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eia-7eo-oa2o City of Zephyrliills Perrimit Applicatian Fax-813-76Q-0021
<br /> ' Building Department
<br /> , . ,,7,^''�;;;�'��t rE3�a F�r�� �' P" .�rr t;�e"?'.°���^7
<br /> Date Receivcd Rhone Contact far PermitEing � �
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<br /> Owner's Name �.. � Cy;� cs r-. . k= - OwneC Phone NumbeY _ ,���L�• t �� tJ
<br /> Ownec`s Address (��'Q��{'�� '�`" 'r'"" p''r
<br /> ��C-s'�^f��J�� ����.�Owner Phone Number
<br /> Fee Simple Titlehotder Name ��r�� `C.._ � Owner Phone Number �—�--_ �
<br /> ' �Fee Simpie Titiehoider Address
<br /> JOB ADpRESS ��� � � uC.t � ,��t� �L'��i� � � " � � "7�T/ LOT# �/�
<br /> �'� SUBDIVISIdN �✓�f � V�e('� r,..�Ca PARCEL ID# ` . F' 'O°`��''i� �""l,� " ' _} � ' �-�"7'
<br /> , (OBTAlNED FROM FROPE TY TAX NOTiCE)
<br /> WORK pAOPOSED �NEw CONSTR� ADD(ALT �] SfGN 0 � DENIOLISH
<br /> iNSTALL REPAIR
<br /> PROPOSED USE �� S�R 0 COMM �] OTNER
<br /> TYPE OF CONSTRUCTION �� BLOCK [� FRAME � STEEL �
<br /> '� DESCRIPTlOIV OF WOAK �'��� ����j 1�G•�G.r1z.-� �, ��'S���r.::��.'�� `! t�.;.tG���2�:"�-}-t � -''c.7��
<br /> I� BUlLDING SiZE 5Q FOOTAGE ���� GJ�� HEIGHT
<br /> "r"P'�rr�r-s"r-r-ir-r'-rs•rrrr-r't-a-e�r-rt'�Trs-rr-�r-i"s-'4-r�_v"rr.'Q'�t-fl�-"c-Q-�-a-r�Q-e"T'9-a�r-�a-�-r-°e-II-e��'ir'a-r-
<br /> [�BUILDING $ i <<-y�G,��,-� VALUATION OF TOTAL CONSTRUCTl4N
<br /> � LJ �/V�
<br /> Q'ELECTR(CAL $ �� AMP SERVlGE 0 PRQGRESS ENERGY � W:R.E.C.
<br /> 1--.���''� . .
<br /> �'�LUM8ING $ ��� � �
<br /> �MECHANICAL $ , ��, � VALUATIdN OF MECHANlCAL lNSTALLATION �� ` `
<br /> 5 ��--c..,�
<br /> OGAS [�r ROOFIN� 0 SPEGIA�TY [� OTHER .
<br /> FiNiSNED FLOOR ELEVATIONS �('I ���,..1 f FLOOD ZONE AREA �YES NQ
<br /> V�j � \.��
<br /> �-¢-3-C-G--a--F-�--�-�'C--l--4--C-II-i-�-G-4-$--G-$-F-i--E- 8-�"e-f,�r+-"•-i--5-•6-9*-0-".-'r-i�F+-'�'-Fi-i-Q-:-8-9-E-'�=s�-9-'v-:-9-'�;P6aSm+r�°�°r-�,-�Q-i-•P-.�-
<br /> 8UlLpER � '��� ,/f�,�,� COMPANY �� � - �-) U,'�'s"�-'c`'.'"'`' �f�"�
<br /> SfGNATURE �`��L��— REGISTERED Y/ N FEE GURREE Y/N ,
<br /> Address ����7v� 1���'<C�.� ,� !"" l�it� �=-- License# �-'��..C�.J`����x '�.� �
<br /> �LEC'CRlCIA(+1 ��'}�,,.z-r,,,,..-,�--' � COMPANY �'�°�''`�������� 4:.�.-�''-�`��"��' �
<br /> SiGN11TURE ��^'P FIEGISI'EftED . Y/ N . FEE GURRER Y/N
<br /> � • �'" ,f � �-^
<br /> Address 0�`'�.�'J�✓ �r'�,�'��`� .��'�v � r?'� .l� License# �C.���,�'c�`�'r� ����
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<br /> PLUMBER ���,,r�'".ad^,.F^`��,�._,...____ COMPANY ' 1`' f'�a'"��,�` .;�,�,��•6"s�,r`.�`�.,'`�.�+ ����;r��a�,�t �
<br /> StGNATURE REGISTERED Y( R! FEE CURRE� Y/IU
<br /> Address ,1"���� �Qr�!"`'�� Al��-ri- G'�i+��,�,'� License# �.��� ��,�r� ./�/J �
<br /> MECHANICAL �,1�+m1�`�^ �-�-^^,_.._-----_,_COMPANY �B�.�i����n�r,�f t(�� ,�°'�^- �., ,��a�"1 r'�
<br /> SlGNA7.URE f,,.-F'F �' �^�� REGISTERED Y+'�( N FEECURREP Y f N
<br /> Address ��*'�� /-�"�'�"��f" �*'� ���'°-'"���'����''�'. License# ����,�'�� � I
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<br /> OTNER " �f^��l,,..._. _... � CQlVIPRNY 1.`��4'� , .�i�.v,*f,/.?i'`��/�.� ��!��''f�,F'�•�
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<br /> SIGNATURE � ��� flEG�STERED Y J N FEE CURRE� Y(N �
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<br /> Address '�_�f"--�`� `� /�,(�� ,�'����� License# �— �
<br /> i i 1 i i I I 1 I I 1 I .1 A 1 9 I 1 ! 1 ! ! 1 ! I i 1 I ! 1 t 1 1 1 t � 0 1 0 1 1 Q t i t I I 1 t i 1 �i i I Q I 0 i 8 7 9 1 0 9 � H G !
<br /> AE81pENT1Al. Attach(2)Pioz Pians; (2}sets of Suilding Plans; (1)set of Energy Forms;R-O-W Permit for new construction,
<br /> MiNmum ten(10)working days after submittai date. Required onsite,Constructian Plans,Stormwater Plans w1 Silt Fence lnstalled,
<br /> , Sanitary FacBiCses&1 dumps#er;Site Work�Permit for subdivisionsllarge projects
<br /> CON1NiERCiAI. Attach (2}complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten{10)working days after submittat date. 'Required onsite,Constructlon Plans,Stormwater Plans w/S3lt Fence instalied,
<br /> ' Sanitary Fac:ittties&� dumpster.Site Work Parmit for ali new projects,Ai!commerciai requirements must meet complianCe
<br /> SiGN PERMIT Attach (2)sets of Engineered Plans.
<br /> � *"*kPRQPERTY�SURVEY required for a(I NEW construction.
<br /> -�i.-i-6-A--d-1-b-d-B-.i-.i..4-1.-F-a-L�i.-G-2--!!-{-.B-G.�F-6-.E-�.E�.3-�-t-Y-8..8--g-A-b-�-a-8-�4�-h-B.-�-S-b.-�-b�..B--0.-9�l�:-.�.�A..E-9�D�..@.�8.�-4�Q�.¢-sb-4�-.
<br /> Direc#ians:
<br /> Fill oui applicaYion complet�:ly.
<br /> Qwner�Contractor sign back of applioation,notarized .
<br /> if aver$250D,a Nottce of Coinmencement is required. (AJC upgrades over$75oQ) � ' ' - •
<br /> "'* Agent(far tYie contractor):,r Power of Attarney{for the owner)would be someone with�otarized letter from owner'authorizing same
<br /> OVEA THE COUNTER PERMI��TlNG (oopy of contract required}
<br /> , Reroofs if shingles Sewery� :3ervice Upgrades A1� Fences(Plot(Sutvey/Footage)
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<br /> Driveways-Not over Counter if on�ublic roadways..needs ROW ,- ' ' � .,;..,, -
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