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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 L <br /> <br />\ LLL <br />t-Jt.~rlA~\:. s:>, ~I.J-L <br /> <br />Owner's Name <br /> <br />Owner's Address I ~'Q :, N , <br />Fee Simple Titleholder NamJ <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address <br />C,\S:)'L Me"\~()w,~,,~ <br /> <br />SUBDIVISION <br /> <br />Me '" ~ ;)\)J;'~, ~ <br /> <br />e>~,~ :> <br /> <br />I <br /> <br />D ADD/ALT D <br />D REPAIR <br />D COMM 0 <br />D FRAME 0 <br /> <br />s: r'.;,}e.. ~ PI(\-: \ '-\ ( €,); ~~ tJ (\L <br /> <br />SQ FOOTAGE I \ 5 ~o <br /> <br />LC0 p "2 Q'~ (~: \\~ f<- LOT # <br /> <br />PARCELlD#1 \';-lio- l..\-O\"IQ '\J~(')o' \11- 0 <br />(qBTAINED FROM PROPERTY TAX NOTICE) <br />S,GN 0 MOVE D <br /> <br />I IlL. <br /> <br />DESCRIPTION OF WORK <br /> <br />t=J <br />E:f <br />B' <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />t-JQ.v.J <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />"8' <br /> <br />..11..11....11.11..1111111.11.11.......1111....11.1111...1111....1",.111111111111111111111.1....111111.1111111...111.............111...'1.1111... <br /> <br />D BUILDING 1$ '50 '3c a I VALUATION OF TOTAL CONSTRUCTION <br /> \ ' <br />D ELECTRICAL 1$ 7... '100 I AMP SERVICE D PROGRESS ENERGY.2 W,R.E.C. <br /> ~OL- <br />D PLUMBING 1$ '-3 .q, c ,) I Q()U..:) PQ;~ ~;;"~E=>6 c.efq/ <br />D MECHANICAL 1$ ';LDO I VALUATION OF MECHANICAL INSTALLATION ~~ <-::.~ -4/~\./ <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I ~1, \/ I FLOOD ZONE AREA DYES DNO <br /> <br />111....1111..'11111.111111111..11.11.11..'......1........................'.1....'..1.1...111..'..........11.1..1.11......11...1111....'...11111111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />I~~\~ <br />I Y N I FEE CURRENT 1& N I <br /> <br />I <br /> <br />License # I ( G ( \S~ 1 ~ CJ 'f I <br />1~~J>€LEC-~t1.-?~ta$ ad <br />( N I FEE CURRENT I [V/ NJ <br />License # I~ 1~()f)3or;2-- I <br />ItI~F~~;--? I <br /> <br />License # Iz,;:- t:1.7:3 C;~ // I <br /> <br />---~r\J~~ <br /> <br />Address <br /> <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/ N <br /> <br />FEE CURRENT Y / N <br /> <br />I <br />I <br />I <br /> <br />Address <br /> <br />License # I (?A(1&!' _t;' s--y r g <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />License # <br /> <br />1111I1111111111111111111111111111111111111111111111111111111111111111111111111'111111111111111111'11111111111'1111111111111111"111111111111111111 <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 onsile, Construction Plans, Sanitary Facilities & 1 dumpsler <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onslte. 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 /> <br />~i~~~~::~~~'~~~:i~~~~ ~~'~~;~:~I~: II. 11111'111111111.1111111, 'IIIII'IIIIIIII{:~ ~ II~\I~'~ 'I~ 13 \11~1'4~1 a I,; I {-;'~)IIIIIIIIIIIIIIII <br /> <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 />