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� I:� � � 1�C� - �02 j <br /> at��eaoozo City of Zephyrhills Permit Application Fax-e�a�so-oo2� <br /> � � ° Buflding Depar6nent <br /> .. - , .. Date Reeelved �p�,-aQ�� Phone CoMaet tor PormiCin 3 i 4 7 _ �-�Y L � <br /> Own�rs Nam� �'`���� ���� �Y'^S Owner Phono Numbor O ��J�,tS b -��� I <br /> o�,.r.�aan., � 5 31�- � t 7�i� Owner Phorro Nmnbv <br /> FN Simple THlaholde Name Qwner Phone Number I <br /> �I <br /> Fn Simple Tttleholda Address i <br /> JOB ADDRE38 3�3�� � �� "��- LOT� � I <br /> SUBDMSION ��'Y",�1� ����� PARCEL IDN �a^��l '�����I GD �6�DZ a <br /> (OBTAINED RtOY PROPFR�Y TA%N0710E� � <br /> WORK PROPOSED B NEW CANSTR B ADD/ALT � SIGN Q Q DEMOLISH � <br /> INSTALL REPAIR � <br /> PROPOSED USE Q SPR Q COMM Q OTHER I <br /> I <br /> TYPE OF CONSTRU ON Q BLOCK Q FRAME Q STEEL Q � <br /> DESCWPTION OF W RK � 1A�Ms...� . Q�Ci��--�o'R..��- �y SI�YP I y �/e�� I QZ-F+,C�LJ <br /> BUILDINO SIZE SQ FOOTAC�E� HEIGHT � <br /> OBUILDING S yp�UATION OF TOTAL CONSTRUCTION <br /> QELECTRIC S AMP SERVICE Q PROORESS ENERGY Q W.R.E.C. <br /> QPLUMBING S <br /> �MECHANIC E ! 1 p gO VALUATION OF MECHANICAL INSTALLATION , <br /> 10'ti <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER �� <br /> FINISHED FLOOR ATIONS FLOOD 20NE AREA QYES NO , <br />� BUILDER COMPANY <br /> 81GNA7URE REGISTERm Y/N �Cuw� Y!N � <br /> amar... u�# <br /> ELECTRICIAN COMPANY <br /> SIGNA7URE REGIS7ERED Y/ N �cuaaa Y/N <br /> �� <br /> Address Lleense# <br /> I PLUMBER COMPMIY <br /> SIGNA7URE REG�STERED Y/N FEE cuRREn Y/N <br /> Mdnu Llcense# <br /> INECW4MCAL `�/� / COAAPANIf �J <br /> S16NATURE /�"�' �cisr�n Y/N �cuw�n Y/N <br /> Addreaa Llcense# <br /> OTHER. COMPANY <br /> SIGNATilRE r��isr�o Y/N �cuwta Y/N <br /> Addross Lioenae i� <br /> 1-�-fI'7'TT�T- ITII �-i'i1-1-11-1-f-�7-1TTTTf1"I7r771I11-r-1C1'7TIIT7I'T11-77T7-TT71iI'1"I' <br /> RESIDEN7IAL ch(2)Plot Plans;(2)sets of Building Plans;(1 j set ot Energy Forms;R-aW PertnR for new construe8on, <br /> inimum ten(10)woridng days eRer submlttel date. RequUed orrefte,Constructlon Plens,Stormxater Plana w/Sik Fenee Instelled, <br /> nMery FedllUes 81 dumpster,Ske Work Pertnit for subdhrletonsAerge�xoJeda <br /> COMMERCIAI. (3)complete sets oT Building Plens plua a Llte Setely Pega;(1)set of Energy Forms.R-aW Permk fw new construdian. <br /> inimum ten(10)working days after submittal date. Required onsite,Construcdan Plans,Stamwater Pians w/Siit Fence installed, <br /> ifary FacUWea 81 dumpater.Ske Waic Permit for all new projecfs.All commerdal requirements must meet compliance <br /> SIGN PERMR ch(2)seb of Engineerod Plans. <br /> PROPERIY SURVEY requlred for ail NEW consWcdon. <br /> Dinetlorti: <br /> Flll out epplican cmnpletey. <br /> Oqmer 3 Con or sign back of applleatlon,notarized <br /> H owr t2500, Notla ot CommeneemerR Is requirod. (I11C upgredes over s7500) <br /> " Agent(tor the tractw)or Power ot Attomey(for the owner)would be someone wfth notadzed letter from owner authorising same <br /> OYER THE COU R PERMIITIN3 (Front ot Appllcatlon Onty) <br /> Reroof6 N ahfnglea Sewers SeMee Upgradas A/C Fences(PIoUSurvey/Footage) <br /> Drlveways-N over Courrtar if on publie roadwayS..neede ROW � <br />