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�j i .� - i a v � Uv�( <br /> , � e��-7eaoo2o City of Zephyrhills Permit Appliqtion Fex�13780-D021 <br /> Buflding Deparbnent <br /> • � '! Dato R�ulwd � �� Phone CoMnet for P�rmittln I� ��� ��!�� <br /> Own��s Naen� �S ��1 F i.� Owner Phom Numb�r o �3� I��"j O C� <br /> Ownds Addras ( �3�B l -1 �1 12P L 1 �wnor Phone N�onb�r <br /> FN Simpfe iWehoid� Nam� Own�r Phone Number <br /> FN SImpN TIH�hold� Addnss <br /> �osnonr�ss ( 3(e l � �^ S�fi�2.ec�� �ors � <br /> SUBDM810N ��`Y IZ Pl P�C'$�. PARCEL IDi o`� ��'�F' `r�( � E/l S O --(JOOQc7--C1�C..1 u <br /> (O�AINm FltOY PROPHi�YTAX M07IG� <br /> WORK PROPOSED B NEW CON57R 8 ADD/ALT Q SION Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROP08ED USE Q SFR Q COMM Q OTHER <br /> TYPE CFCONSTRU ON Q BLOCK Q FRAME Q STEEL Q <br /> DEECftIPT10N OF RK �'1 C C' �� c7�.�� 3 T�V 0 Y S�f��'`��"� � �C LJ <br />' BUILDINO S� 8C FOOTAGE� HEIOH� � <br /> QBUILDING E VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRI i AMP SERVICE Q PROORESS ENERGY Q W.R.E.C. <br /> OPLUMBING S l 9� <br /> �MECHANI y ��3�i VALUATION OF MECHANICAL INSTALLATION � <br /> OGAS Q ROOPINO Q SPECIALT1l Q OTHER <br /> FINISHED FLOOR EL ATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> 81GNATURE rtEcisrERED Y/N �Cu� Y/N <br /> Addrus Llcense# <br /> ELECiRICUW COMPANY <br /> 61GNATURE REOIS?ERED Y/N �CuaWB� Y J N <br /> Addms License# <br /> PLUMBER COMPANY <br /> BtONATURE REOISTERED Y/N FEEcuaaEr Y/N <br /> Aaar.,. ucenae# <br /> NECHANICAL CONpANY d7 �e��/C2 S <br /> SIfiNATIJRE r�cis�aen Y/N �cua�n Y/N <br /> Addras Q� (f �C.)a.��� -� Llcense# ���a d � <br /> 07HER. COAIPANY <br /> SIGNATIJRE r�aist�o Y!N �ctraiee. Y/N <br /> Addru� Lleenee� <br /> r�rnrrr n���rrrrrr�--rrir.r.rrr� � rr�r» inrnri�rr�r� rr��Trrrrn �rrr� <br /> RESIDENTIAL ch(2)Piot Plena;(2)sets of Building Plans;(1 j set of Energy Forms;R-O-W PermN for new conatruetion, <br /> Inlmum ten(10)woridng days elter cubmlttel dete. Requtred amlte,Constructlan Plens,Stormxater Plarro w/SIft Fenoe Inatelled, <br /> Mary FadlWea 61 dumpater,Site Wark PermR for aubdlvielonsllarge poJecffi <br /> COMMERCIAL (3)complete sets of BuUding Plans pius e LHe Safely Pege;(1)set oi Enelgy Fom�a R-O�W Permft for new wnaWetlon. <br /> )nimum ten(10)woddng deys etter submlttel dete. Required or�slte.Construetlon Plana,Stamvvater Plans w/Sltt Fenee Inetetled, <br /> Mary FaeOPoea 81 dumpster.Ske Work PertnR for all new pr�ects.Atl eommerdal requiremerds muat meet cmnplianu <br /> SIGN PERM�i (2)eeta oT Engineened Plans. . <br /> OPERTY SURVEY requlred for ed NEW conatrucUon. <br /> Dlnctl0tn: <br /> Fllloutappli oompletely <br /> Owner 8 etor dgn bedc M eppiicatlan.notarized <br /> M owr=2500, Notla of Comm�neemuR Is nqulrod. (AIC up8ndes owr i7600) <br /> " AgeM(tor the ctor)a Powar of Attomey(for the awner)would be someone with notarized letter from owner eufhorizing eame <br /> OVFR THE COU PERMIf'�1NG (Front of Applleatlon Oniy) <br /> Reroofb H ehingles Sewars Servlee Uppredes A!C Fencea(PIoUSurveyiFcofege) <br /> II <br /> Drlv�rqs-N over Counter H on public►oedrmyS..needa ROW <br />, I <br />