e��s-7so-oo2a City of Zephyrhills Pecmit Appiication Fa�-a�s-7$fl-Qozi
<br /> ' , ; Buifding Departme�t
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<br /> i �t:;l�``�`,���)�o,f�'r�� � �'-- '�� ��m F.��'� I
<br />� Date F3eceived Phone Contact for Permitting '-
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<br /> ,Owner's 13ame �, � �+;^ c� � , �=- Qwner Phone Number � � .�Ll�� . �- ��' � I
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<br /> Owner's Address `��'���'� �'� �'� `�'" �`f T�`�"}���� � /Owner Phone Number
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<br /> Fee Simrfe Titlehoider Name �"'--. ��• �.. Owner Phone Num6er
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<br /> Fee Simple Titlehoider Address ' �
<br /> .IOH ADDRESS �?�k7 � ( � t\ `i 1.� r t�� C' \ �.lfll Ldl"# C_��f�f(� �
<br /> SUBDiViS10N ��f � �•�=f'� �C.a PARCELID# � �/,'�"��•`''���' �� � `• � `wC_/
<br /> {08TAINED FROM PROPERTY TAX NOTtCE)
<br /> WORK PROPOSED ' �NEW coNSTx 8 ADD(ALT �� SiGN � 0 DEMOLiSH ,
<br /> INSTAL� REPAIR
<br /> i PFiOPOSED U5E �`'� SFR 0 CC1MM � OTHER
<br /> TYF'E OF CO.NSTRUCTiON �� HLOCK � FRAME � STEEL 0
<br /> � DESGRIPTIQN OF WQFiK ��� �4�t�'���-� �, �=�`-'Se.����,�aC.'�': w�JC'c� �:2�:"�-},� � ...�{�,,-�.t...
<br /> BUfLDiNG SIZE � � SQ FO(�TAGE ! ���.(�' HEIGHT � �
<br /> 'z�'e-'R"'rr rr-�-r-t-r-r°-='-x"c-�r-,r-a-�Tnr"�"rr-rr"�-t-�-�-r-'a-'e-1-a-P-r-W-9-r'v'_r'P�-a-'r.T_'e-u-t-Q-�a-v-ra-e'-Q"A-Q-u-��-'
<br /> I BUILDING � �j VALUATION OF 707AL CONSTRUGTION
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<br /> DELECTRICAL $ '� ����� AMP SEFiVICE 0 PROGRESS ENEFiGY 0 W.R.E.C.
<br /> ` dPLUMB�NG $ .
<br /> , Ci-�T�� 7 �j�
<br /> * ��ECHANICAL $ �- G��� VALUATION OF MECNANlGALlNSTALLATION �������`''
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<br /> �GAS � ROtJFiNG 0 SPECIALTY �] OTHEFI '
<br /> F1M1i(SHED FLOOfl ELEVATIONS �� t�,.,� FLOClQ ZONE AFtEA DYES NCJ
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<br /> ^�--Q-a--3--0-k-�F--4-F-{--G�-1-�--G-C�-k'-G-F-�'--�-h-0-�'-'+'-6-9-�C-�r-�-�--6-5-'�'C--�--'�' :�E-P-�-6�-c-ir-�:--$--8-fi=v�8�=v�i-0--'�-.;�6�u�-r=i--3-fl.-il�-F-F-a•-
<br /> � BUl1:DER ,�j ��� _.,` �_r COMPANY %1.J� t` - 'B%'J U,�'s"d`C�'.�`' �'1,''�,
<br /> ! SICaNATURE �� RE41STEfiEO Y/ N FEE GURRER Y/h3
<br /> I Address J���� 1'�f�'Cc'J .�"i .t� �"' �G'r}"� �"' License# ���-��`�4 �" ^�`• I
<br /> .�L.ECTAICIA[�! �`����c-,,�-,,...-�'�„�.-' CO1ViPANY �G'�,��"1�C�e�,.�iC�,�7 ��r=.=`'����(' �:
<br /> StGNATUR�, REGISTERED Y� N F.EE CURRER Y(fV
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<br /> Address s,��',��4J��r`��€� �r.� � F�� ' Llcense# �T_;-��,�,!{����1 ���
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<br /> PLUMHER ����.,.�'��,T,�,,,_.___.� COMPANY ' !`'' ��`�f7,�,!` . ..a��b�6'�,��,i�,'f.,� fi" ,��'dd�r�,?fi,� �
<br /> SiGNATURE REGlSTEftEp Y/ N FEE GURREP Y(fV
<br /> ' Address t'"'��C.�'i� F e1� � �t�ll�r+�' �, `f � �icense# ���'�+� ��.��� ,/��` �
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<br /> MECHANICAL �� COMPANY ��"�i(',.���'•Fr,�����' f= °'�f" � , ,%''T�fi7"r..J1�" +
<br /> SlGNA7`UR� f,.�'" ���`"�'�����-^""'"'"" "—`-'-'��REQIS7ERED Y�/ IV FEE GURRER Y i N
<br /> Address ���� �,�-�r^.�s�.� �� f�+��,.a�'''�rt/,�.1��.�,c�f� Llcense# ��������.�fi!.7 %` �
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<br /> OTHER . � .�S'+�:, -r---^,.--'- CQNlPANY �.�A��4"'� f!'��.v�t,��=.-rf ::._/,-f�(�"T°-��r�-�
<br /> 51GNATURE ����- � � REGISTERED Y I N FEE CURRE� Y I N f
<br /> Address !����l�t�+� '� ��A� �'����� License# � �
<br /> X t E i 1 i I t I 1 1 ► 1 i .l 1 1 1 1 ! � i 1 1 Q 1 1 [ ! ! a 1 I 1 8 a � 6 i I 9 I T I I 1 i G E ➢ .o Q i 0 I 9 B 8 9 9 1 0 8 9 1 9 i
<br /> RESlDENTlAL RttacYr{2) Piot Pians; (2)sets af Bui(ding Plans; {1)set of Energy Forms;R-O-W Permit.for new construction, ,
<br /> Minlmum ten(10)working days aiter submitta!date. Required onsite,Construckion Plans,Stormwater Pians w!Silt Fence installed,
<br /> 5anitary Facilitfes&1 dumpster;Site Work Permit for subdlvislons/large proJects
<br /> COMMERCIAL Attach (2) complete sefs of Building Plans plus a Llfe Safety Page; (1}set of Energy Forms. R-O-W Permit for new construc[ion.
<br /> . Mfnimurn ten(10)working days after submittai date. Required onsite,Construction Plans,Stormwater Plans w(Silt Fencs irystatVed,
<br /> Sanitary�acfiities&1 durnpster Slte Work Permit for all new proJeets.Ai(commerciai requirements rnust meet compliance
<br /> 51GN PERMiT Attach (2)sets of Engineered Plans.
<br /> � *"**PROPEft1Y'SURVEY required for aIi NEW constructlon.
<br /> -i-i-L-.b.-b-i-d-d..b--i-i-t--t-a.-�-�t-�-a-d-�*-1-�.-�.-a--s.-�.-�--b--�-&-r-�--B-B-.8-A-6.-8-.P.-G.-E-a..B--�--b.-9--�-&..k�-,t�-4-d1�0-e➢-��-@,.9�-A-A--0-Aeb..
<br /> dfrections: , �
<br /> FIII out applicatlon completely.
<br /> Qwner�Contractor sign back of application,notarized
<br /> 1f over$250D,a Notice of Commencemertt is required. (AJC upgrades over$7500) � � -
<br /> '* Agent(for tile co�traotor)or Power of Attarney(for the owner)wou(d be someone with notarized letter from awner authorizing same �
<br /> �VEfl TNE COUNTER PERMlT71NG (copy of contract reqvired}
<br /> 3eroafs If shingles Sewers ;iervice Upgrades A/C Fences(Plot(5urvey/Footage)
<br /> i Driveways-Not over Counter if on�ublic roadways,.ne�ds ROW �
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