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i <br /> B13 City of Zephyrhills Permit Application Fax-813.750002i <br /> Building Department <br /> Date Rrawod /t Phone Contact for Porin}tUn' t <br /> 1 (0 OwnerY Narrie. �. - L'. � rr tAvnnrFhona Numtwr ' <br /> DwnereAddress =.CJ' 17 tTonorPhanaNumbar7f�- �t(1�1f6L- <br /> Gt <br /> Fee Simple THlshofdar None r. 10I.Phonallumbet <br /> Fee Simple TitishoWwMdross <br /> .JOB ADDRESS � 12(C� � _ LOTtR <br /> SUBDIVISION ;.�Sj PARCEL�Di ~ 2i�2( (ooi(� �* ( 3 U <br /> -- - (QWAWMFRWIIPRQPERTYTMNOTICE) <br /> WORK PROPOSED ® ttflrGkL5iR8 ADDIALT = SIGN CD 0 DEMOLISH <br /> 1NS'TALL REPAIR <br /> PROPOSED USE = SFR �- Comm 17-71 OTHER <br /> TYPE OF CONSTRUCTION ] BLOCK E FRAME STEEL <br /> DESCRIPTION OF WORK Vy.. ' • +.:.t��1 t, r �:( Ul t.V <br /> 13WLDING SIZE :jSG FOOTAGE HEIGHT <br /> QBUILDING 5' VALUATIONOFT07ALeCONSTRUCTTON <br /> A-0-c0b] <br /> QELECTRIcAL g' R{f1 AMPSERVICE C] PROGRESS.ENEF-OY Q W.R.E.C. <br /> PLUMBING <br /> =MECHANICAL §, VALUATION OF MECHANICAL INSTALLATION �'.- + . <br /> =GAS Q ROOFING .0 SPECIALTY r--j OTHER <br /> FINISHED FLOOR ELEVAn6NS. ' FLOOD ZONE AREA [=YES No ' <br /> �94 <br /> (�DER ' cora�PANw F-- ,.) 60. 2 7,ic° <br /> NATURE REt3ieTEREQ •! ... <br /> NATURE ..� �Py�-'.(.r`^�•_ Y 1"t+� >�Cto2Rr:n YIN'. <br /> 2WAL-mTfilc <br /> WN - .r idPANY' lotiWil� �r.(;nccr:, t Of%iW 6- tc�. 1a . <br /> .SIGNATURfi: r- REGSSEER6) YtN' "FEeCu.,F '�ffu <br /> Address. `1'l. .off' ._ fltaAw. �r, Lken:er EC t3o012o0 <br /> PLUMBER ( COMPANY <br /> SIGNATURE l RE(NTEM I YIN, FEECURRen' <br /> Addtw <br /> r <br /> r� <br /> r <br /> ��C r'�� �I}t HAHIt:AI r tOMPANY Wil --� intcri.v ) cL6A*%1-a In(.-, <br /> SIGNATURE ir>ctsTEnm I. Yd N CUFi �Y IIN <br /> Add. 15a C.: .Prdo�• ��.. License lFF&AL VVSo 11 _ <br /> OTHER COMPANY = - - <br /> SIGNATURE _ REGISTERED I Y/N. .I..EE.CURREh ':YIN <br /> Address Ltcertae#1' <br /> RESIDENTIAL Attach(2)plot Plans;(2)"h of BtiUdlag Plaiu;(1)so <br /> ` l of Energy Forms;R Q 1N P,arinll farnve canaWct3on, <br /> hTmtn*n ten(10)working days efidr submittal,dat6:.Required onMte;'C6nstrii66n Pian's,'Slormwater Plans wl Silt(F.enoo inwilail; <br /> Sanitary.Fac7lUea 81.duinpstor;;Silo Wafi Porinl('for;subdh+lsloAsllorge pro)ects <br /> COMMERCIAL Attach(3)comp.1 aid.syls of iOdInq Plans pius a,li(a Sefety;Pago;(1)oot faf 6norgy Forms,,R Ci.V!/,i?rzm)t for naw;oonstructlan. <br /> hCnlmumtun-(1b)ypAIngdaysettnrnubmittat'drito;�Requliedoaslte,�ConsWdanPlan©Storm»aYoiPlans,wlSlttiorfcalnilolied, <br /> ',SantiaryFacllluos:81ldmpster,SilwtacrkPermitfor Olt rf"Pro)beta:Ancoemcidnl'`eguiiemebts'inu,, ir", ,,'mplla- <br /> SIGN PERMIT Attccti(2)Oats or-Englneertid Phis. . <br /> "PROPERTY SURVEYreii adfoioUNEW nstrucUoir.: <br /> DiiacttanD:; <br /> Fill outappficaton completely. <br /> Owner Contractor sign back of aWlcatfon,notarized <br /> If ovor E75Qb,a tfotics of Commoncatitant is requlred. (AIC upgrades over ST500) <br /> Agent(for the contracW)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING .(Front Of AAppticatfoa Only) <br /> Retools If shingles Sowers Servico Upgrades'A/C Fences(Plot/Survey/Footage) <br /> Drlww.ys-Not over Counter Iron public medweys-needs ROW <br /> r <br />