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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />\Q\\~ <br /> <br />Fax-813-780-0021 <br /> <br />Da~ 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 A\Ct" T 0"1 ( . <br />Owner's Address I:S' k, L{ I ~ g ~ . ~. 5 i <br />Fee Simple Titleholder Name I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />ItofJ3S ~~~n:i G:A - ko\- 3 <br />ID I' ; .(\ l.Jood ft./). Sf:lf I <br /> <br />LOT' <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PARCELlDlI 0 l, - 2'- '2 ( -801 <.9 .... c9 'Z fOt!) - 001 0 <br />(OBTAINED FROII PROPERTY TAX NOllCE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />DESCRlPTlON OF WORK <br /> <br />~ <br />D <br />JZJ <br />1(, <br /> <br />B <br />D <br />D <br /> <br />COMM <br />FRAME <br /> <br />ADD/ALT <br />REPAIR <br /> <br />D <br />D OTHER <br />D STEEL D <br />(~ PI~)6 t~,) <br />I HEIGHT Is:" ,it Ski I <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTlON <br /> <br />OTHER I <br /> <br />U..,: l.- <br /> <br />~'""V'\ 1..6", eo s <br />SQ FOOTAGE I 7 ~ ~ 2, <br /> <br />BUILDING SIZE <br /> <br />IRl BUiLDING 1$ I <br />/XI ELECTRICAL 1$ I <br />[Z] PLUMBING 1$ I <br />[R] MECHANICAL 1$ I <br />0 GAS 0 ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />og <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WR.E-C. <br /> <br />BUILDER <br />SIGNATURE <br /> <br />11R{~ <br /> <br />COMPANY I P I J""Y/aNV\ <br />REGISTERED ~ <br /> <br />No(' Sl:x2 ~~c.. ccu-'4, <br />n... ~tOB <br />i rI~. <br /> <br />Eie.tJ-i,c.c[\ <br /> <br />~NoK~cl./Ca..\c.. -C7f2- <br />r}tJ\ Co(,)ll /~/6~ <br /> <br />Go", s hiT., (. , <br />I FEE CURRENT I Y I N <br /> <br />Ucense , I <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA c==JYES <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br /> <br />~:::I4W ~ <br />:'~~~~I:L!~ ~ <br /> <br />Address . <br /> <br /> <br />~I~N~~URE !~ ~ <br /> <br />Address . <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License , <br /> <br />COMPANY bev,,,, " ~ w: \ (; 11 "'" S <br />REGISTERED I Y I N I FEE CURRENT Y I N <br /> <br />License' I <br /> <br />COMPANY ~q,,< ~er..., ~.....-'r.} <br />REGISTERED I Y I N I FEE CURRENT I Y I N <br /> <br />Ucense , I <br /> <br />~~~~~ ~~~~ I ~~t::::~m <br /> <br />Y/N <br /> <br />License ,. <br /> <br />RESIDENTlAL <br /> <br />COMMERCIAL <br /> <br />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 Fadlilies & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Fonns. <br />Minimum ten (10) working days after submittal date. Required onslte, Construct/on Plans, Sanitary Fadlities & 1 dumpster <br />All commerdal requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />--PROPERTY SURVEY required for all NEW construct/on. <br /> <br />SIGN PERMIT <br /> <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. (Ale 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 (PlotlSurveylFootage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />