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$i3�sa°°Z° ��� City of Zephyrhills Permit Application Fax-81378Pd021 <br /> Building DepaAment <br /> Date Received � - " /� 7�, �,(`� - ,�� <br /> �T��- Phone Contact for Pertnittin <br /> Owners Name �c harc� , 3/e Owner Phone Number <br /> Owners Address 5 y i 3 3 r u 6} Owner Phone Number �� <br /> Fee Simple Tftleholde�Name �t Owner Phone Mumber �� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � ( .L�J� 5 ' LOT# �I <br /> SUBDIVISION �C ►, r l,►�`S � PARCEL IDK �'���'`���•��O'�(iC1p -�0�10 <br /> �osTar�n cnon r+aovemv nuc Nonce� <br /> WORK PROPOSED e NEW CONSTRB ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � CAMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL O <br /> DESCRIPTION OF WORK <br /> R - ° <br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT �� <br /> BUILDiNG a <br /> �•� VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERdICE � pROGRESS ENF,Rf,Y � W.R.E.C. <br /> �PLUM8ING $ �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATI N� � � <br /> QGAS � ROOFMG r�J SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATiO4JS FLOOD ZONE AREA �YES NO <br /> BUILDER i`J�/M� �.. � COMPANY C 5�p YQ-}"i O t� cS �C�4 L i a�-S <br /> SIGNATURE � �V�V�-• REGISTERED Y/N FEE CURREA Y/N <br /> Address w h • OCGI I� license# CW.��r'J�0 �3 <br /> 4415 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE RECisiERE� Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N F�cu�� y�p� <br /> Address <br /> License# <br /> MECHANICAL COMPANY <br /> SIGNATURE RECisiERE� Y/ N F�cua�n Y!N <br /> ��Z Address License# <br /> j� THER �� �r��, COMPANY <br /> SIGNATURE ''�r REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> Lice�e# <br /> 1 1 1 1 1 1 1 1 t 1 1 1 1 1 1 1 1 1 I 1 1 1 1 <br /> RESIDENTIAL qttach(2)Pbt Plarts;(2)sets of Build"mg Plarta;(�)set of Erergy Fortns;R-OW PermR for new conshucfto�'----�--.-_��.�y/ <br /> Minim�un ten(10)working days after submital�te. Required onsite,Construction Plans,Storma2ter PYans w/SiR Ferice installed, <br /> Sanitary Facilities&1 dwnpster,Site Work Permit tor wbdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safely Page;(1)set of Energy Forms.R-0-W Permrt for new construction. <br /> Minimum ten(10)woAcirg days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sitt Fence installed, <br /> Sanitary Faalities&1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pla�s. <br /> •k�Dlil1DFDTV CIIDI/FV rn..�u.M i...�II��cUU,.,.,.e�.....�:.... <br />