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"''''Aug. 26. 2009 ` 3 :19PNi' `BATES ELECTRICLui n, r .A na. 01J- sou -uutl No. 5458 P. 1'1 /uul <br /> 013- 78o -002o D D 2 gi City of Zephyrhills Permit Application Fax -813.7e0 -0021 <br /> x'' j 1 3 .5 Building Department <br /> • Date ReGeiVed 5 '. ' b phone Contact for Permli I I 1 <br /> •.•• _ H'ffli'I't it TtF', • iLMF. JS3!,tttM h.CICL4.I <br /> 1 <br /> Owners Name ,r • ' . r .. A j Owner rI•oric Numb ,r __I <br /> Owners Address 1 Owner Phone Number [ • Fre Simple Titleholder Names 1 Owner Phone Number 1 ' • <br /> Fee Simple Titleholder Address I • <br /> JOB ADDRESS 1 - '7 7X O. . i .W ^. - - - I. .LOT* [--- _ — I <br /> • SUBDIVISION ' . ( . PARCEL IDYL I. <br /> . .. . (OBTAINED PROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED . NEW CONSTR ADD/ALT . SIGN MOVE • Q DEMOLISH • <br /> I INSTALL • ':REPAIR . , <br /> PROPOSED USE ' . FT SFR - . 1 • i COMM = OTHER 1 i <br /> TYPE OF CONSTRUL T ONt • r' BLOCK : F ' FRAME. ' . I i • STEEL u ' 'OTHER { - • 1 <br /> DESCRIPTION OF WORK 'I • • _ <br /> AUILDIN ems I I gQ FOOTAGE [ I HEIGHT I.. 1 <br /> [] BUILDING $ VALUATION OF TOTAL CONSTRUCTION ' <br /> Q ELECTRICAL $ AMP SERVICE r PROGRESS ENERGY Q W,R.E.C, <br /> r PLUMBING I$ 1 6 -M/m / <br /> Q . MECHANICAL *$ VALUATION OF MECHANICAL INSTALLATION • , , . <br /> Q GAS Q ROOFING n SPECIALTY 'OTHER <br /> FINISHED FLOOR ELEVATIONS I . • FLOOD ZONE AREA J r1NO <br /> • <br /> BUILDER COMPANY <br /> SIGNATURE RECISIeRED I . J' Y/ N 1 FEE CURRENT i ll/ N 1 I <br /> Address 1 . • . . License Y EA <br /> ' _ I - _ - • 1 1 / �/ <br /> / ELECTpIcIAN �� / / �/ Q PILr!Y ® D 12.5 L \ f i- A ok �0 ! <br /> ( SIGNATURE ..,,14.1P pam •rEECUMEN ' • T - t ( ' <br /> \\ Addr -, , a, • iW �r ll Ucense0 • [t ~ <br /> -- Cad 1 bg i ' f <br /> • <br /> , PLUMBER , . •COMPANY 1 1 <br /> SIGNATURE REGISTERED 1 Y/ N i TEE CURRENT 1 Y/ 1' <br /> Address I Eleanor it i i <br /> MECHANICAL 1 COMPANY I - - - — w J • <br /> SIGNATURE REGISTERED ' 1 • Y / N j' • . 'F¢ ' •J . Y / N , 1 , <br /> Address :.Ucense#' 1 <br /> OTHER COMPANY <br /> SIGNATURE. , iu= clsTeMED 1 Y/ N 1 Feicunemrr 1 Y/ N J <br /> Address I ] - L lcense fi I <br /> ' • . • VP T.rft! g rlrlgT -ITT TIT1Stozr7LII LIT it T <br /> RESIDENTIAL . Attach (2) Plot Plane; (2) sets of Buiding Plans; (1) set of Energy Fonts: R -O -W PCnnlr Io new con ^Mlol '\, <br /> Minimum kin (TO) Working days efter submittal date- Requred onsne, Construction Plane, Stonnweter Plane w/ Sill Pence installed, <br /> • • Sanitary FadNties & 1 dumpster; SIbt Work Permit for subdlvtsions/large projects <br /> COMMERCIAL Altaoh (3) complete sets of Building Piens pip a Life Safely Page; (1)set of Energy Forms. R-O -W Permit for new construction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fenos Installed, <br /> Sanitary Facltities & 1 dumpeter. Site Work Permit for all new projects. AO commercial requirements must meet <br /> 910N PERMIT . Attach (2) sets of Engineered PIsne _ <br /> 'PROPERTY SURVEY requirod fur all NEW construction. ' <br /> Directions: . • <br /> Fill out application completely. • • • <br /> Owner.& Conoacior sign be of application. notarized <br /> If over 52600, a Notice of ¢ommenoemenl is required, (NC upgrades over 56000) . • ' • <br /> " Agent (for the cgnlredor) or Power of Attorney (for the owner) would be someone with notarized leper from owner authorizing same • <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service .Upgrades A/C Fences(PlotSurvey /Footage) ,. i . . <br /> • OHvrweys - Noe ever Counter Ir on pursue roaaweye. ROW _ • <br /> • <br /> 1 <br />