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<br />~\ \:3-~ <br /> <br />City of Zephyrhllls Pennlt Application <br />BuIldIng Oepcutmn <br /> <br />Fax-813-7SG-0021 <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address 5439 RIiun~ <br />Fee Simple Tltleholder~' <br /> <br />'l <br />Owner,P~ Hum,-, <br />", 0wn0r__1 <br />, 33634 I <br />Owner Phone Hum'-, <br /> <br />JOB ADDRESS <br /> <br /> <br />LOT' lIB <br /> <br />Old)-OO~6t90 <br />(08TAlNID !"ROM PROPIftTY TAX N011CE) <br />SIGN 0 MOVE 0 DEMOLISH <br /> <br />OTHER I <br />STEEL 0 OTHER I <br /> <br />I <br />CiJ NEWCONSTR E3 ADDIAL.T 0 <br />D INSTALL REPAIR <br />PROPOSED USE . C&l 8m 0 COMM 0 <br />TYPE OF CONSTRlIC'nON CJ BLOCK 0 FRAMe CJ <br />DESCRIPT10H OF - I ~ Single rt, Resi&!nce <br />BUILDING SIZE I~)l~ SQI'OOr...... n ~ <<U <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />o <br /> <br />HEIGHT' <br /> <br />BUILDING <br /> <br />~ 071~6 <br />b526 <br />kt(o 17 <br />,. 5+60 <br />o GAS '0 <br />FINISHED FLOOR ELEVAnONSI 110 . )() <br /> <br />, <br />I <br />I <br />I <br />o <br />I <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY '0 <br />~S>- <br />R-O-10 L <br />~DC <br /> <br />WRE.C, <br /> <br />o <br />o <br />o <br /> <br />VALUAnON OF TOTAL CONSTRUCTION <br /> <br />ELECTRiCAl <br /> <br />PLUMBING <br /> <br />MECHANiCAl <br /> <br />VALUAnON OF MECHANICAL INSTALLAnON <br /> <br />ROOFING <br /> <br />SPECIAL. TV CJ <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES ~o <br /> <br />~ <br /> <br />Addr... <br /> <br /> <br />3634 <br />I <br /> <br /> <br />A~' <br />"I' ~p <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Ween..., <br /> <br />ELECTRICIAN <br />SIGNATURE' <br /> <br />Addr... <br /> <br />S & S Electric Co. <br />' I Q' J N j '0 CUMl!NT <br /> <br />Lloen.., I_Ill. <br /> <br />.a <br /> <br />I <br />B (2C:tj~;U')G <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Addr... <br /> <br />V1ECHANICAL <br />SIGNATURE <br /> <br />Addr... <br /> <br />Address! <br /> <br />tESIDENTlAL <br /> <br /> Weens. , <br />COMPANY <br />MGItT8ID VI N <br />I Ween.. , [ <br /> <br />)THER <br />;IGNATURE <br /> <br />~ (2) Plot ....... (2) .... of Building Pllln.: (1) aet of Inergy fIonns ' <br />~ tin (10) ~ da~ .,..,. eubmlttlll ct-. "equtred on...., ConettuClllon Plans, Sanlblry lIacJlltI.. & 1 dumpster <br />AtaIoh (8) .. of IIuIdInG .....1 (1) Ht Of.'*DY rworm.. <br />MInInun fIIn (10) wartdno day8 """1Ubrn1tt81 date. fItequ/Nd ontItIt, Construction Plane, Sanitary lIacJlltJ.. & 1 dumpster <br />AI OOftlftIeICltII "*"*-"'__ In'" meet compliance. <br />AtaIoh (2) .... of """'Id PI8na, <br />u..~ i V aulWaY NCIU/I'Id for III NIW 00ftItru0ll0n. <br /> <br />Irection.: : ~ <br />Fill out appllcdM complUlly. <br />Owner & ~ alan NClk of IPP/klItJon, nofMzecJ <br />If over $2SOO, a NotIoe oIC~nt.. NqU!Nd. (Ale u..... over $8000) <br />Agent (for the oontracliar) or Poww of Attorney (tor the 0WMt) would be eomeone with notlirlzed letter from owner aulhorJzJno ..me <br />VER THE COUNTI!R ......In._ (Front of Application Only) <br />Reroofs s.ww. 8erv/ce Upgrades Ale <br /> <br />:OMMERClAL <br /> <br />IGN PERMIT <br /> <br />- <br /> <br />Drlveway&-Not over Cotner If on public roadwaYS..needa ROW <br /> <br />JIenoee (P/ofISurvey!Footllge) <br />