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a�aaso�azo City of Zephyrhills Permit Applic�tion F����0�0'02t <br /> BuElding DapaAmar.t <br /> I Datm Rseofved Pisoae Ccntae4fore era;f�.+n — <br /> Ownors PJamo � I oumer PMorte Nwnber �' .�-(L A <br /> � Ownors Addross L ,�. Owner Phano Ptum6or � <br /> �� <br /> �, Feco Simplo YitlohoWer Rlame �J ONmar Pha�e Numbor <br /> I� I <br /> Fee 3lmple TitlehoFder Addross <br /> I <br /> �I JOB ADQRESS � l0T� L� I <br />, � SUBDI1fISION PARCEL IQ�k ! <br /> (oaruri�cROn�toi�$'S�Jlt7t roart�l , <br /> WORK PROPOSED e NSTALL�e REP RT Q SIGN Q Q DEMOl.�3H _ <br /> PROP�ED USE � SFR Q COPAPA Q OTHER <br /> 7YPE OF CONSTRUCTION BLOCK Q FRAME Q STEEL Q <br /> � DESCRIPT10Id OF WORiC l� � CA ~ �� <br /> BUtLDlPIG SIZE 5�FOOTAGE� HEtGHT �� <br /> QBUILDING $ VALUATION OF TOT�CL CONSTRUCTION <br /> �ELECTRICAL S AMP SERVICE Q PR0C3RESS fNERGY Q W.R.E.C. <br /> QPLUM8ING 3 �/ <br /> I /����� - <br /> �PAECFI{WICAL 3 Q 1� ^� ,� VALUATION OF MECHANJCAL INSTALLATIOfd � <br /> _' <br /> �� Q ROOFING Q SPEGAL7Y Q OTIiER ��y ��� <br /> FItdISHED FLQOR ELEVATIONS FLOOD ZONE AREA QYES NO �� <br /> I _ _oan_" • •_ <br /> �� Bli1LD+ER CQ�IPANY <br /> ' SlGNATURE � �ofs�m Y!N �cu�. Y/M <br /> Addroso Liee�e f ; <br /> ELECTAICIAN CQAAPL14dY � ! <br /> SIGNATURE �cisrEa� Y/N �cuRr�n Y/N � <br /> Addmas Ll�nse��� j <br /> � PLUMBER COMPANY � <br /> SIGNA7LRE t��is�tm Y/ N �cu� Y/N <br /> Address Li�i <br /> ME� �. �_ - _ v l =1`�e ' �- i I k+� _ ; <br />' � nJ� f� REG.s Y/N �cu�n Y1N <br /> � Addisss literise! L� �� I <br /> OTHER � CONIPANY � � <br /> SIGNATURE aewsTERRcD Y!N Fc�cuRREf� Y/R! <br /> I <br /> AddfH9S L1CBn38Y�� I <br /> � e � i � t � i � � o � � e � aote � � eei � aoaeeo � seoeeseoeeas � e � � � aeooeia � e � � � � e � � ie I <br /> RE$�pEP1TIAL Attech(2)Plot Plsns;(2)se4s M Building Plans;(1)set of Ertargy Fortns:R-O-W P�nNt for new con�len, I <br /> Minimum ten(10)worldng days after su6miifel date. Reqwied onsite,ConslntGion Ptans,S!o►ma�eter Ftans w�SDt Fetxe ituteBed, <br /> Sanitary Fadlities&1 dumpsfer,Site Work Permlt foi subdiv4sions/larg2 proJ�cts � <br /> COM�ERGIAt_ Attach(2)mmpleta sets of But�ding Plans ptus a L.ifci Safery Page;(7)set aP Enetpy FO�ms.R-O-W Parmft iw na�r�udbn• � <br /> IuGnimum ten(10)worldng days efter su6mlttal date. Required�tsite.Corsstntt�i411 Ptai�s�SEOIlmtetef'Plana Md SUt Fd�e instBDad. � <br /> Sanitary Fadlities&1 dumpster.Sfte Work Pertnit for all near projeds.Ad commeteia!rt�+lrements mt�s[mee!catnWfahce i <br /> SIGN PERNIIT Attach(2)seb of Engirteered Plens. I <br /> ""PROPERTY SURVEY required tar all NEW construction. <br /> _�� , i <br /> Qfreetions: . <br /> FIU out apaGration comptetely. • , <br /> Owner&Contraetor sign badc of applintion.noteraed - <br /> p N 14 ovor;2500,a Notice of Commeocumerk Is roqufred. (AIC upgrades over$7600) , <br /> IAgent(fw the contrador)or PoNer of Attomey(for the awncf�would be someone ndm na�Zed lettet Lom aa�a'autl�c'i9� <br /> u OVER THE COUNFER PERMITTiNG (copy oi cantra�required) <br /> IRaroofs it shingles Seuvers S�vice Upgrades AIC Fences(PIoUSurveyfFoatepa) <br /> �j Driv�vaaya.M1lot over Counter if on pubUc roedirdys..reeeds ROW <br />