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i <br /> B10.780•0020 City of.Zephyrhills.Permit Application Fa><Oi3 Teo-0o21 <br /> ' F3Widing Doporunonl <br /> Date,Rewlvod Phone Contact4or Pormlttin <br /> vnor'i,Namo 1 o(r_,iF '3 C. (j i l Y.l_ ). .1 V).) .: OwnbuPhona'Numbdr <br /> 2p r n <br /> Ownor s Addrosir 3 t - 1"1 F t Z 1:1 � �Q O,�`\ Owner Ptiono Number <br /> Foe Slmp-la Titleholder Namtr Owner Phono Number <br /> Fro Simple ThIsholdir Addrosa <br /> Jog AD RE <br /> LOT R <br /> SUBDIv►sioN PARCELIDN . "i k IJ J :.�i .-''l C©li}-I)°35t� '�D ( <br /> "IOdiAINED FROM PROPERTY TAX NOTICE) - - <br /> WORK PROPOSED B NEW CONSTR B ADDIALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR. <br /> PROPOSED USE Q SFR Q COMM 0 OTHER - <br /> TYPE OF CONSTRUCTION' 0,. BLOCK Q FRAME 0 STEEL <br /> DESCRIP.TIOH OF WORK <br /> BUILDING SIZE SQ FOOTAGE=. HEIGHT <br /> QBUILOINC+ S' VALUATION GP TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING S <br /> QIAECHANICAL (S VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA []YES NO <br /> BUILDER �. �1'`,.,I COMPANY `>. .I N�U�iI"RI L. �J' I�d CTf.C� <br /> SIGNATURE "�• MdMTERea Y'l'N <br /> tt rr /� 'r FEF..CURREN'. ' : YIN' . . <br /> Addrrrss I rJ n; l0�1-%JC1 C7-ZRt'z / Ucensep <br /> / <br /> ELECTRIC C MPANII r, �P�yp,• <br /> St E a+siCriEo, Y f N . see ctmRFn. -YIN <br /> Addrosa <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y 1 N. FFF CORRIr.. 'Y f N <br /> . 'Addro99 - ..Lif:enSDb <br /> MECHANICAL COMPANY <br /> SIGNATURE. nwameEo Y 1 N FEE CURNEF Y I N <br /> Addrbse Llernsok' ' <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED YIN FEE C FIRED YIN ' <br /> Address License 0 <br /> RESIDENTIAL Attach(2)'Pioi Ptans;(2)sows of Building Plans;(1)set'oi Energy Forms:R•O•W Permit for new rondtruction, <br /> Mtirimufn ICn(10)working days af18r eu>>rTlttal date. Regv:rcd on;ilc,Construction Plans,Stormvrotcr Pl.+ns w/Shc F.enco In_stallod; ; <br /> Sarthary Faulitics&t durnpsler;Silo Work Pormit for subdMsionsAarpe projects <br /> COMMERCIAL l,nach(2)complete idle DI Building Plops plus.a ufo Safety Pagu;(1)set of Enerpy.Forms.R•O•W Permit la naw oonstrucuon, <br /> Afitilmum ton(10)vbd6ng days after submittal date, Roqured onsile,Construction Plans.Stormwotor Plans w/Slil Fence Installed, <br /> Sanithry Fac lll)es A 1 dumpslet.,Slta Work Permit for o0 now projects.NI coinmercial roquiremenls must meet cwmpilanee' <br /> SIGN PERMIT Attach(2)sots of Engineared Plana. <br /> ....PROPERTY SURVEY required lot all NEW construe". <br /> - . . <br /> Diroctlona: , <br /> Fill out opp1=60n completely. - <br /> pr.ner&'Contractor sign Nick of apphwtion,notarised <br /> If over$2500,a Notice of Commencement is rogylrod. (AIC upgradas over$7500) <br /> � Agont.(for.trio caitraclur)o?F'awer cf Atlomey(tor the.rnmer)wovld lie som000a with notarized teller Irorn owilM qutnortrirg same OVER THE COUNTER PER►11'MNG (copy of contract requ red) <br /> Rvduf*ilbhfogls:I' -Sowu(s Sorvico Upgrrnles Pic Fences(P.lousurvcylFoolage) <br /> Orivowap:Not over Countor if On public roadvrays..needs ROW <br /> _ 1 <br /> l <br />