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� <br />' . . � � �rn���� w��d��� P����.Q <br /> . �/���- <br /> s�s-�ao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> i Date Recaived Phone Contact for Permitting �,-�� � -- S �3 <br /> 1 �1 1 1 I� I I 1 1 1 1'1 1 <br /> Owner's Name � � �i � Owner Phone Number c�l 3- . C{�" } <br /> Owner's Address ,,�� -�- . , ,�� Owner Phone Number i <br /> Fee Simple Titleholder Name � � � Owner Phone Numher I <br /> i <br /> Fee Simple Titleholder Address e ,t� <br /> JOBADDRESS � � >� -{-p;� � �: h� 3�5y LOT# �S <br /> SUBDIVISION _ - ' - - _ . G <br /> ,. -�. ra L PARCEL I Dtk , � �- � <br /> � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT O SIGN Q Q DEMOLISH <br /> I B INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> �—p�(a.c� <br /> TYPE OF'ICONSTRUCTIQN Q BLOCK Q FRAME � STEEL Q A/� <br /> DESCRIPTIONOFWORK p_ �SI'l r• �La_(�UC)��p. �� rct- , SL QfQ -, �1� ^ ibp�� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT y' / <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> I �3 �co,� <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> �PLUMBING $ <br /> OMECHANICAL $ � �oO t� VALUATION OF MECHANICAL INSTALLATION <br /> � <br /> �GAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY �C S'� �U� , �`� , <br /> SIGNATURE REGISTERED Y/ N ` Fee cuRrx�n Y I N <br /> Address � 'J'� �C' c ��C' �i �L��� 6 p License# �U(;�,5 ��3 ja <br /> ELECTRICIAN - �'` /� COMPANY ��'�'<' �G�'� f ��7/� r.=�-�. <br /> SIGNATUIRE "�o� REGISTERED Y/ N FEF CURRE� Y/N <br /> �' J� _ G . <br /> � � � -��'r''v� L� `�C��/v - � . <br />, Address /r f� / / � C�i f /� -- �T�' License G � Q <br /> i <br /> `�/ a , l'�4 �1. � <br /> PLUMBER COMPANY <br /> SIGNATUIRE REGISTERED Y I N FEE CURRE� Y/N <br /> Addless License# <br /> MECHANICAL COMPANY �-l��r-. S �. � r �'s <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addiess ? � ' (� , 1� t�� � ,�j�{��J License# C t'�C Q �,`7�j <br /> i <br /> OTHER ;I COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y J N <br /> Addless License# <br /> IIII �IIIit1111111111111111111111111111111111111t1111111111111111E1t1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new consWction. <br /> Minimum ten(10)worEc(ng days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Pertnit for subdivisionsllarge projects <br />' COMMERCIAL Attach(2)complete sets of Building Pians plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> ,I Minimum ten(10)wo�king days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities R 1 dumpster Site Work Pertnit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •'•PR[1PFRTV Al IR\/FY rcnnirnrl inr oll tJC�A/nnnc�.....Nn.. <br />