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; �x <br /> ., - <br /> e�a-�eo�aozo City of Zephyrhills Permii Application Fax�813-780-0�21 <br /> Building Depar,m � <br /> Date Recalved � 1 � � "I ' ' <br /> � ono Contacl for Pertnitttn � � <br /> ` <br /> Qwnere Nama � Qwner Phona Numher I <br /> ♦ <br /> IOwnera Address Ownsr Phono Number <br />' Fae Slmpte Tldsholder Namv v ✓— �n r�or Phone Number <br /> � <br /> Fae Simplo TltleMolder dddreas <br /> JOBADDRESS , ^ LOTN � <br /> SUBDIVISION PAFiCELIDN ` — ��O-� �—U C�O�-- (���D�v vO� <br /> (OBTAINEO FROM PHGPERP/TAIf MOi10E� <br /> WORK PROPOSED � NEW CONS7A� ADD1AlT Q SIGN Q � OEh10L15H <br /> IhfSTALL Ft�PA1R <br /> PROPOSED 11SE � SFR [� COMM Q OTHER <br /> 7YPE OF CONSTRUC710N Q BLOC!( Q FRAME � STEEL Q <br /> DESCRIPZipN OF WQRK � <br /> BUILDING SIZE SO F007AGE� HEtGHT (�{ ��(1� <br /> d�J�W�/ <br /> ----- —- - - ' �_ �--- ----------------, . - .,- .....�--. �i.-�- .��---- -- - <br /> QBUILDING 5 VALUATIONOFTO7ALCDNSTRUCTION� <br /> ELECTAICAI. S, ` AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0 • <br /> �.� <br /> QPLUMBING S � ����� <br />� MECHANICAL VALUATtON OF MECHANICAL INSTALLA?ION <br /> OGAS Q ROOFIFlG Q S?ELtAlTY Q OTHER <br /> FINISHEQ FLOOR ELEVAT10N5 � FLOOD 20NE AREA QYES NO <br /> BUILOER COMPANY <br /> SIGNANRE REa�siEaED YJ N FEEUmliEn Y�N <br /> Addraaa ticerue u <br /> EIECTRiCIAN COMPAWY +�'''y��II; ��'/�;G� 290�� <br /> SIGPdATURE REc.�stEaEO Y FEEcusm� Y f N I�v �,�g <br /> V <br /> Addresa License p <br /> W �D�l o�f g�01� <br /> PLU6ABER COMPANY <br /> SIGNATURE pEG�STEqEo Y! N FFEa�Rap, Y+'N ��,J��� <br /> ���� 'CM50 tt <br /> MECHANICAL COMPANY <br /> SIGNATURE qEtasiE�D Y: !N <br />, �d�� Licensa# <br /> OTHER COMPAPIY <br /> SlciNaTURE aeas�o Y+ N F�cuw�En Ytre <br /> Addrna �censa tt <br /> 11111A1111101111I1A11 [1111IIIIIII11111111BIIIBlYl01111111l111111111 <br /> RESiDEHT1aL qttach(2}plat Planr,�2)seu at Building Ptaru,(1�sal of Energy Forms.R-0•W Permd for new CauWction, <br /> M'inimum ten(10f working days ahcr submitlal dale. Requied onsita,Cansfruction Ptans,Slarmwater Plars�wr5i�t Fenca Instal�etl, <br /> Sarutary Faq7lfies E t dumpster,Site Work Permi!lor suhdrvisronsllarge projects <br /> I CORIMERCWL Attach(2)camplete se�s of BWldkng Pisrta plus a Ufe Safety Page;(S)set oi Energy Fomo.R�O•W Permit for rrew w�nWction, <br /> hfiinimum ten�10�wwking days after su6mitlal dale. Required onsite.Conslrutlion Pten9.Stormwater PIanS w`Silt Fence Installed, <br /> Sanitery Fe�7iGes d t dumpster,Slle Work Permil lor ap naw projects.All eommerclal requiremenLt mwt meat compliance <br /> SIGN PERMiT Attadi(2}sets of Engineered p4�ns. <br /> ""PROPERIY SURVEY required for all NEW eonsWcUon. <br /> o{roeUona:• <br /> FiQ out application completeiy. <br /> Qwner 3 Conlracfor�ign batk oi eRpLcatlon,noturized <br /> If over 52500,s�Nodce ni Commancement is roquired. (AfC upprodes mer f7500� <br /> " Agenl(for tha caMraaor)or Pwrer oi Attamey(for the omier)would be oomeone wilh nolarized lekerfrom owner aulhoriang seme <br /> OVER iHE COUIdTER PERMITitNG (copy o!�ntra�t requimd) <br /> Reroofs if shingles Sewds Service Upgrades A!C FencPs{PIpt/Survey(Footage) <br /> CrlvewaysdJ91 wer Counler I!on pu6fic roadways.rteeds ROW <br />