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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />LQl1A <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />OWner Phone Number <br /> <br />Owner Phqne Number I <br /> <br />_ OWner Phone Number I <br /> <br />OWner's Name I'kQ", T 0'1 ( . <br /> <br />OWner's Address I ~ Co l{ I ~ g ~ . eJ. 5 l{ <br />Fee Simple Titleholder Name I <br /> <br />Fee Simple Titleholder Address I <br /> <br />JOB ADDRESS <br /> <br />I (Q1y \ ~u--~Dc9.. &A - \...o\- <br />IDf';.c\-I.JDOd fI.~o.S~:If I <br /> <br />PROPOSED USE <br /> <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />BLOCK <br /> <br />to <br /> <br />PARCEL IDI I 0 l- - 2~- 2 ( -801 e .. () Z i06J - 0010 <br />IOBTAIIilED FROII PROPERTY TAX NOTlCEI <br />SIGN D MOVE 0 <br /> <br />LOT' <br /> <br />SUBDIVISION <br /> <br />DESCRIPTION OF WORK <br /> <br />~ <br />D <br />JZJ <br />I~ <br /> <br />B <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br /> <br />COMM <br />FRAME <br /> <br />o <br /> <br />D OTHER <br />D STEEL D <br />(~ PI~)6" ''fi:') <br /> <br />I HEIG~ IS:"slt J1rrx'l I <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />u",,:l,.. <br /> <br />~""~ (.6......eS <br />SQFOOTAGE 17 ~ ~ 2- <br /> <br />BUILDING SIZE <br /> <br />[R] BUILDING 1$ I <br />[K] ELECTRICAL 1$ I <br />[KJ PLUMBING 1$ I <br />[E] MECHANICAL 1$ I <br />D GAS [EJ ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />~ <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />~ , c-l:P. "'.n.1L ~D G.- r>R-'- <br />I" 0 c.. ~. ~ cexP-"> 'fl i? <br />PfMt <br /> <br />BUILDER <br />SIGNATURE <br /> <br />11U tJ;Ik <br /> <br />COMPANY I P I '''''y/C.Nn <br />REGISTERED ~ <br /> <br />- [1e.Hi~c.c:.\ <br />/,KlNokiSd'.jCo..k. D1f- <br />r:j1J\ Co{)1.! 1 /~/OG <br /> <br />I <br /> <br />SPECIAL TV D OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />Go", s t-. I T., (. , <br />I FEE CURRENT I Y I N <br /> <br />License , I <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER III II / /}fJ. i . L <br />SIGNATURE ~ ~ <br />........ - - . <br />:~:.~~I;:L l.ij/Li ~ <br /> <br />Address . <br /> <br /> <br />~~N~~URE !/J/II % <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 <br />REGISTERED <br /> <br />De-v", ',1 41; ,(; Il """ .{ <br />I Y I N I FEE CURRENT Y I N <br /> <br />License f; I <br /> <br />~Q~ ~lV'" G.....j;;r} <br />I YI N I FEECURRENT I Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />License' <br /> <br /> <br />~~~~:: ~~d~ I ~~t:::~NT <br /> <br />Y/N <br /> <br />LIcense' <br /> <br />RESIDENTIAL <br /> <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 onslte, 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 onslte, 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 /> <br />COMMERCIAL <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. (AlC upgredes 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 />