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<br />813-780.0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /><6'\;.. 7lD.S Q'Cf3 <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder NamJ <br /> <br />{)(2lUG' <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 7Arne <br />I 51WQ. O~5 <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />/0'/ <br /> <br />PARCEL ID#I <br /> <br />I <br />B <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />E3 <br />D <br />D <br />I 1*0 L. <br /> <br />D- ~ e-v-.. c €... <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />(AI JrA-U"I'p#, <br />SQ FOOTAGE I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />...11......11...11....11..11...111...11...................11..1111.................1111.............111......................1111..11...11111..... <br /> <br />o~ -u, -Z/- otij:) -(}0000 - {O 'fo <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />D <br />D <br />D <br />( <br />I <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL 0 OTHER I <br />72- -'4) <br />HEIGHT I <br /> <br />-0 BUILDING 1$ (2,000 ,. I VALUATION OF TOTAL CONSTRUCTION ])Rc. <br /> 1-\1 m n)~ 1)(2.C- S-(3/0l&. <br />0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS EN GY D W.R.E.C. <br />0 PLUMBING 1$ I <br /> tJOC P <br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br /> ~ 0uJtlU ~(y .-l- <br />0 GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />~ <br /> <br />BUILDER ;)," ~ <br />SIGNATURE ~ <br /> <br />..' <br /> <br />':J COMPANY <br />REGISTERED <br /> <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />".. ELECTRICIAN <br />SIGNATURE <br /> <br />?-;~ <br /> <br />Address <br /> <br />~s-. <br /> <br />~ PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br /> <br />/ ,A:: I '1k <br />~..I <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />i--\~ou.,.,~ <br />I Y I N I FEE CURRENT <br /> <br />I <br /> <br />Y/N <br /> <br />License # <br /> <br />~tNAi ()vlAJ-fr <br />~ N I FEE CURRENT <br /> <br />License # I <br /> <br /> <br />CD~ I eI.!!':'-:;R,"' <br /> <br /> <br />License # I <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />I I I I , I I I I I I I , , I I I I I I I I I , I I I I I , I I I I I I I 1 , I I I I I I I I , I I I II I I I I I I I , , I I I I I , . I I I I , I , , , , , I 1 I I , , . I I I 1 . I 1 1 I I I r , . 1 1 r 1 1 III . . I I I I I I I I II , , f I I III I f ~ I . I I I r I , . I , I I I <br /> <br />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 /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />~lllllllll~IIIIIII..~~IIIIII.IIIIII..I~IIIIIIIIIII.~I~11111..11111.~111111111~1111111111~.~1111111~111111111IIIIII.~IIII~~IIIIIII~IIIIII.IIIIIIIII <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 Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />