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<br />!l13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br />(:.\:e> p-\L. l ~\,a <br /> <br /> <br />Owner Phone Number <br /> <br />"fL5J I, Owner Phone Number I <br />I Owner Phone Number I <br /> <br />Owner's Name 'T r .u-lAY"\c... CYG -~\c.. I-€.f"CU-l..,. V l \Q .<- <br />Owner's Address I \ ()q ':L 50 ~ S~. f..\ . 'T~p~~ rc:...t.... <br />Fee Simple Titleholder NamJ <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 5~~4- ~d(htl(e..&. <br />l'"Ita~~ V\l\Cl.~ <br /> <br />Zpkvrh,\l\ <br />PARCELlD# I <br /> <br />fi.. <br /> <br />3~ <br /> <br />LOT # <br /> <br />..........11...111..111...11..111......................111...11..11.....11............1111........11....11........................................ <br /> <br />I <br /> <br />D NEW CONSTR D ADD/ALT D <br />D INSTALL D REPAIR <br />D SFR 0 COMM D OTHER <br />D BLOCK D FRAME D STEEL D <br /> <br />tr.(,\~l u.... Y\~ ~ ~~ ~~ k\....br-\ ~\6. \ ~ Ga\.~ <br /> <br />I SQ FOOTAGE I I HEIGHT I <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />G)f\t.W <br /> <br />I <br /> <br />fti.nd. <br /> <br />BUILDING SIZE <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />~ 1$ I AMP SERVICE \ ~Q ~ PROGRESS ENERGY -....---....--..---.."" <br />ELECTRICAL W.R.E.C) <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br /> <br />....11....111...111..111...'.........111......11.................111111...11111.......11......'..1111.....1111.11.......111111...................1 <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />5l4\~ q~~~ <br /> <br />~~ I <br />.~~I\\\lb) Fe ?D91t:l- <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />~ -, ~ <br />uSe.... t::. \ e. chi: '- ~ \ , ~ <<- . <br />(.!Y N I FEE CURRENT I N I <br /> <br />License # Il~q <br /> <br />Address <br /> <br />ELECTRICIANI~ <br />S~NMU~ . <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />1111111111"111 1111111'11111'111'11"1'1"111111111'1111'1111111111111111111111111'1'1111111"11111111'."'11111"'11111111...111111111..11111111 <br /> <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 />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />1111111111111111111111~~IIIIII...~IIIIIIIIIIIIIIIII.j~.jllll...IIIIIIII..IIIIIIIII.IIIIIIIII.IIIIIII~~111111IIIII~IIIIII~IIIIIIIIIIIIIIIIIIIIIIIII <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 NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />