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$I3 7$t1U020 Fa813 7$�021 <br /> City of Zephyftlills Permit AppllCatlati <br /> BuIWIrp DepaRment�'{ ��=°`":• <br /> Date Received Phons Contact for Parinttlirt <br /> owners Name SLOAN BEVERLY A OlrrnrPhone Number 813-361-0334 <br /> Owners Address , 592917TH ST ZEPHYRHILLS FL 33542-3869 Owner Phone Number <br /> Foe SImple'ntlehoider Name Owner Phone Number i i <br /> Fee Sinhpte Tttisholder Add"" } <br /> JOBADDRESS 5929 17TTHH ST LOTH <br /> SUBDIVISION 4 PARCELIDAt 11-26-21-0010-04200-0070 <br /> roaTuum FtiQM rttoreRTr rut Nd7fIt:II . ., <br /> WORK PROPOSED NEW CC) M 8 ADDIALT SIGN [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR 0 COMM rI OTHER <br /> TYPE OF CONSTRUCTION BLOCK [j FRAME - STEEL Q <br /> DESCPJP710M OF WORK RFWREP SAME SIZE WINDOWS 2 <br /> BUILDENLi SIZE I $Q FOOTAGE HEIG1IT <br /> BUILDING $3,490 -� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL (S AMP SERVICE Q PROGRESSENERGaY Q W.R.E.C. <br /> f--1PLUMSING <br /> MMECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING 0 SPECIALTY=1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA AYES NO <br /> BUILDER NEW SOUTH WINDOW <br /> AECrharE <br /> SIGNATURE �ti/. COMPANY Y <br /> aED I Y/ N FEE CURREt. Y!N <br /> Address 4901 Oak Fair Blvd Tampa FL 33610 #C'L 1330822 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REolafEaFD Y t N mcuRtse'n�'��� <br /> Amm" LlaemeA l <br /> PLUMBER COMPANY <br /> SIGNATURE REtileTEaEo 1,YJ N IimCURa1A L.XLN <br /> Address License#I77 <br /> MECHANICAL. � � COMPANY = <br /> SIGNATURE REcnaTEREa I YIN t'mcumum YIN <br /> Address Lis n"s <br /> OTHER COMPANY <br /> SIGNATURE F REGIShRm I YIN FMCUR En Y!N <br /> Address Umnse t <br /> it111tiillll,111111111111t,11 all 1IIIIli11,s1111111111111 ilia III it111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bulling Airs;(1)set of Eruupy Fdrms;R.O-W Pemttt for new coristiticlon, Ir <br /> Lftn ah fen(10)wonting daft Mer subminml date.Requited onsite,C.onsbucdon Plane,StOMWAder Plarts w!Sit Fence Installed, <br /> Sanitary Facilities&1'durrhpster,Site Walk PwmB for sutattutdonaAarp pro" <br /> COMMERCIAL Attach(2)complete sets of Building Playa plus a Life Safety Pape;(1)act of ErmW Forms.R-O-W Petit for new construction. <br /> Minimum ten(10).worldnp days alter subrtdla)date.Required onsb.CansMml m Pitins,Stommaeter Plans wl Silt Fence.mstaied, <br /> Sanitary Fadilea 61 dumpsler.Ste Walt Petit fa el rtew proJSas AI wmmeretef requtrerrhntta must meet eomp9mtce t <br /> SIGN PERMIT Attach(2)sob of Engineered Puns. <br /> PROPERTY SURVEY required for el NEW canaLucilon. <br /> Din Fill a �,nl 9 <br /> Fill out application completely.*fSly. (r / <br /> Owner&Contractor sign be of applicallm notarized �( <br /> It over$2600,a Notice of Commahcemevt is"Dad. (AIC upgrades over$7t$LO) <br /> Agent(for the contractor)or Power of Attomey(for the own"would be someans with notartzed leterfrom owner authwWrig sane <br /> OVER THE COUNTER PERMITTING (oopy.of contract required) <br /> Remals I stdngies Sewers Service Upgrades A!C Fences(PIot 5ur%*1Footepo) <br /> Driyowaeys-Not over Counter If on public rva*mp..nesds ROW <br /> �J ✓ <br />