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� l S � O 2S U ° bOL( <br /> e��-�eaoozo City of Zephyrhills Pertnit Application Fez-e��-�ea�o2� <br /> ` �:,^ :; Bullding Department <br /> y <br /> Drte R�eeNed (,�,. �S� Phone CoMect for P�rmtltl I� �LJ 7 _ 7 7 Z <br /> Own�r�Mem� �a��� �-D JY\ 1 G� �J Ormer Phom Numb�r /�y' �I Q°�/�0 <br /> Ownn's Addms - �.3� I°1't' �72-� �'� Owner Phone Numb�r <br /> FN Simpb 71Neholde Name O�r Phone Number ' <br /> FN Simpfe Tttlehold�Addross <br /> J�ADDRE83 S��y I�3l° :. A�� �� LOT s C� <br /> SUBDMSION PARCEL IDa I O"��(i,'.Z j 'E''� J G� /�� "'� <br /> (DETAINFD fROY PROPFR�YTAX NOTCh7 <br /> WORK'PROP08ED B NEWCONSTRB ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF.COHSTRU N Q BLOCK Q FRAME Q STEEL Q <br /> DESCWPTION OF W wc �' C �Rt►A.a, e � �-.S >�'� r�S�=F� la C�.,r.�T <br /> BUILDINO SI� SQ FOOTAOE� HEIGFR � <br /> QBUILDING E VALUATION OF TOTAL CONSTRUCTION <br /> QELEC7RIC S AMP SERVICE Q PROCiRESS ENERGY Q W.RE.C. <br /> QPLUMBING S <br /> �MECHANIC � �(� l.t-�, VALUATION OF MECHANIGAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR E AT10NS FLOOD 20NE AREA QYES NO <br /> BUILDER COM?AM11 <br /> 9�W�'N� REGISTERED Y/N �euwtEn Y/N <br /> t Addrqs Llcense# <br /> ELEC7WCUN COMPANY <br /> gIONATURE r�cisreaee Y/N FFECURae� Y/N <br /> Addrsss Lleense� <br /> PLUNBER �P� <br /> 8�p(��(� REGISTERED Y!N FEECUar�T Y/N <br /> �d� Llcense# <br /> IIIECHANICAL % "°"J'.--- COMPMIY '� ��/�.�J <br /> gIGNATURE �� t+�cisrEaEO Y/N F�cuar�. Y/N <br /> Address SC1 10 � � 0�.�"K'`� ��GQ— Llcense# '�-��/8 ��' a y <br /> OTHER. �P�1' <br /> SIGNA7URE rtecisr�o Y/N �cuRRe� Y/N <br /> Addnss Ltcense# <br /> T771�'1"7IT" 77� fi"ii'1'7"i'T7`�T7-i'fTTTI'fI"7T77117I'Y'1'I'IiTi1TIfT11"i1iTTT71TfTi <br />' RESIDEN7IAL ch(2)Plot Plena;(2)sets of Bullding'Plans;(1)aet o1 Energy Fortns;R-O-W PermR Tw new wnsWdion, <br />' inlmum ten(10)working days e}tersubmitlel dete. Requlred ormlte,Conetrudlon Plans,Smrtnx�eter Plana w/Sitt Fence Inalelled, <br /> itary Fadiitlas 81 dumpater,Sfte Work Pertnit tor subdhrialonsllerge p�oJecta <br /> COMMERClAL (3)eomplete sets of Buflding Plana plue e Li(e Sefety Page:(1)set of Energy Fomis.R-o-W Pmmft for new correWcdon. <br /> irdmum ten(10)woridng daya aRer submrifal date. Requtred onstte.ConaWctlon Plans.Stnrtnwater Plans w/Sitt Fenee Inatelled, <br /> FeWidea 81 dumpster.Stts Work Permit for ell new proJeets.All eomma�ial requiramerds must meet eanpltanee <br /> 81GN PERN�T (2)aeffi of Engineened Plans. <br /> PROPERTY SURVEY required for all NEW consWcdon. <br /> Dlnetla�s: <br /> Fl�l out eppu comptetey. <br /> Owner 3 eign badc of appllcetlon,noterized <br /> H owr f'1500, Notlee ot Commaneemrnt b requlrod. WC upgrada over i7500) <br /> " pgent(Tpr the Gor)or Power of Attomey(for the owner)would be someone with noTarized letter from owner authorRing same <br /> OVERTHECOU RPERMRTINCi (FrontolAppileatlonOnty) <br /> Reroofs H ehingies Sewers SaMce Upgradea AIC Feneea(PIoUSurveylFootege) <br /> over Caunter H on publie madway6..needs ROW <br />