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s��-�eo-oozo City of Zephyrhills Permit Application Fax�13780-0021 <br /> Buitding Depertment <br /> DaM Rs�siwd ^' Z/ Phane Confact Tor <br /> • Owr�'s Name L �S.i.� Ownsr Phone Numbar '� -� <br /> Owr�s Addr�ss Ownar Pl�ons Numb�r �� <br /> Fae Sim�le TiYN�oWsr Mrns N Owmr PiaM Dlwn�r �� <br /> Fea Simple Titlaholdsr AddrNs <br /> .106 /1DOftE$$ �./ I � � �OT / � <br /> SUBDIVISIOM PARCEL ID/ - � - - <br /> foeruw�n Fnor raovdeir r�x xo7� <br /> WORK PROP06ED � NEW CONSTR B Apq/ALT Q SIGN Q O �Npi_ISH <br /> 1NSTALL REPAIR <br /> PROPOSED USE [��SFR Q CONM Q OTHER <br /> TYPE OF CONSTRt1CT10N O BLOCK Q FRAI� Q STEEL � <br /> DESCR�TION OF YYORI( <br /> BINLdNCa 312E � X� 1� SQ FOOTACaE � ►IEIq{T �� <br /> UILDiNG S VALUATION OF TOTAL CONSTRUCTIONI��L.�. D� •� <br /> � [ <br /> ��FC�CTRICAL S AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> �PCGMBING S <br /> L ECHANICAL S VALUATION OF MECHIWICAL INSTALLATION <br /> � � 2 ��� <br /> �GAS Q ROOFING Q SPECIALTY Q O7FIER <br /> FINISHEO ROOR ELEVATIONS FLOOD ZONE AREA �YE$ Wp ✓ <br /> BWLDER 4- /'�//, ,� � COMPANY �J 1 1`�� Y I <br /> SIGNATIIRE �� J rtEC�sTQteo �cYJ/ N I FEE cuRkE� / N T <br /> Ad�s . � �2US License # <br /> ELECTRICIAN C ���� ' / �„ � CpwpqNy <br /> SIG4tATURE � <br /> REGISTERFD / N FEE CURRF.A / N <br /> � �IC6f13B * - O v <br /> ���R ���� �P�„ � �1.�r rv� � Ssr� . <br /> ��T�E REGisrQx� I N "_ �cunr�n 1 N T��' <br /> •b" <br /> Adtksss Licer�se � + <br /> MECHAMICAL COMPANY � �1 <br /> ��� R�sr�o N � cuprt�r, N <br /> � 3 �# <br /> O7HER Cpypp,�y <br /> `� REGISTERED Y/ N FEE CURRFI. Y/ N <br /> � �ICBfl6@ # <br /> � � � � � � � � � � �{ � � � � � � � � � � � � � � �� �� � � � � � � ��� � � � � � � � �� � � �.,� �.,/ � �{� � � � �� � � �� <br /> RESIDEN'f1AL Attach (2) Pbt Plens; (2) set,s d BuikSnp Plans: (1) set of Energy Fortns: R� W Penn� foc rreiw omghuclion. . <br /> Minimum ten (16j v�ortu'�B days aflet submd6al date. Required ansite, CorbVUClion Plens, Slartiwaler Pharu wf Si4 Fence instatled, <br /> Sanitary FaciFties 8 1 dun� Site yyork Pertni[ for subdivaionsAarge prajects <br /> COMMERpAL Atfach (3) oomplete sets of Buiiding Wens pkis a Lile Satety Page; (1) set d Energy Forms. R�W Permit for new �ion. <br /> Mirrimum ten (10) workin8 deyg eRer subnrittal date. ReQ�ired onsite. Canstruction Plans. Sfamwaler Plor�s w/ Sik Ferae insta�led, <br /> sarritary Faoibties s 1 dumpster. site w«k Perma ror eu r,ew prajecis. a� commercia� requ:ements must meet camp�iance <br /> SICaN PERMIT Attach (2) �e1s of Ergineered P�s. <br /> ""PROPERTY SURVEY reprred far ad NEW construction. <br /> DirxUo�: <br /> Fill out appliration completey- <br /> Owner & Contradar sign hedc of aPdication, rqtar¢ed <br /> H orar t2500, a Noliw of Comm�ncamMt is ►a4� U� �P9��s owr 57500) <br /> " Agerrt (for the cor»ra�x«) « Power or Anomey (r« v,e owner> wa,a be saneone wiv, rpterizea �ecter rran owner auMiormng same <br /> OVER TT� COUNTER PEFt�11TTING (Front of Application OnN) <br /> Reroofs if shingles Sewers Serrice Upgradas A!C Fer�ces (PIW/Survey/Foofage) <br /> D�fimvays-Not over Caxxer if on public roadways..� ROW <br />