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■ ■ <br /> � � F�omk 09/22/2011 09:10 #520 P.001l002 <br /> ti�, <br /> �� a�aaao-oo2o CIty of Zephyrhills Permit Application Fax-813-780-0021 <br /> .■ Building Departrnent <br /> ■ <br /> ■ <br /> Date Recelved '� <br /> Phone Conlad for PertnlHin <br /> Owner's Name 51NC1� T r ��\ N e. Owner Ptrorre Numbar ��—� 1 Z' � 1� 3 <br /> Owner'a Addrsss 3 p � � Owner Phone Number �� <br /> Fea Slmpls Tllleholder Name Owner Phone Number �� <br /> Fea Simple TlOeholder Addross <br /> JOB ADDRESS O�� J�� LOT 8 N/ <br /> SUBDIV1310N � .N /'J"1 � PARCEL IDA ►-� ' Z� ' ��t o' I`15 ov �' C7 UZ d <br /> (OB7AINEO FROM PROPEHTY 7AX NOTICE) <br /> WORK PROP03ED e NEw CONmt 8 ADD/ALT � SION [� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> 7YPE OF CONBTRUCTON Q BLOCK Q FRAME � STEEL Q <br /> DE9CRIPTION OF WORK G � <br /> BUILDIN(i SIZE SQ FOOTAOE� HEIOMT � <br /> Q9UILDING 3 VALUATION OF TOTAL CONSTRUCTION � <br /> / � � \ <br /> QEIECTR�CAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. / � <br /> / \ <br /> QPLUMBINO $ r � <br /> �MECHANICAL $ �y � VALUATION OF MECHANICAL INSTAILATION � � `( � <br /> �AJ � i/ <br /> Dons 0 RooFiNO p sPECinLrr [� OTHER <br /> FINISHED FIOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � COMPANY � <br /> SIGNATURE REGI5iERED Y/ N FEE CURREl. Y 1 N <br /> Address Llcense # � <br /> ELECTRICIAN `f COMPANY [�// _/ G � <br /> 81GNATURE .(, _ r rx�cls�En Y f � Cuars�n Y/ N <br /> Addnss Ucense # �� 1����� <br /> PLUMBER � COMPANY � <br /> SIONATURE aEOisraeeo Y/ N FEE CUtRE� Y/ N <br /> Address License # �� <br /> MECHANICAL COMPANY i'L B (iX-U!C G/ �L�� /�G <br /> 81ONAlURE REGIBTERED Y/ N �e cu+ttEn Y/ N <br /> Addresa 0 �� U License# �I��. <br /> OTHER COMPANY � <br /> SI6NATURE REGISTS2ED V/ N FEE CUftREn Y! N <br /> Address Ucense # �� <br /> RES(DENTUIL Attech (2) Pbt Plans; (2) sets of Bufidi� Plans; (1) set o/ Energy Forms; R-O-W Pertnit for new consW dion, <br /> Mlnhnum ten ('10) working days eHsr submittel date. Roqulred onslte, Construc6on Plens, Stommnater Pleris w/ Silt Fence kistalled, <br /> Sanitary Fadlitles 8 � dumpafer; SHe Work Pertnit lor subdlvisionsAerge proJects <br /> COMMERCIAL Attech (3) complete aeb o1 BWiding Plana plue e LHe Sefefy Page; (1) set of Energy Forms. R-0-W Permlt for new construeUon. <br /> Minimum len (10) working deys etter aubmlNal date. Requfred onsite, ConsWCflon Plens, Slormwater Plans w/ SUt Fe�ce instaNed, <br /> Sanlfary FedilUes & 1 dumpster. Slte Work Permit for all new proJects. All commercial requirements must meel compflance <br /> SIGN PERMIT AHach (2) sats of Engl�eered Plens. <br /> ""PROPERIY SURVEY requlred far etl NEW construclion. <br /> Dlrectlons: <br /> FIII out eppliption oomdetely. <br /> Owner 8 Contractor sign bade of applicatlon, notarized <br /> If over S2S00, a Notiee o( Commenwment Is requlred, (A/C upgrades over 57500) <br /> " Agent (for U�e eantractw) or Powar of Attomay (fa the owner) would be someone with notartzed letter from owner authorizi� same <br /> OVER THE COUNTER PERMIITING (Front of AppllcaUon Only) <br /> Reroote if shingles Seuvers Servk:e Upgrades P✓C Fences (PIoVSurvey/FOOtage) <br /> Drivewaya-Not over Counler if o� publlc roedweys..needs R�W <br />