
<br /> "` Agent{far the contractor}or Ppw�r of Attomey(for Yhe owner)would be someone with notarized Ietter from�bwner authorizing same
<br /> ?VEA 7NE CQUNTER PERMITTiNG (copy of contracY required}
<br /> �eroafs if shingles Sewers Service Upgrades R/C Fences {PIotJSurvey/Footage)
<br /> F?riveways�Not over Counter if on�ublic roadways..rieeds ROW , ` '
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