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<br /> Sl -780-0020 C�ty ofZephyrhills PermitApplicatfon FA.-813-780-0021
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<br /> Da�a Re�e� ed �C �K/ __ J35 /1
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<br /> Ow�a�'� Name FIE�CTN' CA�E 2�� INC+ CO fIL'Tv5 P Ow„a� Pno.,e N,.mbe�
<br /> Ow�e�'� Aad�e�� {� 130� �jalu� SouY�f-l.�{-►ee' J X 76C�� Ow„P�Pho„a N,.mbe�
<br /> Fee Si.,,Pie Tivanoiaa� Na�.,e ��„�.,e�Pno„e �J��„be�
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<br /> JOB ADDR SS 3gi3.� ��Q K�T ����� ZC17/�`��F���C.-s Fc, '�3 Sya LOT# �
<br /> SUBDIVISI N PARCEL ID# oa-a�-ai - c��ro— O�ef��— (�jp'3O
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PR i POSED e NEW CONSTR� ADD/AL 0 SIGN Q Q DEMOLISH
<br /> INSTALL IR
<br /> PROPOSE USE 0 SFR � COM 0 OTHER
<br /> TYPEOF ONSTRUCTION Q BLOCK Q FRAME � STEEL Q
<br /> DESCRIP ON QF WORK �6�� Fy E�C�S71��� F�R� SPi���KC�� S�ST�M ��� �U�R- — I�o
<br /> BUILDING SIZE N� SQ FOOTAGE o` � �G HEIGHT Nft"
<br /> � UILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> Q•LECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W R.E.0
<br /> Q LUMBING $ �� �/��/�j
<br /> l(/ �
<br /> Q ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> Q AS � ROOFING Q SPECIALTY � THER T ��-` �IN�G�E2 � o�� S��v �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> 1 1
<br /> BUILDER COMPANY
<br /> SIGNATU'E REGISTERED Y/ N FEE CURRE� Y/N
<br /> Add� ��
<br /> L��e„se #
<br /> ELECTRI IAN COMPANY
<br /> SIGNATU E REGISTERED Y/ N FEE CURRE� Y/N
<br /> Add� = L��e�se #
<br /> PLUMBE COMPANY
<br /> SIGNATU E REGISTERED Y/ N FEE CURRE� Y/N
<br /> Add� s� L��e.,�e #
<br /> MECHANI�CAL COMPANY
<br /> SIGNATU E REGISTERED Y/ N FEE CURRE� Y/N
<br /> Add��s�
<br /> L��e.,se #
<br /> OTHER (�__ „ COMPANY ���+4N F��iZE S — Lo
<br /> SIGNATU E � � REGISTERED Y/ N FE URRE� /N
<br /> Ada�es� $lCb ��(lp/�DW/�`I Ail� SJlT� A- TA�f� �L �olg Li�e� e # FpC� `�'2")��
<br /> 1111 11111111111111111111111111111111111111111111 11111 11111111 11
<br /> RESIDEN IAL A«e�h (2)P�o�P�A„=, (2) ,ess o�B,.��d�„9 P�a„�, (1)�oz of E„a�9y Fo�m 5, R-O-W Pe�m��.o�.,a .,�«,.���o�,
<br /> M�.,�m�m �e„ (10)working day� a.�e�s��/,�bm�«��da�A Re9���ea o„��ze,Co�s«„«�o„ P�A„�,S�o�mwaze� ��„s �,. ���Fe„�e �.,�za��ed,
<br /> Saniinry Facillties lX� tlumpster,Site VVork Permltforsubdivisions�large proJeccs
<br /> COMME CIAL Azza�h (2)�o P�o�e se« or B���a��g Ra„5 P�„s a L�Fe Se.e�Y Page, (1)�a�oF E„e�eY Fo�m s R-O-W P��m��fo��e,��o.,s«„«�o„
<br /> M�„�m,.m1-�e., (10)working deys af�e�>�bm��a�da�o Req„��ed o„��za,Co„�«,.�z�o„ P�a„s,S�o�mwa�e�P�a„s w/5���Fa„�e �„��fl��ed,
<br /> Sanitnrylxcllities &1a��„Pst¢r SlteWorkPermltforallnewproJects Allcommarcialrequlrementsmustmeetcomplixnce
<br /> SIGN PEf�MIT A�za�h (2)�e o.E„9�„ee�ed P�a„s
<br /> ""PROPERTY SURVEY�eq„��e, fo�a„NEW�o„�«„�z,,,,
<br /> 1111�711 •
<br /> D��a«�o
<br /> Fill o tapplicailon complecely
<br /> �w r tX Contracior sign back of applicatlon� notarizetl
<br /> �4ov r�250��a Noticeofl.ommancemenGis �equlretl �lVl..�pgratlesovery7500�
<br /> �+ Age t((or tho con[ractor)or Power of Attorney �Por the owner�would be som eone with notarizetl letter from owner authorizing sam e
<br /> OVER T E COUNTER PERMITTING (�oP,,of�o„z�a���e9,,,�e,)
<br /> Ra�oo.s If shingles SawP�s Sa�„��e Upgratles A/C Fe„�as (P�oJS��„oy/Foo�a9e)
<br /> �riv� a ys-Nof over liounter if on public roatlweys .neetls R�VV
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