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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />I <br />I <br />I <br />LOT # 15;2. I <br />PARCELlD#1 ;?-i-dJ..0 -2/- OCJOO-CJ6//J~9ol <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />NEW CONSTR 00 ADD/AL T D SIGN D MOVE D <br />INSTALL D REPAIR <br /> <br />:::CK B ~:~ B ~~;:~ D OTHER I ~f<fn/nlj~- : <br /> <br />(to.(o "- ~. ~ ) f;<n {! (Y\ G";,, 21. '" ') rM ("',J,.. (Uo ,1.>,(. t 2-) I <br /> <br />I sa FOOTAGE I /f33. 5 I HEIGHT I I <br /> <br />1$ 0177 t2.9 I <br />o ELECTRICAL 1$ I <br /> <br />o PLUMBING 1$ 1 <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br />111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIII~I~~IIIII; IIIIIIIIIIIIIIIIIIIIIIIIII:;;~ 1I11111111II11111111111111111 <br />BUILDER "JA! / I CO~PANY I ~S~ A-lumlf7ttA'77 I <br />SIGNATURE ~ REGISTERED 1 N I FEE CURRENT ~ N I <br /> <br />Fee Simple Titleholder Name <br /> <br />Same <br /> <br />Owner Phone Number <br /> <br />33~ Phone Number I <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Address <br /> <br />sam~ <br /> <br />SUBDIVISION <br /> <br /> <br />JOB ADDRESS <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />D <br />D <br />I SY\.Qd <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />BUILDING SIZE <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />{tiff ~-, 7..' . <br />- I ~Ic\ <br />AMP SERVICE l <br /> <br />QQ <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />NOC- <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br />I <br />I <br />I <br />I <br /> <br /> <br />Address License # I <br /> <br />MECHANICAL I COMPANY I <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address I License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address I License # I <br /> <br />1111111111111'11111111111111111111111111111111111111111111111111111I1IIIII111IIIIII11I11I1II1II11II11111111111111II11I1111IIIII1I111I1111I1111I1I1 <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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 Attomey (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 />Address <br /> <br />3!>5 ~ <br />I ~&i E/,f,;!:;!,u <br /> <br /> <br />License # I <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />(y)N <br /> <br />PLUMBER <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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />