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813-7$0-002U �ify m�'Zephyrhills Permit Application Fax-813-780-OQ21 <br /> Bu�iding Deparkmen4 <br /> Dafe��aelv�d ��� "t()"� — ���� <br /> Phane Contac�for P+�rcnittin <br /> C1wrn�r°��da�me l�� t,/lV �� V 1 (e� O�rr�ee PhonQ Rinntber <br /> Qwn�r°s�ddress 1 UL� w V �� "[ - �nee.Phan�Plumber r� � <br /> Fae Slmpl�Tl�lahold�e Name Owe�er Phone Rlumfber � � <br /> ��e Simpi�1'Iki�holder Address <br /> JO��DpRES$ ���t 1 i iv1./I � '� iV��� �� � L�T� ��� <br /> su�a���siow ��1�' �U1 �ll���0� �,�ac��i�� � ��t� -o�1-�t3R0 �t�t3C>C?0- 1 E��t� <br /> (QBTdINED FROM PROPERTYTA7C Np'PICE) <br /> �,�����$�o�E� t�EW CANSTR ,�a,A�� o ���� o o ���a���H <br /> e INSTALL e REPPJR <br /> P"�OPO���?tD�E Q SFF2 [� COIUit1� Q t?7HER <br /> 'i'YPE O�COR9�TRUC'�lOR9 Q BLOCFC " �J FRAME � 5TEEL Q <br /> DESCRIi�Y1�A1 OF i�l�RiC ���� Vt��!� ' . t�t���1 ' . <br /> �ilIL�2AtC�I�E �t�FOO'�'R�Gg�� t�Etfi,tiT ��� <br /> Q BUi€.DII\tG � � VALt1ATtOt�OF 1'OTA�.COFVS7RliCTtOi1t <br /> QELECTRiGAL � � AMP SERVICE - Q PRdGRESS ENERGY Q W.R.E.C. <br /> QPLUMBIfdG $ ���� ' ��� ` <br /> QMECMANlCAL �� V;4!_UATIQiV OF MECHAPl1CALl�lSTAI.LA7'iON � <br /> ' �3 31 <br /> �]GAS [� F3QOFISdG .�] SPECIAI.TY � OTHER <br /> FiNISHED FLOOR ELEVATIONS �� FLOOD ZONE ARE.A �YES NO <br /> � � - <br /> �tillLt}�� �OAi��'�Y <br /> �����+��g REGISTERED Y/ PI FEE CURRE� Y/N <br /> �Sdt�Y47B� L�CBtiSe# � � <br /> �6��:��IirtPea'Q° +tiV7�7i'/�7 � - <br /> �«������ � REGISTERED Y/ fV FE@ CURRE� - Y/fU <br /> ,�dt0��S8 l#Cet1S8# � - ( <br /> � <br /> ���m��� �� .�� n ��. co���eaY �'� �'1(`�`� ,Y"l�l �«� <br /> �IGPIA�T�DRE /( REGIST@RED Y J:N_ �e cu�n - Y/ <br /> Addr� � ���� � - Licen88# [ ���`•����j t�t � <br /> i��CtC�t1��sL C��Ph►WY <br /> �«������ REGISTERED YI iV . F'EE CURREP. Y/IU <br /> �iddP��B � �ct�ri�9# � � <br /> t�Yk��� CO�f1�;�PiY <br /> �IfaiitA'�'ld�� REGISTERED Y/ 1d.. FEE CURREA Y J N, <br /> Ad�ea�� Ltcense#-� � <br /> �C�lD�fi��'IRt; Attach{2)Rlot Plans;.(2)se4s:of.Builrling�P,lans;(-1)sat of Eeiergy:Foiins;Ft-t�Vt1 Permlt fcr new construction, <br /> NEinimum:ten.(40jvuoricing�days,after:subm[ttat date:�:Required ansiEe,:Gonstruc8on Plans,Stomiwater"Plane w!Siit Fence insta{ted, <br /> � Sanitary Faci�ftles.&;1,dumpste.r,,Site.Work.F?ermit�iar.subdivisionsAarge.prajects � - <br /> COM4�l�R���aU. Attach{3)t�ompieYe sefs of Buitditig P[ans plus a t.if�Safe4y Page;{'t}set of Enetgy Fasstts.R-fl-W Permik far neud construction. <br /> Minimum ten(10}warking days after submittai date. Requlred onsite,Conshuction Pians,S4ormwater Ptans w/Si{t Fence instalied, <br /> Sanitary Faciiities&1 dumpster.Sike Work Permit for all new-projects.All cAmmercial requlrements must meet compltance <br /> SI�Rt P��lY Attach{2)"sets of Ertglneered�Pians. . � <br /> "•°•PROP.ERIY SURVEY required fae atl PIE1i►/construction. <br /> C►tra�4ton�: <br /> Filt out applicaUon compiet�ly. <br /> � Ouvner�Contractor sign back of appitca�o�,nota�ized � <br /> �f asaree�25�Q.�Nlo4i�of Comm�ne:���ea�3s requireal. {�il�u�gead��oer�e�i?��0} <br /> '* Agent(for 4he contr�actor)or Power ofAttamey(far Uie ouuner)wouid be someone writh natariaed letter fram owner authorizing same <br /> C?V�R TME GOtlA£�Eii��t�Hi't'�'Fi�G -{Frant af�Appilcatton Only) <br /> Reroofs If shingies Sewers Ssrvice Upgrades A/C Fences(Plat/Survey/Footage) <br /> - � - <br /> �riv��nrsp�-SVflt aver Gount�r if,on publlo roadways..ieeeds ROW <br /> �... - � - � <br />