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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 /> <br />Owner Phone Number <br /> <br />Date Received ;1 - l ~ - 0 f..o <br /> <br />Owner's Name m a.r.f-t/? F (}J)i~ <br />Owner'sAddress I 31939 /Sl ,4t/e/Jt/e <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number <br /> <br />I <br />LOT# ~ 1/014'1 <br />PARCELlD#1 J/-d.~-c)/- 00/0- cJ-()(XJO - CJ/OeJ I <br /> <br />JOB ADDRESS <br /> <br />I .3J'93'j /~f dte/Jt/e <br /> <br />I ~~ Of ~P":J/'kJJs I <br /> <br />m NEW CONSTR D <br />[C] INSTALL D <br />PROPOSED USE 0 SFR D <br />TYPE OF CONSTRUCTION 0 BLOCK D <br /> <br />DESCRIPTION OF WORK loSt /'eR./} rtYJ/n <br /> <br />ol(J I X VIP J SQ FOOTAGE I <br /> <br />SUBDIVISION <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />o <br />o <br />o <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />9 r.UJ [1J <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />1$ /~ off), {JJ I <br />1$ I <br />1$ I <br />1$ I <br /> <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111I1I1111111111111I11111111111111I1111111111 <br />,-~ 5~ <br />v=l-rLt~ ~ - ~9-ed /~ fl ~~:~:R~~ <br />q. ? r (1J1l>.Jl I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br />~OC- <br /> <br />W.R.E.C. <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License # I I <br /> <br />1111111111111111111111111111111111I111I11111I111111II111111111I1111II111111II1111111111I1111111111111I1111111111111111111111111111 <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 />11.111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111 <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 />13 tLA~ 0"4h/ll.;/lt/ /7J <br />I (;JI N I FEE CURRENT I @ N I <br /> <br />License # I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />