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813-780-0°2° City of Zephyrhills Permit Application Fax-87&780-0021 �� (��
<br /> Buildinp Departrnent ^ �I
<br /> �' 1�
<br /> � ' Date Received — Z Phone Contact for Permidin ' J Ip — 0 0 p N � J
<br /> TTr1-r rr-r �j�
<br /> Ownera Name �ln r1 e �10U Owner Phone Number �.3� 39�`S7/
<br /> Owners Address J 1[ ,d� u19 (� Owner Phone Number J 7��y�O '�.�J
<br /> Fee Simple Tltleholder Name Owner Phone Number �-�
<br /> Fee Simple Titleholder Address -�
<br /> JOB ADDRESS O �G� C�.Jw �D l�� e � ^h 1 I �3S�e2 LOT S ��
<br /> susoms�oN " C H 'd PARCEL IDM 0 3-a la' a I- 013�- o��- p�7 V
<br /> (087A1lED FROM PROPERIY TAX NOTCE)
<br /> WORK PROAOSED B NEW CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR � COMM Q OTHER —�
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q �--, S'C,(�/,I'�
<br /> DESCRIPTION OF WORK IV w 1 n �d Co�c1�{t �;n��,,� �l ��k oZ� � ��
<br /> BUILDINGSIZE __.. .S4F09TAGE� HEIGHT �
<br /> QBUILDING J J S ''1'`�� VALU9TKffl OF TOTAL CONSTRUCTION �
<br /> °� _ __ ��l 7����
<br /> QELECTRfCAt '- - AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> / � .
<br /> QPIUMBING s � ,\��.� �C
<br /> r' `��
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALtATION
<br /> ��\ �- �� � �
<br /> Q OTHER V ��/;( `, � �
<br /> QGAS Q ROOFING Q SPECIALTY \1'�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � � '�
<br /> BUILDER \Cj� •�OMPANY• • SG • • OlJ7� •PW� CJ'C+fi�i�I?G
<br /> SIGNATURE �c,�S7ERED Y N �cu�� Y/N �� ' I ;
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<br /> ,�d� t as� a �' n� ,�I 3� o ��,�� ��asas.�Y9 �����
<br /> SIGNA�TURE� � ` � rtECM�D Y/ N �CA.I�C.tY/J'(ZtN J V1S
<br /> Address or-f �C License# � p
<br /> PLUMBER y��, � C�OMS�D p��{t.�µ+�^ P�7O�C�^lhwi /rYl.(�
<br /> SIGNATURE v
<br /> naa,.� /'/zs Kq nn ,�► �G a t;c�,�s (�.P�55K9.3,S
<br /> MECHANICAL COMPANY ��3i g�.
<br /> SIGNATURE r�c,�s�t�o Y/ N F�curx�� Y/N
<br /> Address n License i� �—� �
<br /> �a, �����t �NCt
<br /> OTHER ,�f,� � COMPANY �c.FJefr /nwNf711AM g SCJ�/��� ' �
<br /> SIGNATURE �'^""' rx�S�p Y/ N F�cur�n Y/N � /�/
<br /> � TCiI•.�
<br /> �d�g �� ��aA � �, �►� 3�� ��,�� s�o��ns� ������
<br /> , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Y
<br /> RESIDENTIAL Attach(2)Pbt Plans:(2)seLS of BuiWing P�ns:(1)set of Energy Fortns:R-0-W PermR for new canshuclion, � �, �,�(�
<br /> Minimum ten(10)working days after submit[al date. Required onsite,Construction Plans,Sto�mwater Plans v�d SiR Fence installed, �g /�GV" —/�
<br /> o mwa �d
<br /> Sanitary Facilides&1 dumpster;Site WoAc PermR fa subdivisions/large projects �` , O,\ _J/
<br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sefety Page;(1)set of Energy Forms.R-O-W Pertnit fa new conshuc6on. UT�E,C.� l���
<br /> Minimum ten(10)Harking days after s�miVel date. Required onsite.ConsUVdion Plans,Stormweter Plans w/SiR Fence installed, _( �
<br /> Sanitary Faali0e5 8 1 dumpster.Site Work Pertnit for all new projects.AII commercial requiremeMs must meet oompliance ��e T
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans. �
<br /> ""PROPER7Y SURVEY required for afl NEW conshudion. ����—'
<br /> Dvectlons.•
<br /> Fill out applicaGon completely.
<br /> Owner&Contractor sign badc of application,notarized �-
<br /> If over s2500.a Noflce ot Commencement is required. (AIC upgrades over 57500) I���,� �� r����
<br /> " Age�t(for the co�tractw)or Power of Attomey(for the owner would be someone with notarized letter fiom owner aulhoriang same .�,
<br /> OVER THE COUNTER PERMITTING (Front of Application Ony) y� '`
<br /> RerooTS'rf shingles Sewers Service Upgrades A!C Fe�ces(PbUSurvey/FootaOe) ��� '1 �� "'
<br /> Driveways-Not over Counter'rf on public roadways..needs ROW 1
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