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sas-7sa-ooza City of Zephyrhills Permit�,�pptication ~ Fax 843-780-0021
<br /> • Building Department
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<br /> Date Recei�C�d.• -�
<br /> �Phone Contactfor Permitting �
<br /> Owner's Name N /rP'rTl�'" O�rner Phone Number 'I
<br /> Owner's Address t9's� L�Lb/L'���d� �� Qwner Phone Number � � (
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<br /> Fee Simpte`fittehotder Name �� T� Owner Phone Number �- I �
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<br /> Fee Simpie Titlehotder Address
<br /> Jos auo�i�SS �S� 1�f��'?'GrJ�� 1,��- LOT# �
<br /> su�o�v�sio� �.5'tLrlG-1L- ���� � PARCEG 1D# !�7 '•L �/--�!1���' P���al�----��
<br /> f (OBTAINED_FROMPROPERTYTAXNOTICE7 �
<br /> WORK PRCIPQSED . NEW-CQNSTR AQQ%AL.T Q SIGfV �Q � Q DEMOLISH
<br /> e INSTALG 8 'REPAIR '
<br /> PROPOSED:USE Q SFR Q GOMM � OTHER `
<br /> TYPE`.OF COi�S'f12liC'i10N ��BLOCK • Q �FRAME � STEEL Q
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<br /> DESCFt1P�ON OF WORK 1� �B�x t�/l��i� �' ��' � 5����'� �
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<br /> BUli�1?ING�B}ZE � � SQ FOOTAGE��' HEiGHT �� �
<br /> QBUlLDING $ !`��� �"� VALUATtON'OF Tt7TAL CONSTRtlGTION
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<br /> �ELECTftICAI� $ , AiUlP BERV{CE Q Pf�O�RESS ENEFtGY Q W.R.E.C.
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<br /> OPLUMBING ($ ��� � ��
<br /> ' �"� � �
<br /> MECHANICAL $ VALUATION OF MEGHANlGAL INSTA�LATlQN �
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<br /> QGAS �pOFING Q SPECIAl.TY � OTHER _
<br /> FINISHED FLOOR ELEVATtONS �� FLOOD ZONE AREA QXES NO
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<br /> BUILDER � COlIRPANY
<br /> SiGNATURE REGISTEREp Y/ N FEE CURREn Y/N
<br /> � Address �Zicense# �� ���
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<br /> ;..-`'fLEC,,TEi(GIAN , CLitU1PANY •
<br /> �-:;.�SiGNAYtJRE REGISTEREp Y/ N �Fee CURRen Y/N.
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<br /> r �t��$SS u �
<br /> ` License# �� '
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<br /> ..y�RI�UM.BEtt,i., . . 'C014tIPANY�
<br /> , SIGNATURf� � " �Gls7erteo Y/ N, � FEE CURRE� X/N"
<br /> " Acldress - - �Licerise# � ��
<br /> '�:..`MECNANIGAl::�. - � ' COMFANY , -
<br /> `'�"SIGNATURE '" '±�" ' � •• REGISTERED , Y/ N FEE CURRE� .'. Y/N : �
<br /> aaa��ss.r> _ - � .. . , �ice►,S�# � �.
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<br /> oT�r��t:�. :_�: :�_ ��v� ` =coMFar+nr - ��rl�nJ /�f�D�i,r1G ,
<br /> �A;''SIGNATURE�;��:}: .-t; : ` REGISTERED ` . Y/.N FEE CURREK Y/N k
<br /> ' �at�s1.' -_- �.Q�:�Q`�._.�:�;�..�:b._3: �-���� �,' _}.: � . =« � �,m������
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<br /> ''�::REsi�ii��tt�►t::� �;atta��z.x��ot=P - - �.,,. - � . . . ,
<br /> { L , �,; _(_}, ,!..<lans;�{2).�efs�of'�Buiteling�?lans:(1}`setof�Energy'.Fqr'rris;R=�1�1t Peircil#for.�neuv:const�uctian,.
<br /> {.: �.. i_ . . . . . . . ' h ..•,r
<br /> �;,. ., --�:=•a-�ry`};��,�,��Minimum;.ten:(=10);�vo�king;rdays:aftetsutir,"riitta'I:date:�>Requiretl'onsite;�Construction'Plans;StoririwaterPl.answ/S(ItFence_installed,
<br /> � ..: � ���� Sanit�ryMFac�lities�&3�dumpst�r;�S[te WA�lcFermlGfor�si�bdivis'ions/large;pro]ects:; ,- '�:'• ., • � , � ' �
<br /> � GOMNIERGfAL Attach={2�•cd�ptete`se#s of�Bullding Plans ptus a`I:ife Safety�Page;{1}set of Energy Farms.F2-Ct-W Permit farnew canstrue�oh.
<br /> `^�` Minimum t�n(10)working days after submittal date. Required onsite,Construckian Plans,Storrnwater Plans w/Silt Fence.insta,lled,
<br /> ��"�`� Sanitary Facilides&1 dumpster,Site Work Permit fo�•aU,ne'w.�piojects.A!!commeeciai requirements must meet campliance
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<br /> ��;SIGN;PERNtiT 'Attac�i-{2}sefs,of Eiigliaeer,,ei3;Plans:;t= _��. " ,t •�- .
<br /> � "•""PROPERl'Y SUFtVEIf reguired,for.all,NEW construction..
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<br /> `°:Dicect3oos: . �:<,.;;;•.-,;
<br /> ' ' � FUliout•application completely.�
<br /> F.`=. Qwner&GanVactar.sign:back of appAcation,notariiad
<br /> � �;�`� tf over:$2500;_a l�btice.of:Gommencement is requirad. {A!C upgradas over$7500j
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<br /> i';Yy- >i4gent�(for`the'�contractor)�or Power of•Attomey`(fo�'tFie owner)wauld'tie someone with natarized letter from owner authorizing same
<br /> � ;�i01lER�:TFlE�COtJNTERlP,�RM(iT1_NG,...._. {c:opy af-:coniract:reguired) � , ..
<br /> r�Re�oofs�if;sfiingles M 'Sewers Service Upgrades A/C Fences(Plot/Survey/Foo#age)
<br /> ` "DciVeways-Not over Gounter if on publicrvroadways..neeiis�RO1N } �
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