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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 /> <br />Date Received <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name S G"13 /La"u -r t-/o ^1 <br /> <br /> <br />Owner's Address 13 '7 , '7 5 L e f/I.{ b I/\.J .!'tV G . <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />~'7 / CO <br /> <br />o-~ <br /> <br />13 0 U LE U~ !J LOT # <br /> <br />I PARCELlD#1 I If-2<P-;U-o (0 G- 03CcOO- /0070 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />c=J ADD/ALT CKI SIGN D MOVE D <br />D REPAIR <br />D COMM D <br />D FRAME D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />D NEW CONSTR <br />~ INSTALL <br /> <br />PROPOSED USE D SFR <br /> <br />TYPE OF CONSTRUCTION D BLOCK <br /> <br /> <br />DESCRIPTION OF WORK I ::r"v5~ <br /> <br /> <br />BUILDING SIZE I. 4 q I ~lto """or- I <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />0) LVe-W <br />SQ FOOTAGE I <br /> <br />W~ <br /> <br />s ( erN <br /> <br />1111111'11111"1'11111111'1111"'1111111"'1111111111'"'1111'..11111'11111111111111111"1111"1111111'11'11111111111111'1111111'1111111""111111 <br />42l' BUILDING <br /> <br />70,5 <br /> <br />HEIGHT <br /> <br />1$ I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />VALUATION OF TOTAL CONSTRUCTION ~ ..It ,;2/ C/o 0 . e. 0 <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W,R.E,C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN I '" 4, ./' Af2~ <br />SIGNATURE ~\.--(.,.... <br /> <br />Address 1/~j"I( 0",,, J.,ff''-'-SJ!JoLc<I(h'f RUt'". <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />License # <br /> <br />?;).~D <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />FEE CURRENT <br />License # I e.s 00 00 1'(0 <br /> <br />1~.tO/f-, g, ?.:fG. If.-> <br /> <br />I COMPANY I <br />. ' .'GOSO,RED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />c&~ ,&~ 52.. ';'v I <br /> <br />REGISTERED FEE CURRENT <br /> <br />Address 1/031/ oCCJ fI/~sl!~ooG-1'I' -9V~ rAr-fIHI~t 'J.1~rO License # I I <br /> <br />111111111111111111111111111111111111111111111111111111111111111111111"1111111111111111111111111111111111111111111I11111111111111111111111111111111 <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 />II.'III!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111 <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 />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br /> <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />