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813r780-0021? City of Zephyrhills Permit Application -- -
<br /> `�Fax-813-780-0021- � �
<br /> Buflding Depariment �
<br /> Date Recelved :; Phone=Confaat-far�Perm[ttin
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<br /> Owner"s Name W� .�I � f {� Owner Phone Number �(/ - ! ry�/��
<br /> Owner's Address t / I � l,-�U� Z y" 3 ��'� Owner Phone Number .�� �
<br /> Fee Slmple Tt#Ieholder Name Y • Owner Phone Number '� , �
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<br /> Fee Slmple Tltleholder Address �
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<br /> J08 ADDRESS iv A � Vl Z( 1� r!���j t� � � �� LOT# C��
<br /> sue�Ev�s�o� ; r� �Zr �l;J PbRc��.�a� � '�-� ",� ' ,� J G'�/��.�P11 � �
<br /> j (08TAINED F,ROM PROPERLY,TAX NOTICE)
<br /> WORK FRQPOSED �_NEW CONSTR ADDIA�T � SIGN "Q, Q pEMOE.lSH
<br /> , , e. INSTAI:I, 8 � REPAIR
<br /> PltOPQSED:USE Q SER Q COMNI� [� OTHER '
<br /> TYPE OF CONSTRUCTiON CJ BLOCK " [� FRAME � STEEL �Q
<br /> DESCRIPTION OF WORK- µ l_ U 1 �/1 O �1 1/ ��/t � 1�J t'l C� / Z..('n.N /Jil�f7 l� �1� ,
<br /> BUI�.DlA1G SlZE + SQ�FOOTAGE� .NfIGFiT �E�� . -_
<br /> QBGtl.I}ING � � VAU:IRTIOi�l:�F`'f01'AL CON3TF2UC`i'ION � '
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<br /> QECECTRIGAL $ ' ANIP SEt2ViCE �'Q Q UV:R.E.G.
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<br /> �Pl�.UMBING� :(y>���� ' � .
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<br /> �]MEGHANICAL �;,� ' „ VALIJATION C1FiNlECHANICAL IIdSTALLATlON
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<br /> [�GAS [� ROOFlNG Q 3PEGIAL'TY.[�� � ,,,OTHER� -
<br /> FINtSHED FLOOR EI.EVATIQNS r FI.00D,�ONE AREA QYES. NO . ��
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<br /> -eua����r -� ca�nP��t+nr�� � � � , � .
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N .
<br /> Acldreas � ' Gicense#`� i��
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<br /> EIECTRIGlAl+1. .. , , ` �C�ENN�AidY � .
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' -Y/N .
<br /> AtSdrBSs � . � �1.tC8ASB'#.� ��
<br /> � PLUMBER ; ..COl4�p.,AN,Y�„; , _ � � � � ---
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<br /> SIGNA'TURE' � " ' _�. •_,;REGIS'fERED , �Y/..N�� •--.�:�•FEE CURRE� . Y�/N.
<br /> Addre�s . _., • I.�cense.#`� -�. ��.
<br /> MECHANtG�1l: �� �J1��,r� CONt,PANY ._ l)/!f1Vw f �J(.(J�! 1�3a Cq7'r'� (";
<br /> StGNATURE t� i �f REGISTERED_., , Y�/ N. . FEE,CURRE�: „Y W
<br /> Addre�s� '� 1 �� t�G- �� �, /�'`1 �,� 'j`` � Lioense#� �. _�V� I ���
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<br /> OTHER ; - - , . �';CO[VIPANY, " ,- '
<br /> StGNATURE ' ` ' � ' REGISfERED , ;' "Y J N..� 'FEE CURRE� Y/N
<br /> I. 14ddress - - ' ' . _ - ' ' Gceiise# � ' � _ ,
<br /> r ., � - :. .�,.:: ... ; .
<br /> REStQENTtAi:.; Attacti'(2)�Plot�P,lan's;:(2)sets_of�Buildf'ng'Plans;'(1)set af'Energy�Fa'rins;Ft-O=W':PemilE for a'sw const;rr�tian, '
<br /> � - •-Mlnimum:ten;(10};woricing;days:after„subiniftai date.:'itequiretl ohsite�EonstiucHori`Flans,Stortnwate'r Pians°w/Sitt°Fence instatieil,
<br /> ,`r� Sanf�ary Facilftles;&:1,dumpsterlSite;Work:.P,,ermit,forsubtliv_lsionS/large<pro)ects�' -` � � - ` '
<br /> COM4AERClAl. _,Attach{3}�compfete�se4's of'BufSiltng"Pians'plus a L.ffe Sat'ety Page;{1}set cf Energy Fosms.R Q-W Permit for new construcHon.
<br /> 1 � � `` ` Minimum#en(10}working days after submltMal date. Required onsite,Constructlon Plane,Stormwater P1ans w!Siit Fence lnstal�ed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new.,projects:All commercial requlrements,muat meet campllance
<br /> S1GN PERMIT AttacFi{2)�sets df Engirie9red.Pians:. : . � ,- - � .
<br /> •"`PROPERTY SURVEY reGuired for_ali.,NEVV canstrucUon. ,_
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<br /> �� Dlreettons: . , . -`
<br /> ' FIII out applicallon wmpletely.
<br /> Owner&Contractor sign back of appllcatlan,noNadzed
<br /> If over�2500,a Notice af Comms�camen!1s rsqulred. {A!C aggrades over�T500)
<br /> Agent(for tfie contrac� �rv
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<br /> '" tor)or Powe�.of'Attbiney'(far tFie awner)�would be someone with natarized letter from owner autharizing same
<br /> �YER TME Ct}UNTER.PEEtMIT'fiNG - (Front af-ARPltcatfon�Oniy}_° � -
<br /> Reroofs If shingles Sewers Service Upgrades A/G -Fences(PIoUSurvey/Footage) .
<br /> � Driveways-fVot over Counter if on public roadways..iteed's ROW - - ' .
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