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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-78U-UULl <br /> <br />Date Received <br /> <br /> <br />4)0;J <br />~~ N\: \\~(VN' F\ \ <br />-T?, 0 -;S w ' t-J~ ~l v.. ~ \c. c <br /> <br /> <br />-g \~ - ~ \u- So'-( \ <br /> <br />Owner's Name <br /> <br />LLL <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder NamJ <br /> <br />~VlL <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />SUBDIVISION <br /> <br />Me~tlll.\J<I"- ~ <br /> <br />e,:>+-~\-e~ <br /> <br />I <br /> <br />B <br />D <br />o <br />~~.JS\e. ..rA'\A~ \"\ <br />SQ FOOTAGE I <br /> <br />Loop <br />PARCEL 10#1 <br /> <br />LOT # <br /> <br />b't <br /> <br />JOB ADDRESS <br /> <br />~c,s \\ <br /> <br />(V\ Q f\ ~ (hV n ~ <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />W" <br />[g <br />I <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />\ 3 - 1.<0 - 1 \ - QlYC - OOD() -O<.oq 0 <br />(~TAINED FROM PROPERTY TAX NOTICE) <br />S~GN D MOVE D <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />D <br />D <br />D <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />N~'^' <br /> <br />re~; ~ff'J(e- <br /> <br />....11....11.1111..11....11.1111......11111111111..........11...111.11.....11111...111....11..11....11111'.....11.11....11..111111111..'1.1111.11.. <br /> <br />HEIGHT <br /> <br />"8' <br /> <br />BUILDING SIZE <br /> <br />D BUILDING 1$ -7:' 300 I VALUATION OF TOTAL CONSTRUCTION <br /> \ . <br />D ELECTRICAL 1$ 2 -,00 I AMP SERVICE 0 PROGRESS ENERGY V' D W.R.E.C. <br /> ~t.'c:. _ <br />0 PLUMBING 1$ '3 'goo I (<.ow ~<<o c;A.y..ecJ ~l't / <br />D MECHANICAL 1$ ':) &0:::::' I VALUATION OF MECHANICAL INSTALLATION ~~ <br />0 GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I ~ \. 5~ I FLOOD ZONE AREA DYES DNO <br /> <br />~~;~~~""''''':: ~'~\'~"""""""'"'''''' ";~;;" '1"1:;~"; ~rl~":""""'" "I <br /> <br /> <br />License # I (. Gc ISv'7~c;/ I <br /> <br />1 #f~OEl!ffL!7~/i, f*w~ <br />License # I {3C- 13 0tJ7otJ 2.. I <br />~_-l (~ I <br />vn <br />I N FEE CURRENT Y N <br /> <br />License # IR/Fo036~ II I <br />I ~~AJ7) 1/~ pr~p;'1:-?Ler~81 <br />I (_~ I F ECUR~NT ._ _ <br />, License # 1~~7'r9g I <br />I <br />I <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />III 111111111111111111111111111 1111 ' I , 11111111111111..' 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns <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 on sIte, 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 />I III, 1111111 11111 , j 1111I . III 1111111111111111111111111111111111 .. 1111111, 1111 , , . 1111111111 . 1I1111 , 1111111111111 , 111111 III · 1111111111111111111111111 <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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />