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a�s-78o-oozo City of ZephyPhills Permit Applicafiora Fax-813-780=0021 <br /> Building Department <br /> Dage��e�iv�d " Phone Con4�ct 908 Pere�eit4in � �� <br /> f � <br /> Owner's P9are�e l� �� Oo�rn�e Phon�Fluemb�P <br /> Owner's�ddr�ss ' �!�' � � l�- V� O1N190P PI90d1�IdU1P6�P �— <br /> F�e S0m�s9�TeQleieo�dee�9�me Ouvn��Phono P�umber <br /> F��Sinnpl�TB41�holc9er Adelress <br /> J�������� i�5�`� Si �,�e�� �` � ���� 0 <br /> su�oo�isio� e� v ��c��oo� -d�'a 14- 1 -QO`l0 —0��� `DD l� <br /> (OBTAINED FRONJ PROPERTYTAX iVOTICE) <br /> �i►OR6L�RBPOSED , � �EwrCONSYR� ADD/f4L7 Q SIGN � 0 DEMOLISH <br /> INSTALL REPHIR <br /> PROPOSED:l15E Q SFR � COMM Q OTHER <br /> TVP@ O�C06�STRUCTIOR9 � BLOCK ' � FRAME Q STEEL Q <br /> ��SC�������F���� �%1 (;L L�(1- 1 �l S-�f�L � - <br /> BUILDI�G SI�E SQ FOOTAG�� HEOGHT . _ <br /> �BUILDIIVG � VALUATION:OF TOT�4L COiVSTRUC'iION <br /> QELECTRIGAL $ � , AMP SERVICE Q PF30GRESS ERlERGY Q W.F3.E.C. <br /> OPLUMBING $ - <br /> OMECHAPIICAL $ . VALUATION OF MECHANICAL INSTALL4TIOfV <br /> QGAS Q ROOFING Q SPECIALTY �_ OTHER <br /> FIiViSHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. fV0 <br /> �UI�DER COflflPA4�Y <br /> ���N���1�� REGIS7ERED Y/ �1 FEE CURREP Y/N <br /> ��dP��s License# <br /> �LECT�ICIe�19 C04'�P/�Y _ - <br /> SIGNATl1RE � REGISTERED Y/ N - FEE CURREt� `Y/fV <br /> �d�Pess Ltcense# °� <br /> PLUM�ER CO�flP�+IY � � l�V�I ! �Y � I �-` I d� <br /> S�GPIA1'19R� REGlBTERED Y./ N. FEE CURREP -/N - <br /> Addrass � � I� l_I r 1 Licens�# l.�J'- .' '' � . <br /> NAECM,�IdIC� COftflP� <br /> S1GV�/ATIIIZE REGISTERED Y/ iV F�cuw�n= Y/•N � <br /> Ad'dre$s " License# <br /> O�HE� - - CONJP� � � <br /> SIC�aRlAYl1F2E • REGISTERED Y I IV__- FEE CURRE� Y/N . t <br /> AddP�:� , Llcense#' , � <br /> RESIDE6�TIA� Attacti(2)P1of Ptaris;(2)ssts o`f Building Plans;(9)sef of'Energy Forms;R-0=W Peimit far new constructidn, <br /> Minimum terti(i0),vrffrk€ng da}rs after.submittafdate.� Recjufreii onsite;Constructian Ptans;Starmvrafer Ptan�K�f S��F�-srz ir�..:�4�. <br /> � Sanihary FadC�es�.1 dumpster;Site Work Permit for subdivistonsllarge prdjects^ . <br /> CORfl�AA�RC!l�L. Attach(3)compiet�sefs af Sa:�:ng P�ans plus a Lifie Safety Page;(1)sst of�rt�r�y Fa�ns.R-0-W Pern�:�:s�.,�r c;s:-rs�-a�i_ - <br /> Minimum ten(10)woriting d-ys'aft�sut�anit�21 date. Re�uir�of�,Cr�.,,.��ucti�n r�s,S�rmvra=s r"`t�-r�v,�S�:�=�tce���ed, , <br /> Sanitary Fadlities&1 dumgster.S'�:z Work P�nit fcr aiT reN pr-mg�s.f,�i x�ms.:�rEqa�._.r��rsr:[n�s?�np��ce <br /> SIGR�PERRAI'f AttacFi"(2)sets of Erigineered Plans. - - <br /> ""PROPERTY SURVEY require�i f�r��'Elr'J�.�.'�,�. <br /> DIr�cBfon�: , - - - • - • -•--- --- -- - --- - <br /> \ Ffll out applicatlon completely. <br /> , Owner�Contractor slgn back of appltcation,notarized' • <br /> �',, 1�ov�r$2500,a�Plm4ice of Comen�nc�man�i�r�cyuired. (�JC up�r�des over$7500) � <br /> �,c.:at(for the conVaotor)or'Povirer of A4tomey(for the owner)wrould be sbmeone with notarized lefterfrom owner authorizing same � � ` <br /> "�a=C�U3dTER PERPn91'iTih9G -(Front of Application Only) • ' _ - <br /> .>'4.s�:�� a�� Service Upgrades A/C Fences(PIotlSurvey/Foatage) ' � <br /> �'���:�-fr�-,�c�-,�,-�.�_:.�.:rr-_ya..nesdsR0ln/ - '� <br />