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8��-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> , Building Department <br /> Date Recelved $/ 3 f�( rJ'' � Y Q�? �3 <br /> Phone Contact for Permittin <br /> Owner's Name L. �NN�/e oMES Owner Phone Numbor `/�/ 7 �' ��QQ <br /> /S55o LiL�rwAvF A�1 •�2/o C 33's° �- � <br /> Owner's Address �N/¢1!�'/1 �- Owner Phone Number <br /> Fee Stmple Titleholder Name Owner Phone Number �'�+�� <br /> � r., <br /> Fee Simple Titleholder Addreas <br /> JOB ADDRESS �I�� �3 (t.I 17 �U' �E/ 7R�I� rL ' �? C� LOT # p� <br /> SUBDIVISION flLANp /�Ale/�. PARCEL ID# 0� — ��O '�2�' Q� 3 D� QQ! 3O <br /> (OBTNNED FROM PROPERTY TAX NOT1C� <br /> WORK PROPOSED � NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK /I�Fw Co�vsr�Pvc r�o�/ " TO Gt//✓/yOM�S <br /> BUI�DING SIZE SQ FOOTAGE L� HEIGHT a� �STOR y <br /> �BUILDING $��, `SO VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ 3 y � o AMP SERVICE � PROGRESS ENERGY Q W:1'{�.C. <br /> ' ' �. <br /> �PLUMBING $ � <br /> �MECHANICAL $ y � ys VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> -�—�-�.-►_F-�-� <br /> BUILDER COMPANY ��N��� D��S <br /> SIGNATURE REGISTERED Y/ N FEE Ct� Y/ N <br /> Address �ss$ LI�.N �.�/0 CLE91PNATF/t� FC,� �O License # G. �T C �s � �t0 � <br /> ELECTRICIAN COMPANY OMon/�pq/ �LE�'T/e/G 211/G • <br /> SIGNATURE REGISTERED Y/ N FEE C�N Y/ N <br /> Address ��37 �Kll� %19 I� . f� 33�i/ License # F� A�� �'.S7 <br /> PLUnnnFR COMPANY 8� �V P'����1V G' <br /> SIGNATURE REGISTERED Y/ N FEE Cl1FtREA Y/ N <br /> �1C��rocS �! ��� y vrEw �� l LIC@(1$e # � F� D a/54 4 <br /> MEC��^"ICAL COMPANY ���/�NFT �vM�B/N� /7�Nfr $�� <br /> SIG� '��rE REGISTERED Y/ N FEE CURRE� Y/ N <br /> A�!�!ress /"• �•BG�.3.30 NFl �0/NT L.3��►?7 LiCertse # C.1��Qs,� lt� �O 2��� } <br /> OTH=� COMPANY [. C.S�Tf/(,(�Nb vilAC.i i /QOA�i�C+� .�N�'• <br /> SI G "' �^ F REGISTERED Y/ N FEE CI�REN Y/ M <br /> �., , �., s `1��� .SNoAL i.lNF Bt-vQ cSpR��vb f/ic� F� 3yi� � ucer�e # CC �' OS 99/ <br /> i�����iii��ii�i�ii��ii�iii�i�������iiii�ii�i��i����ii�i��������i��� <br /> RF °�� � �� � � Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new constnx,�tion, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construcfion PNans, SLOrtnvvater Pians w/ S�t Fence instaqed, <br /> Sanitary Facilities � 1 dumpster, Site Wor1c Pertnit for subdivisions/large projects <br /> COn^ ^^ �^�� � L Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Fortns. R-O-W Pem►it iw new construdion. <br /> M�nimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sbortnvrater Plans wi S�t Fence ins�abed, <br /> Sanitary Facilities & 1 dumpster. Site Work Pertnit for all new projects. AII commercial requiremerrts must meet compfi�Ce <br /> SI�"' ^ ^^!T Attach (2) sets of Engineered Plans. <br /> '*"PROPERTY SURVEY required for all NEW construction. <br /> .�„6,. o , 1,L,. . . . . . . . . . . . <br /> Dire <br /> F �piication completely. <br /> � � �or�ractor sign back of application, notarized <br /> ' � Sn�., a Notice of Commencement is required. (A/C upgrades over 57500) <br /> "' � r the contractor} or Power of Attomey (for the owner) would be someone with notarized letter from owner auUiorizing same <br /> OVE" oUNTER PERMITTING (Front of Application Only) <br /> Rer� ` �� "-�i�s Sewers Service Upgrades A!C Fences (PIoUSurvey/Footage) <br /> ' �ys-N�t over Counter if on public roadways..needs ROW <br />