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���-78o-ao2o City of Zephyrhills Permit AppEication Faic 893-7$0-0021
<br /> • . Building Department :��„
<br /> Date Received � :p�one Contact(for Permltttng r �:?I ✓ �T V �
<br /> Owner's Naroe � 1���'-�c..a' Orwner Phone Plumber ���J 7 �Q �d (
<br /> Owiners Aildress �3�� \ Y ' � Owner Phone Number � �
<br /> Pee Simpte Tttlefiotder Name�- � Ovirner Phone Number � �
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<br /> Fee Slmple Titleholder Address -
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<br /> JOB ADDRESS ��� � � 1 � �� LQY# �_�
<br /> SUBDIVtS10Pt � � PARCEL-ID# �1—F�S—��---8�3� "''�L?d�� ^'� LI
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<br /> (OBTAINED FRQM PROPERTY,TAX NOTICE) �
<br /> W4RK PRCIPOSED e ,. N�W.CONSTR°8 ADDtA�.T Q StGN �Q � Q DEMC?LISH
<br /> ' INSTALL REPAIR
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<br /> PRQPOSEp'USE. `� SFR Q "GONIM ��' OTHER
<br /> TYPE`OF CONSTRIJCTION Q • BLOCK • [� T FF2AME �. STEEL Q
<br /> dESCRIFTION OF WORIC M^ D �� 1C�—C�� �� t'�� � C� C d� .
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<br /> B�11Gt}IPIG S1ZE � � 9Q'FOCITAGE I� . .HE[fiaHT •�� �
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<br /> BUILQING $ �5--�� �" VALUATION`OF TOTA�Ct3RIS7RklGT.IQN
<br /> �ELEGTRICAL �� ANtP SERVICE � P120GFtESS ENERGY Q W.R.E.C.
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<br /> QPLUMBING � � �
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<br /> OMECHANICa4L $ VAIUATlOfV QF MEGHANICAL INSTALLATION
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<br /> Q;CAS Q. ROOFING �_ 3PECIA�TY � QTHER
<br /> FINISHED FL.00R ELEVi4TIONS ��� FLOOD ZONE AREA QYES NO
<br /> BUIi.DER . COMPANY ,
<br /> SIGNATURE REGISTEREQ Y/ N FEe cuw�n Y/N
<br /> Address _�License# + �
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<br /> .'.° ���cr�i.c..�at� coM�aMr
<br /> �:;..SIGNiATURE REGISTERED Y/ N • �FEE%CURRE� ' Y/N.
<br /> Adclress ' - '„
<br /> License# � �
<br /> , � P,E:UMBE,fi;; . 'CG?I�JPANY"
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<br /> �SIGNATURE'� '' ` -REGISTERED Y/ N: � ,FEE CURRE� Y/N "
<br /> � � Address - License# �— ��
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<br /> ::'MECliANtGAl:� ., . ' COMPAt�iY
<br /> "'SIGNA'PURE'° � � REGISTERED , , Y/. N Fee:cuw�en . .Y/N
<br /> Aiiii�ess�,�= - ' - u • r License.# � �.
<br /> ; ,.om�a=L�. 1�-.. : t � -�coM��ar " � jl'?t�t.�...'.� S � � .
<br /> ";'SIGNATURE::,,.� :� � , .- ' � REGISTERED' Y/,N FEE-CURREA' Y/N
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<br /> Xitdress. �":>,.,'A� ,� i�� ,�v�'2 .'�`.+`lt3 Licerise# ��� ✓�
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<br /> �,�;RESIDENTIAl::r >i4::.�.��= _ -,�:, , . . _ .
<br /> E_ � m���, .v:;.�Attach�{2,};FlatiPlans_2�"'sefs'of�8ultd[n �Plans� '!� setof�Ener �For'iris;sR`-.0,=:t1VPermit,fqr-new.constivct�on,.
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<br /> �;,,,_ -���::,,,-;�,�,;-t�;F�:;Minimwm,ten;(;10)Y'v`y,.;r,_;;,g,'' ys;afte�''si�itimitt`al�clate:`:Requiretl'on§Ite;�"Co�istructiori�Plarf's,'Sto`rnnwaterPlanswPSfltFenceinstalled;
<br /> �:�.f.5-rt_.. '_� .. . ^ Sanitary,Fac�l�6es&�i dumpster48{te,Work Permit-for�siabdiirls'iansBarge projects � `" _". �._ - � .. .
<br /> ..C.ONIMEi�ClAl. Attach'(2)coriipiete�"sets of'8uililing Plans ptus a Cife Safetj+�Page;{1}sef of Energy Farms.R-O W Permit for new canstrucfion.
<br /> �-"�'_" - Minimum ten(10)working days after submittal dake. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.installed,
<br /> �'�'.., - Sanitary Facilities&1-dumpster.Site Wotk Parmit fo�a8=new�piojects.A!i commerclai requirements must meet comptiance
<br /> G��SfGN.PER�fIiT "i4ttaeli-{�)sefs;�of;Engineered;Plans:;?.._:.., � � . . � '
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<br /> r'`�"'��' "`""PRORERTY SURVEY re wred.,for aII,NEW constructipn._
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<br /> �^�Directliiiis: �r�;s:._, ... ,��:F=�.. ,__ . _. ..
<br /> '`""���'Fill':out�applicatlon completely. ,
<br /> 'r';`�. Owner'&-Gantractocsign.back of appllcation,notariied
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<br /> �� °If ovec.$2Sd0;_a Notice af:Gommencement is required. (A/C upgrades over$750Q)
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<br /> ..���� AgenY(fdr`�ttie'�conbracto�)°pr.Power•ofAttomey(for the owner)wauld lie someone with natarized letter from owner autharizing sarne
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<br /> ,,,QV.ER;;i'EtE CQUNTER;'P�RMITTIN.t'a;. _.,� ;..(capy..of<cantraek:reqwlred) `
<br /> '�Re�vofs�if:sti(ngles Sewers . 'Service Upgrades A/C Fences.(PIoUSurvey/Footage) „
<br /> � DYlveways-IVot over Counterif on pubiic;roadways::neeiis�ROW ,' �
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