|
s�3=7eso-oozo City of Zephyrhills Permit Application Fax s73.7$aao21
<br /> Building Department
<br /> Date Recelvad;,._,::..:: ..
<br /> PharteCantadtttorrmitttr 13 / S
<br /> Owner's Name 1-A&rvNo_i*CR S Owner:Phons .Numbr� .
<br /> ,
<br /> Y ..
<br /> -
<br /> Owr#ar s Address .
<br /> . . .: ...:. .. .:.
<br /> :.. ..::_.:.
<br /> Fee Simple"fl8eholdar Name Owner..Ph one.;Num6er
<br /> Fee SimP le TI e r .
<br /> tl
<br /> JOB-ADDRESS 37.w $Kv'eA�c rbrOb�. l n• L42hy r he %j �L 636 LOTS 8y
<br /> :.: ......:..:.'..
<br /> `
<br /> t• der► R,.v{r = z.y-2 - i of oo 0 6aav;�,;
<br /> SUBDIVISION ' . . PARCEL=:ID# U�1
<br /> '<oarAirlEo;>rto�Ira+RO!* r�Ncr:oace
<br /> WORK PROPOSED: _:;:,:a::.;"_-,44i1N Ct1N5Tit ;: ::
<br /> t. -
<br /> SIGN' -.. ;[ .•.::.. a :.,:..:[ ::. .:::::;QEMOLISH;
<br /> H �INSTALL:: �:r.,..
<br /> PROPOSED,,USE;` SFR" ``COMM::`."
<br /> 0 Q .. Q; .
<br /> :
<br /> TYPE OF CONSTRUCTION
<br /> ro
<br /> DESCRIPTION OF WORK' ,. ' �'In6}Q,�` F,yy�,lp5tAYG � t'.1fi>S{t C ;2Ck`INlfyl o y�rf.'s0/r�( 'F!O6
<br /> BUILDING SIZE F00�"�1®E HEIG
<br /> _: - .,
<br /> i kW
<br /> UiLDING S. q; ALUATION bF'TO`rAL-COl!i15TRUCTION `
<br /> [ u
<br /> !;.
<br /> -
<br /> ELECTRICAL::;::;;'.:: .: $': ,; :<:_:. :..;, .:::;:;.: ="AMPSERVIC)r'... _. :: PRQi3RlrSS;ENERGY C:`:
<br /> =PLUMBING -
<br /> 5 ':
<br /> ,
<br /> Z b
<br /> =MECHANICAL:; OF MECFfA[FICAI;ENSTAi LAT10t
<br /> GAs IooFrNa:m=. SPEC1ALiY`[ :;:..;':;.OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES•, , NO
<br /> ad*motile! a
<br /> -.
<br /> .. ., .. -. f.;;...
<br /> / '.>
<br /> BUILDER ' t,COMPAPiY`" a ('rrr rC�'I ~1 {u►Yl to
<br /> SIGNATURE �r REGISTERED'
<br /> Y/ N. FEE•CURRED Y-I.N''::"
<br /> Address Pa 2CIO "Cawn jL 331�'7:::: :.:: ::
<br /> copse
<br /> ELECTRiC :=,:':�. .. ....:.:... .. . .°�COMPANIr'', .°.,:.,...::.. :... ...:.; :.:..:..h,:: . - . . .:...
<br /> SIGNATURE " 4' REGISTERED YIN
<br /> Address
<br /> �Uaanse
<br /> ......:.,.
<br /> PLUMBER .COIIARAW`_..
<br /> SIGNATURE REGI:ikiERED.";" rY`/,�AN=::° FEECURREI�'' :Y/;N:
<br /> Address
<br /> ......., cans
<br /> MECtfANICAL... ..... ...:.. ... .:....,... _-.: -
<br /> COMPANX.
<br /> R
<br /> SIGNATU E
<br /> Address
<br /> - ;_-;license77-77.
<br /> #;
<br /> :may,
<br /> P
<br /> OTHER
<br /> , .Cif A�tit`<<
<br /> SIGNATURE.r ; . .:;..>.,' -.REGIStEHEq:::::r:.: ;: '.;Y/>N::z-> ':wFEE:CURRF,[� _
<br /> Address
<br /> .
<br /> ! t2
<br /> • „' r ctlo YtWOW =CwW;Pe 'tt`a a n
<br /> s €Id� -
<br /> R IDt:N �ati= ,,:` �f!1tis-2 -
<br /> ES � rrl)T1l _
<br /> Alta a
<br /> x
<br /> .,S
<br /> g3,
<br /> 'rl
<br /> r natal
<br /> Sto metert?lans='A1::31tt:Ei�i►ce-1 .:>
<br /> . ;_�'�:Mlntrrlun►; , s 10'tonoiit(n •. ys�afler3suk)rilttel�sit9,,.F��qull�ert ti1%ir�ICe;t3Ci�etnedtrail?ails... rm,., �!r _
<br /> ,: ,.:_..•_ ..�,.11rEan�.�.x)x»._._,y -
<br /> ? x _
<br /> -
<br /> SI .t•o L_ ii 04W #.Sant a ties" 011i`
<br /> �b3.:a�ser.s c��;.-_�a �- ., _ •T.s.:.... ........,a r ..: - - -- .;..,.: _ :. .
<br /> COMMERCIAL Attach(3)'compt+�te'sets 0 SaA�ing Plans plus a'Life Safety Page;{I)sat of Energy Forms.R-O-W Per far new conslrudlon
<br /> • Minimum:ten(10),working days aftersubmittal date. Required gslte,,_Constructlon Plans,Stor'mwater'Plans w/S[ItFence Instdlled,
<br /> ;;•
<br /> so-
<br /> San Facltides,&:.4.dW..n .
<br /> S1te.Work,PemtltforrallctsAll cornmerciat taqu[remertis must meet compliance: _ .
<br /> _.., ......�... ....,.: .-�..:. _ ram,. ,...:.:....
<br /> SIGN PERINiT, Attach 2 sets of Eng Itpered Plans 3. r
<br /> ( ) .
<br /> :..
<br /> �:..:. ..
<br /> _.,,hem
<br /> A
<br /> ro.
<br /> ....
<br /> E 'Can aU n:.
<br /> PROPERTY SURNE reld.< W
<br /> •
<br /> : .,........e.ar.tw ...8 .- ,..,?"7,...czh:..'n,..,.,u: ...,..,�..Y:: ,..:a.y, "95:::. ?-•?'.>h _
<br /> FIII:ouCapplicatlon completely.
<br /> Owner.&.Contractor-sign;back-of application,notarized
<br /> If ever'$2500i.e Note ort;Comrmencem®nt is rctquired. (AIC upgradee'ov r 7500)s•-R..
<br /> .. _
<br /> Agent(for tiffs.contractor)'Or.'Poiarer Of Attorney(fdithe owner)would.be someone with notarized letter from owner authorizing same
<br /> OVE Beware_ ..... Sen+loe.0 Upgrades', °n'O�iiy)
<br /> R THE CpUNT,SR`PERCVtiTTiNG�`":-. �Froht"of•`�pltcatl
<br /> Reroafs:�tshingles pg ,.AlG; r"enges_(Piot/SurveyLFootage)
<br /> Driveways-Not over Counter If on public roadweys::aeeds ROW
<br />
|