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, � � i <br /> 813-780-0020 City of Zephyrhills Pemtit Appiication F���-�� <br /> BuEkfing oeparbnent <br /> � DaW Rec�fvod � . C� . ��.,L FhotssCasstaetfarPesmt#�e► i � - �."! ! �-"" . <br /> � OrmoYs fd�mq �� aY-Q. �'�,�.�' Ownor P4►one Number p d- � 1 y�„ <br /> I Owmpre Address ����j�J i v tSf"^'�i � �'v�Q..- Q+mar Pfioae Num6cn <br /> � <br /> Feo Slmptv T{!lehalder Name � �� Qwner Phan�Numbcsr � ..� <br /> � F�o Simpb 17tleholder�ldress <br /> I JOBADDRESS LOTS C� <br /> su�ns�ns�o� f �'� �a��.i� 6��ea�t �. — "' C3 l C��"'{) ��?" <br /> ' (GBTAtttID Fti4t1 PA�Y,A7I►� <br /> WORK PROROSED e NEW CONSTR 8 ADDIALT � SIGN [� [� DEMOLISH <br /> iNSTA�L REPASR <br /> PRQP�ED USE [� SFR Q COMM � qTHER <br /> TYPE QF CONSTRUGTIQN Q BLOCK Q FRAME �� S1EEl a <br /> � DESCRlP170NOPWqRK r� � � 3 `�'�n C \ ' 1�� S �'- C.�nl�� <br /> ' Bi31LDINt3 St7!E � � SQ F04TAGE� HElG4fT �,�� <br /> � QBUlLQING � � VALUATION OF T4TAt COtdSTRUGiIOM <br /> QEIECTRICAi. �� AMp SERVICE [� PROGRE88 ENER�Y Q W.R.E.C. <br /> QPLUMS(NG $�'—� �/� � <br /> �, � <br /> �MECHANiGAL S -�i ,F"1 VAi.UATIOAi OF MEGHARSCAl.tNSTAltA7tOtd � <br /> l l,J � <br /> OGAS Q ROOFIPIG Q SPECIN.N �� 07NER <br /> FtNISFiED FLOOR ElEVATIONS �� FLOOD ZONE AREA QY�S NO <br /> BUIl.DER � � COAHPANY � � <br /> SICaNATiJRE R�caGs�stEa Y/ N cff ctu� Y/N <br /> Addrosa l{cense���' �� <br /> II ELECtRiGlSisl � � COABPANY <br /> SIGNATURE � t¢Ecust�a X!N �CURR�n YtAi <br /> �) Addresa Llr�r�se tF J 1 <br /> I� <br /> PI,UMBER CORIPANY <br /> S{GPdATURE R�c�srerteo Y! fd �cut�n Y!N <br /> IAddress UCenssi�� -1 <br /> r��cs�nr,�cn�. �'=�_��� GQ�Pa�v 1 -�T2CYt lY ��t i�Q�"1bl'1,L <br /> sfnr � � <br /> ( Sl�NATURE R�tsre�D 7 N �cuFt�t� Y t N� <br /> ,�d,�� 3�qy S e 5 u��B��C1Ss1�-41��1 � <br /> OTHER � � COAlPAAP7fY � � <br /> SIGNAYURE HEo1sT� Y/N �ECukRE� Y/N � . <br /> Addro�s Lieense i j E <br /> IIIIIIOIIIi11C16L111698YiE10101E6i1Bi96lB9pi1B11E6pIBLi911111t101l1 <br /> R6gtpENS1tU. Attech{2}Flat Plarss;f2}sets oi BuGding Ptnns;{1}set ot Eaergy fflrtns:R-0-W PermfY fot rrew cns�aw�{en. <br /> Minimum fen{t6)uvrking days after sut�mittei deto. ftequired onsite.Cass6vGiari PtarFs.Stotmtuater P3�ts wt SAt Festa�3sis#�, <br /> Sanitery Fadiities&7 dumpster,Site Wwk Permit for aubdi��isiansAaJga.pro}P,cLs <br /> COMMERGAI. Attach(2y complete sets of eutlding Plans phrs a Life 8afety Pe�e�(1)se2 of Energy Pams.R•tYW Pesmt!tor�rt oumtrudlan. <br /> tr4nimum ten{S 0}v�ridng days a{!et su6miitat date. t2equited onsib,Can�on Plarzs.SiozYmus�et Ptana vd Stl!��a$�B�Sf. <br /> Sanitary�adi'�ies&1 dumpster.Sits Work Pamrit tor afi neva pinyects.A!i commatr�al m,quhe+me�s must meei eettrp6s�s - <br /> SIGPd PERNlIT A#ach(2)sets af Enginesred Plans. <br /> ""PROPERTY SURVEY required tor all WEW consUuGion. � <br /> Dlt�actions: <br /> FlQ out app6r�tion completely , <br /> � 4umer 8 Contradnr stgn beck of apptication.notarized <br /> ( « K aror$25�,u Ptot3ca of Comr�zencemeM ls ree}ui�d. {AlC upgrades aver$78{3Q} <br /> I, Agertt(fw the cronUactor)or Pov+er of Attomey(fiar the wmerj wwutd be someane valh natariaed lettor irom ow�ter authotizl�same <br /> OVER THE COUMER PERMITSiNG (copy of cantrad re�uired) <br /> Reraa(s#sh3ngtes Sev,�rs SerKc�Upgrades AiC Fences{P!a#?SusveytfooL�ge) <br /> Driveways-Not over Counter if on public roadvrays..naeds ROW � <br /> �� <br />