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� i .� - i�v - 6o�z� <br /> e��-�eo-ooso City of Zephyrhills Permit Application Fax-813780-0021 <br /> Bullding Depar6nent <br /> � i p c <br /> � � •Date Reeehred � a�— � �" Phone Confeet for P�rtnHtln U(3 7 8 7 — �7� 7 2 <br /> Ownds Nam� ��O�.JJ IT y 1.-� S- Owner Phorro NumWr ��3`�$3' ���•3 <br /> owners�ddnss S7 3 v A L���J �y� Owner Phone Numb�r i <br /> FN Slmpl�Titleholde Name Owner Phone Number <br /> FN SImpN 7Wehold� Add►es� <br />� JOBADDRE33 3 S '1 3 o A-(�$"�o J �/e- LOT� � <br /> SUBDM810N � t" L+� L' s PARCEL IDA �3`'��'-���Oa'f 0 ��n-GclT �D t�C: <br /> I coeruHm r�o�aROPamr r�x wonce� <br /> WORK PROPOSED e New coNsrR e ADD/ALT � SIGN Q Q DEMOUSH <br /> INSTALL REPAIR <br /> PROP03ED USE Q SFR Q COMM Q OTHER <br />'i TYPE OF'CONSTRU ON Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF W RK � �e ��•.+ r..� 3 .S To:s /`l S��rz /�P p it <br /> BUILDINO SIZE SG FOOTAOE� HEIOHT � <br /> II� <br /> I QBUILDING 5 VALUATION OF TOTAL CONSTRUCTION <br />' �ELECTRIC S AMP SERVICE Q PROGRESS ENERGY Q W.RE.C. <br /> I QPLUM8ING S ' I/ j / �� � <br /> � 1�" � lY <br /> MECHANIC E ��� VALUATION OF MECHANIGAL INSTALLATION "� ' <br /> i <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br />� FINISHED FLOOR EL AT10NS FLOOD ZONE AREA QYES NO <br />' BUILDER COMPANY <br /> 81GNATURE REGISTERED Y/N Y/N <br /> Addnss Lleense# <br /> ELECiRICUW COMPANY <br /> SIGNATURE REGISTERED Y/N FEE cuRFtB� Y/N <br /> Addnas License# <br /> PLUMBER COMPANY <br /> SIGNATURE r�oisrer�o Y/ N �cuarte� Y/N <br /> Addnu Llcense# <br /> MECNANICAL � � COINPANY S� � S <br /> SIGNA7URE v REGISTERED Y/N t�e curtt�n Y/N <br /> Addreis Lleense# <br /> OTHER. COMPAN1f <br /> SIGNATURE r�oisr�o Y I N �cuwta Y/N <br /> Addras Lkenae# <br /> n-� n rrr r n��_r_�..�.�._�_�._�._�_r r rr�r rrrrr n n T r r� rrrrr�rT rT�i rr� ��rrrrn �rrr i <br /> RESIDENTIAL ch(2)Plot Plena;(2)sets of Building Plana;{1)set of Enargy Fortna;R-6�W PermK for new construdion, <br /> inlmum ten(10)woridng deye elter submktel date. Requded onsRe,ConeWctlo�Piene,Starmweter Plane w/Sllt Fence Instelled, <br /> nitery Fecflitlea 31 dumpater,Sfte Wmk Permk for subdivfalondlerge proJeetn <br /> COMMERCIAI. (3)eomplete sem af Bulldinp Ptena plua e Life Sefely Pege;(1)set of Energy Forms.R-aW Pertnft far new censtructlon. <br /> Inimum ten(10)worMng days efter submHfal date. Requlred onsite,ConsWctlon Plens,Stormwater Plans w/Sllt Fence insteiled, <br /> Mery Fadiitlea 31 dumpater.Ske Wa1c Permk for all new proJects.All commerdal requlremerita muat meet campllance <br /> SIGN PERM�T ch(2)seta oi Engineered Plans. <br /> PROPERTY SURVEY requlred for ell NEW consWctlon. <br /> Dln�tlonr: <br /> fill outappiicatl completely. _ <br /> Owner 8 etw sign�dc ot a�lieatlon,noterized <br /> If owr SZS00, Notlee of Commeneem�M Is�mquired. (AIC upgrades ov�r i7500) � � <br /> " qgeet(ior ihe ntraetor)a Power ot Attomey(tor the owner)would be someone with notadzed letter trom owner authoribng same <br /> OVER THE COU R PERMRTING (Front of Appllcatlon Only) ' - <br /> Reroofs H ahingles Sewers Service Upgradea AIC Fences(PIotlSurvey/Footage) <br /> Drlvewrys-No over Caurrter if on publle roadways..needa ROW <br /> I <br />