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�i <br /> 813-780-0020 City af Zephyrhills Pe�r pli ian y�\. Fax-813-780-0021 <br /> Buildin ,D�rt � <br /> ��� � <br /> Datg 12ecetved � f � j f!f <br /> Phone.Cantaci far Perm� ' <br /> Owner"s Name � '�..//S� GLG Lli- y Owner Phone Number <br /> Owner's Address�77�7 / 'R srF(Z//�y �- �� � .� �pwner Phone Number � � � <br /> ) <br /> Fee S3mpte Tltleholder Name 4wner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRE5S �S Q L"' !�»t Z l�! [4 j `�L. � Ya- LOT# a/ <br /> SUSDIVISION Q(�1�i rI G �f�.�I PARCEL ID# �t-a�-a r �t1Vt!{J '"{�{�l G!{�"�{1� GI <br /> T-- (OBTAINED FROM PROPER7Y TAX NOTICE) <br /> WORK PROP4SED e NSTAL�STR� REPASR � SIGN Q Q DEMOLISH <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF C4NSTRUCTipN Q BLOGK Q� FRAME � STEEL Q 1 <br /> DESCRIPTION OF WORK (J C•! T f !�L"'�. T' �7( l� � � I�I W[,�(J(Y �l4" �`, ��u�� �� � <br /> BUI�DtNG St2E l��"�3 � SQ FdOTAGE C� FiEIGNT [___� <br /> rmrrr�-er nrr�-m-r-rrr�-�rrmrrrmrrr-mrrr-rrm-rrm-rrmr- <br /> �BUII.DiNG S n� VALUATiON{7F TOTAL CONSTRUGTI4N <br /> V <br /> QELECTRICAL $ �4�v � AMP SERVICE �'� u� GY Q W.R.E.C. <br /> ' QPLUMBING r' � (o ti� �� ! � <br /> L "�y u <br /> QMECHANIGAL $ ��J` VA�UATl4N QF MECHANICAL[NSTALLA'S'tON �� <br /> U <br /> QGAS Q ROOFING Q SPEClAI.TY 0 OTHER <br /> F1N(SHED FLOOR ELEVATIONS �� �LOOD ZONE AREA DYES NO <br /> �:-w.C.�-'�7-'�-:-��-i-+'r�.:-:-�f7-0-'t:-�.E-:-%--•--•-Y-•--r-;--S-F��:-'��.p-'r'.5-:-7--.-.-..-rr+-i-:-�FL-+'..p-:-'r',�+-:.�t�7�.S-r <br /> BUILCIER /�,,,�,� � COMPA� � ��((�(-P I ! ✓�u � <br /> SIGNATURE � L�//iC/J REGISTERED Y/ N FEE CURRE� Y/N <br /> Address S� '�� �`+j^ � i � G�� 33rY1—ucense# G�G C�Sc��j7 <br /> ELECTRSCIAN J1 ,n'- _ � 7� �dMPANY a1-�tS3't �/'�''��Y�t L_ -1 <br /> SIGNATURE /��/"� /��(/�P " REGISTERED Y/N FEECURRE� Y/N <br /> . 7� � � <br /> Address ��i�v"✓ �� 7j;r'35 License# �� �U�� �i 3 � �1�` <br />' ::.. ... '�7 y� t lY����� � �`� <br /> PLUMBER /+�COMPANY � � � �I" <br /> StGNATURE REGISTERED Y EECURRE� Y/N <br /> Address License# �- lta-- ��� <br /> , � . �. ��'-�- � ��-�--� <br /> MECHAt1ICAL /j���`� GOMPAHY CiG Y�,j� F�t l�C k P <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � 1{�/? "G- t �.� 3a'�! 1 License# �� 1�'L d � <br /> OTHBR COMPANY � <br /> SIGNATURE � REGtSTERED Y/ N FEE CtlRRE� Y(N <br /> Address License# � � <br /> IIIIIIIIIIl11.1111111i11111111111111111111111I1111111111111111111111 <br /> RESIDEMIAL. Attach{2}Plot Plans;{2}sets of Building Pfans;(S)set of Energy Forms;R-O-W Permit for new consWctior�, <br /> Minimum ten(10)working days aker submittal dale. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence instalied, <br /> . Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsAarge projecls <br /> COMMERCtA� Attach(2}compiets sets of Building Plans plus a Life Safety Page;(S)set of Energy Forms.R-0-W.Permit for�ew construction. <br /> tviinimum ten(10}warking days after submittai date. Requlred onsite,Construction Pians,Startnwafer Plans wt Sitt Fence instalied, <br /> Sanilary Facilities&1 dumpster.Site Work Perrnit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sels of Engineered Plans. <br /> ""PR4PERTY SllRVEY required for a3t NEW construction. <br /> -�-i-i-i-I-.I-.I�i-�4-1-i.��i-S�-i-i-�Fi-i..i.d-i-l-i-i--i-i�i..4-i-1--i-{.-Fi-F-I-I-4-t-E-i-i-.4-I�i-�t-i�-i-i-i..I-I-.4-i-i.-i-I�-i-i�.i-�i-1-.i-t- <br /> Directions: <br />, Fill out application completeiy. <br /> i Owner 8 Contractor sign back af applicatton;notarized ' ' <br /> if over$2500,a Notice of Commencement is reqaired. (A1C upgrades over$�564) <br /> " Agent(for the conVactor)or Power of Attorney(for the owner)would be someone with notarized Ietter from owner aulhorizing same <br /> QVER THE GOUNTER PERtutITTiNG {capy of contract required) � <br /> Reraofs if shingles " Sewers Service Upgrades A/C Fences(Plot/SurveylFootage) <br /> Driveways-Not over Counter if an pubifc roadway's..needs ROW � <br /> r , , � i ,. <br />