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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address 1 Lf ~.2.~ C~ \ \ <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />f:S-D <br />:? \ vJ \-I.I.~ '\ 3,0) i <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number <br /> <br />PARCEL ID#I <br /> <br />\~u '30 ( <br />I <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />4<t~;;l.. <br /> <br />beLli <br /> <br />e\Vd <br />I <br /> <br />B <br />D <br />D <br />\\ \ Q...'f \IV) <br /> <br />SQ FOOTAGE I <br /> <br />SUBDIVISION <br /> <br />DESCRIPTION OF WORK <br /> <br />E3 <br />D <br />D <br />I ~ \'", Q. <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />AD DIAL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />OTHER I l=" \;'e.. ~ \a... 11.1 <br />STEEL D OTHER _ <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /><; '.i ~VI1 <br />I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />~ERCI~ <br /> <br />License # I <br /> <br />~ l@,(., \ ~ \ C.- I r\ C <br />I FEE CURRENT I Y I N I <br /> <br />License # I); R. 0 tJ f O:L2 D I <br /> <br />I <br /> <br /> <br />Address License # I <br /> <br />MECHANICAL I COMPANY 1 <br />SIGNATURE , REGISTERED Y I N FEE CURRENT Y I N <br /> <br />Address I License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE REGISTERED Y I N FEE CURRENT Y I N <br /> <br />Address I License # I <br /> <br />111111111111111111111111111111111I11111111111111111111111II11111111I111111I1111111I111111111111I1I11111111111I1I11111111111111I1111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance, <br />Attach (2) sets of Engineered Plans, <br />''''PROPERTY SURVEY required for all NEW construction. <br />11111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />Directions: <br />Fill out application completely, <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />1$ <br /> <br />1$ 3!Q%~. ~ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO <br /> <br />11111111111I111111111111111111111111111111111I11111111I1111111111111111I11111111111111111I11111111111111111111111111111111111111111I11111111111111 <br /> <br />I <br />I <br />I <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />j2( <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W,R.E,C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />~. ~_ a.o.Gb <br />Pt+ <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />, FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />I ~,L, <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />