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<br />813..780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />r-aX-l:H.j- (tlU-uu.o <br /> <br />Date Received <br /> <br /> <br /> <br />PASCO PERMIT SERVICE <br />-5 <br /> <br />'1- 'liJ-Oh <br /> <br />RtJ <br /> <br /> <br />Owner's Address I 193 Jf q.;n 5-1ree.:6 <br /> <br /> <br />Fee Simple Titleholder Namel sa me rJ =:; ~. V~ <br /> <br /> <br />Fee Simple Titleholder Address I ~ a m~ Ii. '5 a..btJ ve <br /> <br />! 'jq.:3L{ 1-#1 S--i7Rd-; rit'17f'/1s, R- 339121 LOU ~r13 <br />l~rg5 fif5f /W,-j,ml PARCELID#IIIf-;26-Jl-OdI{)-CJ()~7Jt!J-(jI:;l..() <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />l2:Sl ADD/ALT 0 SIGN D MOVE 0 <br />[=:J REPAIR <br /> <br />q COMM 00 <br />~ FRAME <br /> <br />R C1) (Y\ Am OY\ <br /> <br />BUILDING SIZE I SQ FOOTAGE II ~ tJ zP <br />111111111""'I'lllllllllllllllr,r"I"IIIII"I"rllll11111111111"'11'1"111111111111111111111111111"'1'"11'II'IIII""II"Ir'lllllllllllllllll <br /> <br />Owner's Name <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />E3 <br />o <br />o <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT I <br /> <br />~ BUILDING 1$ 750Gl ~ I VALUATION OF TOTAL CONSTRUCTION I ,~.~ ".,:> ~fzl) t.rJ "If.....pi'A rp <br /> ~ <br />~ ELECTRICAL 1$ I AMP SERVICE PROGRESS ENERGY D W.R.E.C. <br /> ~\ec\nd an -:/ <3,"\0 Oc) <br />D PLUMBING 1$ I me CXll\.>n' c a..\ <br /> NO~ <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS 0 ROOFING D OTHER <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br /> <br /> <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br />/) Address I <br />y\fA" .p.% <br />MEC~~NICAl. V <br /> <br />SIGNATURE L <br /> <br />Address I <br /> <br /> <br />OTHER I <br />SIGNATURE <br /> <br /> <br />Address I I License # <br /> <br />1111I111I1111I11III11111111111I111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllllllllllllllll1IIIIIIIIIIIIIIIIIIIIIIIlIIIIIIIUilll <br /> <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 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 />1111111111111111111111111111111111111111111111111111111111/111111111111111111111111111111111111111111111111111111111111II11111111111I11111I1111111 <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 NC <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />0/L'~ <br /> <br />~ <br /> <br />I <br />3'-~ <br />:;, <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />To 4/1 <br /> <br />(}W M r <br />I YI N I <br /> <br />FEE CURRENT <br /> <br />fv~f11J <br /> <br />License # <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 roadwaysuneeds ROW <br />