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a�saso-nozo City of Zephyrhills Permit Application Fa�a�a-�aaoa2i <br /> ' a�admg o�en:++�m <br /> � oate Re�ivea w+a�.cadace for P�nitti � J "`��� <br /> Owners Name Ci O�rner W�ooe N1Mnber VL 11.' <br /> Ownels Address O O�woer Pfwne Nunber <br /> f ee Slmple Titlehdder Name Owner Phone N�wnh�r �� <br /> Fee Simple Titlehdder Address <br /> .1oB ADDRESS ! I r- LJ LOT• �,Q� <br /> SUBDIVI310N i � �II�CL IDi� ' "" � <br /> (OBTANI�fltOY PROP9tTY TAX M0710E1 <br /> WORK PROPOSED NEW CONSiR ADDfALT � SIGN � O DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE � SFR COMM � 07HER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME Q STEEL Q <br /> DESCRIPTION OF WORK '� � " ✓' � � ` <br /> BUILDING SRE �� S�FOOTAGE GI �,�_J HEIGHT <br /> QBUIIDWG $ �D� � VALUATIONOFTOTALCONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUM8ING S � j v <br /> oMECHANICA� $ VALUATION OF MECHANICAL INSTALLATION � I 1 � � <br /> � <br /> Or,qg O ROOFING � SPEqALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER � C�P� � � <br /> SIGNATURE r�c,�s7Er�o Y/ N �E cuRaen Y/N <br /> ��� License# <br /> ELECTRIGI/W COMP/WY � <br /> SIGNATURE r�c,�s�REO Y/ N �ctxt�En Y/N <br /> �� Licerise# � <br /> PLUMBER � CONP/WY <br /> SIGNA7URE REGISTERED Y! N FEE cuRt�� Y/N <br /> Address Lice�e# <br /> NECHAMGAL C�P�Y � <br /> SIGNATURE rzEC,�s�r�o Y 1 N F�cukr�n Y/N <br /> Address License# <br /> � � <br /> OTHER C�P�r <br /> &IGNATURE REC�ISTERED FEecuRREI. Y/ <br /> Address t Jr D./ ��cer�e# <br /> IIIIIIIIIIIIIIIIIIIIIIIII � IIIIIII � t1111 / / 111111 � 11 � 11111 / 1111111111 <br /> RESIDENiIAL Attacfi(2)Plot Plans:(2)sets d Bu�dng Plans:(1)set d Energy Forms;R-o-W Pertnit fw new wnshudia+, <br /> Minimum ten(10)wrrking days aflel subndttal date. Requeed onsRe,GansWdfon Plans,Stamweter P�ns wl Sit Fmce installed, <br /> Sanitary Facililies&1 dumpster;Site Wdic Pertnit for suhdivisionsllerge projeds <br /> LOMMERGIAL Attach(3)mmplete sets of Building Plans pkis a Li(e Safaty Page;(i)set of Energy Fortns.R-O-W Pertnit for new mnstruction. <br /> Minimum[en(10)waking days aftu submittal date. Required w�site.Construction Plans,Stamvuatu Wans w!Sik Fenc�instaNed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for aN new prajeds.AM cammercial raquirements must meel comPMance <br /> SIGN PERYIT Attad�(2)sets of Eng'eieernl Plans_ <br /> ""PROPERTY SURVEY required fw all NEW constniction. <br /> Directions: <br /> Fitl out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over f2500,a Notla of Commd�ednent ie►equlred. (MC upgrades over 57400) <br /> " Agent(for the contracta)or Pawer of Attomey(ta the owner)would be someone wilh ndanzed lette from owexJ authorizing same <br /> OVER THE COUNTER PERNIiT1NG (Frari of Appicaaan Oriy) <br /> Rrsoofs if shingles Sewers Service Upigades A/C Fencos(PIoVSurveylFootege) <br /> Drlveways-Not over CouMer if on puhlic roadways..needs ROW <br />