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a��-�eaoozo City of Zephyrhills Permit Application Fax-813-7840021 <br /> Building Department , <br /> Date Received � � Phone ContaM for Permittin �� � _ p�F�/ <br /> 1 1 1 1 1 1 1 1 � � ��1 <br /> OwnersName �� �� Z , p..N OwnerphoneNumher 0 (r7 �/p�'(p�2, <br /> � <br /> Owne$Address Owner Phone Numher <br /> Fea Slmple Titleholder Name i�� Owner Phone Num6er <br /> Fea Slmple Titleholder Address /r <br /> JOB AODRESS (/ � /Y�� �Gt(.L� �� �r��[I LOT� � <br /> SUBDMSION s ppttCEL IDft J 7'a� I~D�d�'�OQQD ^�(,� <br /> (OBTIIEIED FROY PROPFiiIY T!U(NOTCE� <br /> WORK PROPOSED NEW GONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> B INSTALL 8 REPAIR <br /> PROPOSED USE �C SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL <br /> DESCRIPTION OF WORK .L.�4S l� p�'S V f�� O� � <br /> BUILDING S� SC FOOTAGE� FfE1GHT �—� <br /> i <br /> '"`y i <br /> QBUILDING $ VALUATION OF TOTAL CONSTRLICTION <br /> ELECTRICAL $ / J Z _� AMP SER1/ICE Q PROGRESS ENERGY �E.C. 2u'���1�,��� � <br /> ( (O ��,Z- �I <br /> QPLUMBING $ � �J�/n'� �/ C ./]'�/'` i <br /> X/ �f•J Y/ <br /> O �" � � � �s ` ` � � �I <br /> MECHANICAL a VALUATION OF MECHANICAL INSTALLATiON p '�(,'- <br /> �^ ��� �� i <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER /� � ��/ � <br /> , `// �V <br />� FINISHED FLOOR ELEVATIONS C� ROOD 20NE AREA QYES NO U� d <br /> / <br /> BUILDER COMPANY I <br /> SIGNATURE r�c�s�o Y!N �cuwien Y 1 N i <br /> ,. Addr�s .o� Llcensa tJ � <br /> d ,t��� � ,� p � <br /> ELECTRICIAN f COMPANY <br /> SIGNATURE reEcts7�o Y/N �cuwten Y/N <br /> Address 2 L •�'7WP0 �(/ License# V �L� <br /> PLUNBER COMPANY <br /> SIGNATURE rs��isre»eo Y/N rtEcuw�n Y/N <br /> Address License!( <br /> MECHANICAL COMPANY <br /> SIGNATURE aeGisr�n Y/N tg curu�n Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNAiIIRE �cisr�o Y/N �cuw�n Y!N <br /> Address Llcense 8 <br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ! 1 1 1 1 1 t 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t 1 1 1 1 1 1 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets af Bullding P�ans;(1)set of Energy Fortns;R-O-W Pertnit for new cnnsWctlon, <br /> Mmimum ten(10)wmking days aft�submittal date.Required onsite,CansWcNon Plans,Stwmvrater Pians w/Silt Fence instatled, <br /> Sanitary Faalities&1 dumpster,Site Work PermR tor su�visionsllarge proJects � <br /> COMMERCIAL Attach(2)camplete sets of BuGding Plans pius a Life Safery Page;(1)set a1 Energy Fortns.R-aW Parmtt fw new consWctlon. <br /> MGnimum ten(10)wo�fdng days after submNaV data.Reqtirced m�site,Construdion Plar�s,Slormvraler Plans w/Silt Fenca inslalled, , � <br /> Sanitary Facilides&1 d�nnpstec SRe Work Pertnft for ali new pro�eds:Afl commerclal requ"vemertls must meet compliance <br /> SIGN PERMfT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requ'ved fa e8 NEW construction. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Dlractions: <br /> Fifl out applicatlon completely. <br />' Ovmer&Contractor sign back of applicatian,notetized <br />� If aver s2500,a Notice of CommencemerR is raqulred. (AfC upgrades over$75Q0) <br /> " Agent(tor the contractor)or Power of Attnmey(for the oumer)would be someone with notarized letter from uwner authariztng same <br /> OVER THE COUNTER PERMIITING (copy of convact requGed) � <br /> Reroofs if shingles Se�vers Service Upgrades A/C Fertces(PIoUSurvey/Foatage) <br /> Ddveways-Not wg Counter N on pubGc road�rays..needs ROW <br /> �T��'�l . II <br />