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1 <br /> ' _ - . . . . . - _. . . _ . . . -- . _ .._ --�- - <br /> a»-�eo-0o2o City.of;Zephyrhills Permit Application Fax$13780-0021 <br /> 8uilding Department <br /> ' 'Dete Recetved. Phone;Contact for Permltting <br /> Ownera Name ��S.'12E'GkIL S'to�s Owner Phone Number. �3'Z'�'ri b-'O.1�0 <br /> Owners Address �, �ss �'!.�"Z�',W oo�BQ=AaE;N$-0'fO4S Otirner Ptione Number ' <br /> Fee:Simple TUefiolder Name Oivner PHone Number <br /> I <br /> Fee Slmple�Tltleholder Addrese <br /> JOB'ADDRES3� �'�✓I� _(y/L-l.L ViLVVy'Z.e.PHYR41IU.5,I�F� LOT# . 00��0' <br /> i <br /> � <br /> sueoiVisioN PARCEL IDfl Tti,'2�'2('o000-uo3oo -vdao <br /> � (OBTAINEDFROMPROPERTXTAXNOTC� � <br /> WORK FROPOSED NEW CONSTR ADDlALT IQ °SIGN Q Q DEMOLISH i <br /> e' INSTACL ,� REPAIR <br /> PROPUSED U§E Q' SFR' Q COMM � OTHER <br />' TYPE OF CONSTRUCTION � BLOCK Q PRAME Q STEEL Q <br /> DESCRlPT10NOFWORK �����' �r'LO�V GSPEEDwAY # 6Q.58� <br /> BUILOING SRE '. � '$Ta�'Y SQ FOOTAGE 3�oDZ I ,HEIGHT �� <br /> ' QBUILDING $ VALUATION OF TOTAL GONSIRUCTION�a S0�Opd <br /> � <br /> QELECTRICAG, $ AMP SERVICE Q PROGRESS ENERGY ,Q �W:R.E.C: <br /> QBLUMBINO 3 � <br /> QMECHANICAL $ VACVATION OF i ECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY IQ OTHER <br /> FINISHED FL"OOR ELEVATIONS FLOOD ZONJ AREA QYES NO <br /> - I <br /> BUIL.DER CO�lAPA1dY lnSt,"BAUE DuSI�'=ti)f. C'oM?hN`/ ' <br /> SIGNATURE aEClsreri�o• 'Y/.N F�cua�n Y/N <br /> , <br /> ess � �NIOST,�lo1�`S(,tk5u(k,{rt, 3A2310- � ucense# �G.C 'O5�i5-74, <br /> ELEC7RICIAN TgV COMP� <br /> SIGNATURE �ais��o Y/•N_ F�Cufift�n Y.7 N <br /> Address � License#•. <br /> PLUMBER TQ�b COMP� <br /> SIONATURE REQiSreREO. Y/N ' Fee cuR�. Y/N � <br /> Addiess � Gcense# <br /> � <br /> MECHANICAL '�'�j�'j COMPl1NY <br /> SIGNATURE rtECisreriEn: -Y 1'N rt�cuaaen Y/N <br /> i. <br /> Addross � Llcense'# <br /> � OTHER � COMP'�' <br /> $IGNATURE' aECiSteaeo' Y!':N �euar�n Y/N. ' � <br /> Address� I License#. ' <br /> 1'l l 1=1 1:1 1.1-1,1 1 I 1 1'l l l l l:l l l l,l 1 1 1 1 1 f l l l"1 I 1 1 1 1 1 1•1'1.1 f l l l l l l'l l.l l.l.l l l'l l CI 1 1 1 <br /> RESIDEMIAL Attadh(2)Plot Plans;(2J_sets of BuIlding Plans;(1)set of Energy Forms;RA W.Pertnit for new construcUon, <br /> i Mlnlmum tan(10)work(ng days after submittal date. Required onsfte;Constructlon Plans,Storinwater Plens wLSiit Fence,installed, <br /> Sanitery Facllitles 81 dumpster,Site.Work Peimit for subdfvisionsliarge'prcJeots <br /> , COMMERCIAL Attabti(3)oomplete sefs.of Buflding Pians phis o IJfe;Saf9ty,Page;_(1)set of,Energy Fortns..R-0 W Permit.tor new consWctlon. <br /> Mlnimum;£en;(10)worliing deys'akensubmlttal date;'Required onsite,Conatrucdon Plans,Stortnwater-Plans w/Sift Fence installetl, <br /> Senitary Fadlitles'&1 dumpster.SIto�WodrPertnit for all new pioJects.All comme[cial requGeinents must 7oeeCcompllance <br /> SIGN PERh11T Attarh(2)sets bf Engineared Plans:. <br /> ""PROPERTY§UR_VEY required for etl NEW construcUon. <br /> Diroetlons: <br /> Fill out epplicatlon.completely. , <br /> Owner&Cantrector sign back of:appllcaU6n,notarlieG <br /> If oJe�$2500;:a Notloe of Coinmencemant Is requlred., (A1C upgrades over 57500) ' <br /> " Agent(far,the cantractor)ocPower of Attomey(tor the owner)wouid tie'so i eone with'notadzed letter iroin owne�authorizfng,same <br /> OVER.THE COUNTER,PERMITTING (Fronl of ApplicaUon'Onty) <br /> Reroots if shingles Sewers SerNce Upgrades'A/C Fences(BIoUSurveylFootege) <br /> � <br /> Driveways-Not over Counter if on.pubiic roadways..needs ROW <br /> I <br /> I <br /> I <br /> I <br />� I <br />