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~ 13-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received ':)-'1 -0 to /lJ,UE-V i.,J'!si Z~jJk.otdl.M',;:Z 5h'-~'/ I i: /j7rl L . I Owner phone Number Owner phone Number I OWner Phone Numb~r I Owner's Name Lf -f3 9 Fee Simple Titleholder NamJ Owner's Address JOB ADDRESS Fee Simple Titleholder Address I I !fP 39 I S' /h11 v t LA ,)/ c- h 14.. $ 3 i5~ry( LOTti DESCRIPTION OF WORK B D D I I NEWCONSTR r=J ADD/ALT D INSTALL CJ REPAIR SFR 0 COMM D OTHER I r&c-~ BLOCK 0 FRAME D STEEL D OTHER I J/v~~ 2t~ / iff , /'f4ttucc,',t) ~. Wlf/J Z. 91"t-1rS sa FOOTAGE I I HEIGHT I (, / I PARCEL ID# I \ L\ - ';;) ~ - Q. l - 60 \ b '. 0 \ 566 .D('.)?O (OBTAINED FROM PROPERTY TAX NOTICE) SUBDIVISION WORK PROPOSED SIGN D MOVE D DEMOLIsH I I I PROPOSED USE TYPE OF CONSTRUCTION BUILDING SIZE ...11...11...11....................11.11.11...........................1111....11..111.....11....111..11.........11.............111.....11.111..11. 0 BUILDING 1$ 3691.\- . .on I VALUATION OF TOTAL CONSTRUCTION 0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. 0 PLUMBING 1$ I 0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION 0 GAS D ROOFING 0 SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 1111..........111.......11111......,11'....1111....11'....11................111...11.11.11..11........1111......................1..........1..,... ./ BUILDER SIGNATURE ./ COMPANY REGISTERED Y/N FEE CURRENT License # Y/ N FEE CURRENT License # Y/ N FEE CURRENT License # Y/ N FEE CURRENT Y/N Address ELECTRICIAN I SIGNATURE Address I PLUMBER I SIGNATURE Address I MECHANICAL I SIGNATURE . Address I OTHER SIGNATURE COMPANY REGISTERED Y/N COMPANY REGISTERED Y/N COMPANY REGISTERED Y/N Address ~- ju/ I/E; II/Sb. I COMPANY REGISTERED vJ'1f Y/ N I License # I 6"/nJ ~l-L/ I Y/N FEE CURRENT ~~.f ClUhr.J R "3 j 53 License # RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. COMMERCIAL SIGN PERMIT . II111III J III1I1I11II ~ 1111111111. & I111I111I . ~ I ~ ~ IIIIII..~ 1111. I ~ i II . . II1111I11II11I111111 i i i III ~ I i II i 1II1 i I i 1II11 i ~ i 1I11 i 1I1I ~ III i Iii i I ~ i i i .11 i II i i Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (Ale upgrades over $5000) .. Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Driveways Fences (PloUSurvey/Footage)