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<br />813-78G-0020 <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />"3, c <br />W'o..rrtf\ !n",,, rot. <br />1'3 q'fU (if/llktr <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br />fl,~ !>T <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br />I 3'1'(0 "v,,-her <br />Im~)tJn'v O"/U <br /> <br />JOB ADDRESS <br /> <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />o <br />o <br />IrlPI.,.u <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />D BUILDING <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS 0 <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />ROOFING <br /> <br />I.,~, ST LOT # <br />I PARCEL 10# I J. 'f-){,.,)./ -0030 -tJtP~t:I() - (7)0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br />fi3 AD DIAL T 0 SIGN D MOVE 0 DEMOLISH <br />REPAIR <br />- <br />CJ COMM 0 OTHER <br />CJ FRAME 0 STEEL D OTHER r:== <br /> .f / DuD!" S/~ /-. f Sn.-! <br /> I HEIGHT I <br /> <br />{,ALUATION OF TOTAL CONSTRUCTION <br /> <br />,~DC <br />D <br />t"...~..\-nOlf L-+t-- S'i~ Cbn~ <br />.>/- WMro.c~ ~ ~ <br /> <br />I <br />I <br />I <br />CJ <br />I <br /> <br />CJ <br /> <br />AMP SERVICE <br /> <br />PROGRESS ENERGY <br /> <br />WREC, <br /> <br />VALUATION OF MECHANICAl INSTALLATION <br /> <br />DNO <br /> <br />},.-vi'n l.0/Tt rn (i"'("" &~o..dcl""'" <br />',I)~ ~ III do" <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address i350 <br /> <br />ELECTRICIAN <br />SIGNATURE , <br /> <br />Add ress I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Add ress I <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I ~~~ ~~~~n, ?1fN1f:oV <br /> <br />License # I CGc. \ ~50 l f:3 7 <br /> <br />$,(<,54 W. <br /> <br />LrrY'"\,.t...\"'ln.~ ~_ <br /> <br />~ 'I <br /> <br />COMPANY <br />REGISTERED <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />~ <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED ~ FEE CURRENT L~L!:U <br /> License # <br />COMPANY <br />REGISTERED ~ FEE CURRENT ~~ <br /> License # <br />COMPANY <br />REGISTERED ~ FEE CURRENT ~~ <br /> License # <br /> <br />RESIDENTIAL <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 onsile, 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 /> <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. lAIC upgrades over $50001 <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 (PloVSurveylFootage) <br /> <br />Driveways-Not over Counter if on public roadways"needs ROW <br />