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eis-�eo•oozo City of Zephyrhills Permit Application Fax•813-780-0021 <br /> ��_ Bui�ing Oepnrlment <br /> Dale Rscaivad _ - <br /> t � ' , ' ' ' , Phon�Contact tor Perm'tt,np, 9 7 9 7�,Tz ._ 3 5 2 9 <br /> � <br /> erc ants Station LLC <br /> f?wn�r'a Nam� Ownsr Phona Number <br /> Ownar'a Address / Owner Phons Numbe� � <br /> Fea Slmple Titlaholdar Nama � Ownsr Phon�Numbar � <br /> Fae S�mpla TItlsAotder Addross � <br /> ---, �, . . � C� <br /> J08 A�DRESS � LOTN <br /> SUBDIYlS10N PARCEL tblf � <br /> �OBTAl11E0 FROM PNOPERTY TA7[NOTIGE� <br /> WORK PROPQSED e NEW CONSTN 8 AODlALT � SIGN Q Q OEMOLISH <br /> INSTALL REPAIR <br /> PROPO8EDUSE Q SfR O COMM �� OTHER � <br /> TYPE OF CONSTRUCTION Q BIOCK O FRAME Q STEEL Q �-� <br /> Z ._ r,,.,.:, � � <br /> DESCRIPTION OF WpRK `� <br /> 9UIlDtNG SIZE Sp FOOTAf3E� HEtGHT �� <br /> OBUILDMG S , . VALUATION OF TOTAL CONSTRUCTION <br /> OELECTRICAI �� AMP SERVICE Q PROGRESS ENERGY � W.R.E.C. / <br /> �PIUMBING S 1 ���� ���v <br /> C� �4 I Sl.a�l <br /> OMECHANICAI S VALUATION OF MECHANICAL INSTAILATION `i� <br /> � ��l-►-�c�C..Z.,Z /�11� 5�� <br /> QGAS Q ROOFING Q SPECIALTY � OTHER � /� � ��,�_5 S J _ n,���� <br /> C�-C.! (i�. 1��r_Y <br /> FINISHED FIOOR ELEVATIONS � FLO00 20NE AREA �YES NO �.w.1 ��CIrS ` <br /> <-1/� � j,// � <br /> ( (7�� <br /> BUI�DER t 1� C�1�+qNY � �p by S�^U/r!, �„ <br /> SIGNATURE �•� qEGISTERE� Y/ FEE C RE� Y I N <br /> afaroas 7Td7 S/�.J �/�/?�+S_Ol'l� ��censeu �� � <br /> _,.,, r- � <br /> ELECTRICIAN R �COMPANY <br /> SIGNATURE T�,J REGISTEREO Y! N FEE CURR£A Y 1 N <br /> Ad�as Litense p I � <br /> PlUMBER .{�4, � MGANY � <br /> SIGNA'NRE ��7� REG157EREp Y/N +!4 CURR!'� Y±N <br /> ........_................ <br /> ��u Liwnse M �� � <br /> MECHANICAL I COMIPANY � <br /> SIGNATURE r��isrEneo YI N �r+.cu�.�tn Y N <br /> Addnss llcense tt � � <br /> OTHER � COMPANY � <br /> StGNATURE qEG�siERED Y I N Fr:cu++c;c.� Y/N <br /> '��� L{cense M � <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111 <br /> REStOENTIAL Attach(2)Pbt Pfens;(2)sefs ot BWlding Pl�rn;(t)eet o/Ensrgy Forme;R-O-W Permrf tor naw conscrve6on, <br /> Mirwmum len(10)working days afler submittal da1e. Requirod ansite,Constrticlron Pleru,Stormwater Plans w/S�it Fence.ns1a11eC <br /> SenMary FacqNiss 6 1 Oumpster,SNS Wak Permit br eubdNisbneAargs prqects <br /> CONMERCFAL Altach(3)complela sels ot 8uibwq Plans plus a li(e Sataty Pape:(1)set of E�py Forms.R-0�W Parmit br new conslruction. <br /> Mktimum Isn(10)workinp daya aNar aubmittal da1e. Requked onaiM.Conabuction Plans.Stamwatar Pkns w/SAt Far+ce installsd. <br /> SanMary faciUqea 3 1 dumpstec SIIe Wrnk Partnit for aq new proJects.All commerc�al requ'aemeNS must meet compHance� <br /> SiGN PERM17 Attach(2)asla o(Enpmaered Plans. <br /> ""PROPERTY SURVEY rpuired(or aN NEW consWCbon. <br /> Diroctlona:. <br /> fNl oW app6calbn completely <br /> Owner E Contractor sipn back of appRcalion,notanzed <br /> It ov�r;2500,�NoUC�ot Commmc�m�nt Ia nqWr�d. (A!C upyndss ov�r 57500) <br /> " Agent{fa ihe contrector)or Powar of Atlomey(fa the owner)vqWd be someone with notarized letter hnm owner authorizing seme <br /> OVER THE COUN7ER PERMITTWG (Fronl ol ApplicaUon OMy) <br /> Reioo(s if sh�ngles Sewers Sernce Upgrades NC Fences(PbuSurvey/FOOtagot <br /> �rFVSways•NOt over Counier il on public roadways..needs ROW <br />