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s��-�so-aaza City of Zephyrhiils Pet�nit AppEication Fax-$13-780•0021
<br /> • Building Department _�-..-�----~~- 'i t��1 `� / ��.
<br /> Date Received � )� ^
<br /> �' .,� �Phone Contack�:for Permi n 1 � " � � - �,.��
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<br /> Owner's Plame ��`'.y �� 7"�� Owrner Phone Plumber �l - l�,.S�." � ,
<br /> Owiner's Address 4'.l �Gr"(� l'G:. Own ,
<br /> Fee 5imple Tit(ehotder Fiame�� � Ovi►ner Phone Number
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<br /> Fee Simple Titlehoider Address
<br />' J08 ADDRESS t'}�� G3'� � lQT# �
<br /> SUBt�IVtS10N ��t{1 �t'c5��57Tr 2S .PARCEk ID# C'��'� +3�-_ " � �`t�t?�" ��
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WOI2K PROP!QSED NEW CONSTR:. ADDIAI.T Q SIGIV •Q � Q DEMOl:ISH
<br /> � INSTALL. 8 -REPAiR �
<br />� PRORQSED:USE ��' SFR Q GOIVlM � OTHER
<br />� TYPE`OF COWS'iRUCTION [�` BLOCK • Q FRAME [� STEEL Q.
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<br /> DESCRlPTI01�1 OF WORK � ��t.�.� � �1 r� , i �-- ,�c��
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<br /> BtIt1:ClI�IG SIZE � � SQ FOC?`TAGE . ��� HEt�HT -
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<br /> Og��l���� � � ' �y�y VA�UAT10�'OF TOTAL CONSTRtJCZiON
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<br />' �E��CTRlCA,� $ j�y{-}-^C� AiVIP SERVICE Q PROGRE3S ENERGY Q W.R.E.G.
<br /> Qt?LUN161NG �> � . �� -1l �
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<br /> �NlECHANICAL � M � VALUATION QF MECHANICAL.lt4STALLf�TIQN ����
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<br /> QrCu0.S Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED F'LOOR ELEVATIONS � FLOOD ZOIVE AREA QYES NO
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<br /> � ;SUSI.DER ; �"��" �_. �' �' CtOMPANY C��- l�n `.^ Cy .S .S
<br /> SIGNATURB �— REGISTERED Y�/ N . FeE CURrtEn � Y/N. . (
<br /> � Address 7 /tJ, �tr(e �r���f u G�� ��or f� -i.ieense# C�G E?37n ���� �
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<br /> :�ELECTEtIC#� � `�` �C 141PANY _ tC' aft4 e,_.f'Uj~G.�'�' I
<br /> :.'M4'SIGNATURE ''�� REGISTERED Y/ N FEE"CURREA ' Y/N_
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<br /> '�" Address ���`'�� .� �'��lJ,i.'. ..�3 iicense# ��.3D4�f 3�`s''""�, '
<br /> PCUMBEFt.�; , ��iti�PANY� �--ylc�(Ic;� � �t.�
<br /> ,'`�SIGN�TUI�E ' � REGISTERED Y•/ N • FEE CURRE� Y/N
<br /> � Rdd�e�s � � co! �Q��i � /� '�3�'/''' �icerise#� �G�57� �l�LS ' �
<br /> {:"MECHAtdIGAI: . � C{}MPAN1l,
<br /> `,�"SIGNATURE� ' - � ' " REGISTERED , , Y I N FeE cuw�n , Y/N .
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<br /> ''� Ait�`ress£X' =`� ` � Licens,e.# �-� � ��
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<br /> �;OTNER'=._",t.�: , � . COM FANY
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<br /> ,�;.,SIGNA+,;URE[t.�r>� :s -t'>n, �< � - - ' REGISTERED ` . Y I.N FEE-CURREK Y/N
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<br /> �, ,�ddress;v - -�� xk':M - ' ,�` '?� . -License#
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<br /> �-:RESlD #, { _�:-€::.=: .:. ,
<br /> �TFAI:; SAttar�i�{2�FP.,Iot:.P..,lans;x'�2�sets�of�Biiililliig:F?laiis;('I)=setof��Enecgyr$Fpr'irms;•;R`Q=l1V Peririltfqr.°navir,cdn"sttuction,.
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<br /> -;�:=.:A;�Y°��-,?,�.f�,c-itMinimum!�t,e.,nr(10,);i�ko;�king�'iiays:afte��'"s,utii'tiittal:tlate:��Required`onsite;Construction Pla'ns,Stocmwater�Plans w/ tlt Fenc, ms#al e,,
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<br /> ':;;�4: " " Sariitaejr;Facil.�,ties�&,�IR,duttipster,Sit��WarlePermlt•for.;;st�bdivistons/large;pioJects :�.``' .. ._.. - -, .; . --
<br /> �N'GO}�MERCIAL Attacti��2)'completessets of'Bultdtng P�ans pltis a Life 8afefy`Page;{1)sef of E�iergy Farms.R O-W Permit for'new construoUon.
<br /> ���`��=��L . Mlnimum ten(10)working days afker submittal date. Required ansite,Construction Plans,Storrnwater Plans w/Silt Fence.installed,,
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<br /> F��- Sanitary�Eacillties&=1 dumpster;Site Wotk PeRnit'€oTaih`neKr:proj+ects.Ail commeecial requirements mtast r�eet compi3ance -
<br /> �;�-;$i,GN.PERIVIIT 'Pittacli(2)sets�ijf;�ngineereci,Plans;at,�:s;�, .:. �_ ,`�� •� � � ` �
<br /> '`"� PROR'ERTY$URVEY,re uired for.all,„NEW g6nstruction.>
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<br /> �;;Di�ectlons: �. {;,,;���A;; .,.
<br /> `t'�' '���^Fill,:out�application completely.
<br /> ?% � Ouvner'&Contractorstgn back of apptication,natarized
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<br /> if over'$2500;.a N.otice•.bf:Commencement is required. (A/C upgrades over$750Q)
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<br /> .,,..�..Ag�nk�(for�the�con'tractor)�or-�Power•of�Altomey(for the owne�)waulcJ�tie'sarrieone with notarized lekter from owner autharizing same
<br /> �;O`V.ER:,TFIE`CQUN�ER„;P�RMIT;TiNGM_;,: ....(copy..of contract=reyuired) ""`' ' `:
<br /> '.=:.'Reroofs',if'sFi�ingles � Sewrers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> •�S.LaPn..:;sv.,��;w:r:t��Se*faJ+'+s;a.,:'i^: ' ,,*,' • ' _
<br /> D'rtveways-Not over Counterif on�public`roaduvays.:needs R01N"��-�"�"""- "�'
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