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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application Fax-813-780-0021 <br />Building Department PASCO PERMIT SERVICE <br />8. . 31 <br /> <br /> <br />(~. po ~ <br />1~1 <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />c Daniel <br />TourlYlarine.-- Dr: /..1Jt ~fO <br /> <br />Owner Phone Number <br /> <br />3d fitRer Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />134'% TOc.umA-line-- "Dr.) Zephyyh,'//5) Pi- -33StfO <br /> <br />bhe.lZmera..-ld foinfe ~V I PARCELlD#I~'f-~-;U-OOFO-OOOOO-~~OO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />1 ;zgO <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />~ <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I /.11 na.A' -+ <br /> <br />/ ~ X '12 I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />B <br />D <br />0Cl <br />~5c (e~ I<?JJDrr'1 <br />sa FOOTAGE I :SOt.! 1/1 <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />111"""111111"'11111""11111"1'11111"""'11111111111111111111111111111"111111'1111'1111111111"'1111111"1111""1'11"'1'1111111111"'1'1 <br /> <br />D BUILDING 1$ J,D}OOO. ~ I1\zV~LUrl~~OFTOTALCONSTRUCTION <br /> <br />D ELECTRICAL 1$ , I 1'1J~SERVICE D PROGRESS ENERGY <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />I111111111111111111111111I1111111111111111111111111111IIIIIIII~IU,IIIII~IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111I1111I111111I1111111 <br /> <br />BUILDER jJ s IA.. ciJ ft.,,".J COMPANY I Owner I <br />SIGNATURE f\( c:., /1 J REGISTERED I Y I N I FEE CURRENT Y I N <br /> <br />Address 3 <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />rJbC, I <br /> <br />Address <br /> <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />Address License # I I <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111 <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 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 />11111111111111111111111I1111111111111111I11111111111I11111111111111I11111111I11111111111111111111111111111111111I111111111111111111111111111111111 <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 NC <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />O{))n~r <br />I Y I N I <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Owner <br />I YI N I <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 />Y/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 />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />