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s�3aeo-oa2o City of Zephyrhills Permit Application Fax 813-780•0021
<br /> Building[?epartment . ��`:
<br /> Date Received r" Rhane�Contact for Permitf�n
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<br /> Owner's Name v� f /7` c G. �l1/ Owner Phane Number 3 '—��
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<br /> Owner's Address c�g J� (v 7 �j/t � . �� ,� Owner Phane Number �O.✓ ��,J��1�/ �
<br /> Fee Simple Titletiolder Name � � � • � Owner Phone Number � ��
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<br /> Fee Simple Tltleholder Address
<br /> �as�►oaREss 3`c�sSt/' v� � r .,f.s L. �3,�' LOT# ��
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<br /> suaa�v�sioa . � � px�c��.�a� - �
<br /> i ' , , , (OBTAINED FRpM PROPERTYTAX.NOTICE)
<br /> WORK PRQPt}SED NEW CONSTR ' ADOIA�.T � S1GN [� � �Q DEMOLISH
<br /> + �e.- IPISTAI..L B i2EPAIR - ,S'!��// v{)e..� F"'rn,.s� oUv
<br /> PROPQSED.USE SFR a 'G4MM C� QTF{ER " n� ,,ts' ' io',•.•
<br /> TYPE OF CONSTRUC't10N � BLOCK " � FRAME � STEEI. [�
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<br /> DESCRIPT{CYN OF WORK �J(,Tb'`� �/ ��� � � ,�. �
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<br /> BUII.DtN�a SIZE SQ fOOTAGE ' � ,.HEi,GHt�C,___� �.
<br /> B�ILDiNG $ . VALtlATtON'OF TO'FAiL CONSTF2l'lCTION + � '
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<br /> EI.ECTRRGAI {$ ' � AMP SERVICE Q PFtOGRESS ENERGY Q "W:R.E.C.
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<br /> QPLUMBlNG. $ - . �
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<br /> OMECHANICAL $ VALUATlOi�tQF.MECNANICALlNS7'ALLATIQN �"�
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<br /> Q��.$ Q ROOFING .Q SPECfALTY � OTHERf - , -
<br /> FINISHED FI.00R ELEVATIONS (��� FLOOD ZONE AREA QYES :,NO
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<br /> BUlLDER i �/�COMFANY:° . �-C�ti'"�� �
<br /> SIGNATURE REGISTERED Y/ N FeE cu�t�n ' " Y/'N'
<br /> Rddres's - �tcense'# � �
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<br /> �LECTRlClAN: � � COMPANY -
<br /> SiGNATURE � REGISTERED Y/ N FEE CURREK " '`Y/'N
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<br /> �4tidress � ' . _ Cicense# � . ` �
<br /> PLUMSER-�j : COMPAt+tY� - „ ` •
<br /> SIGNA`NRE' ` � , ._REGISTERED; Y•./..N.� o n�FEECUIiREA Y-/N. - -� �
<br /> Addr6�s � , _. , _ . . • . _ . :_ . '_�.
<br /> :� . , � , lEcense.#+�: - .
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<br /> MECMANIGAC � ' .. G4IYPPANIf �.\; . � . ". , . .
<br /> SIGNATURE• ' ' ' "` REGISTERED ,.Y/.,N., , � FEE CURREA. .
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<br /> Addre�s� � - � ' *- ` licerise#_
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<br /> QTHEFt . �, , . .... ..�:._,E ., � - <
<br /> " ��COMPANIf� �
<br /> 3lGNA7tIRE . • � � " � ` � " "REGISTEREO ` ° Y/ N;. FEE CURRE� Y/N
<br /> Add[es8 � , ,.,. • ' CECetiSB# �� —�� .
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<br /> RESIDENTI�+. '( ) ,.. ., .,.. „ , .�. ,. ; , . � ,. , ,
<br /> °��= Attaoh°2 yPtot Pians�..(2)sets_of�Buftdln �Plart`st 1 'set of•Ene Farms;;R=O;W Perinit•far new coiistrtictton,
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<br /> -R ��,e.>Minimum;ten°(�1.0}�uvortcing;clays�after`;:sGbmiftal'dater.�=_Requlred onsite;�GonstnicUon�Plans;Stormwate�'Pian`sw!'SIIt�Fence�installed,
<br /> ` "'•' Sani'tary Fa_cilities&ry1{dumpste_r,•SIte�Work;;Permitrfor.sub'diVisions/Iaige.p.roJebts,v �--.;', -'' � '' . ' "` `
<br /> GO�!lMERCIAL Attach(3j cbsiiptefe'sets`of Bsiiidfng Pians�pius'a�l:ife Safety Page;�(1}set of E�iergy Forms.i2-L1-V1t Penn�t far newr construc�tion.
<br /> Minimum ten{98}working days after submittal date. Required onsite,Canstructlan Plane,Stormwater Plans w/Sflt Fence installed,
<br /> Sanitary Facilides 8�1 dumpster.Site Work Permit for all new,projects..All commercial requirements_must meet compllance � �
<br /> SfGN PERMlT Attacti(2)sets�of�nglnee�;ediFiaris:< < i��_� ti ,. ' , , - ,
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<br /> """PROPERTY SURVEY reguired for aii_Nk"1N construction.. ' ,
<br /> I?1l8CtlOi18: . . . _ ' _ ' '
<br /> Fiil out apptica8on complately. ,
<br /> Owner&Contractor sign badc of applfcatlon,notadzed
<br /> If over#2500,a Noti�of Cammertcemen#Is requlred. {A/C apgrads�avsr�7500)
<br /> " Agent(for the contractor)or"Power of Attamey'(fo�Ythe awner)�would be someone wlth�notarized letter from owner autho�izing same
<br /> dYER TttE COUNT.ER,RERMlT'fiNG --(Front of-Applicatian-Oniy} - . . , .
<br /> Reroofs(f shinglas Sewers Service Upgrades.A%C Fences(Plot/Survey/Footage) `
<br /> Drtvewaya-Na#aver Caunter tf on pubiic roadwajrs..iseeds R8W � ' ' f ..-.
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