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<br />Date Received <br /> <br />? /17.../67 <br /> <br />~\.r {;VI(J I {t. tJ-€fh"'l <br />2/J/. >1- <br /> <br /> <br />Fax-813-780-0021 <br /> <br />*~~tJV <br /> <br />813-780-Q020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Owner's Name <br /> <br />Owner's Address I ~ t > 0 <br />Fee Simple Titleholder Namel <br /> <br />C/...uc?' <br />2. - ;('//~ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />~t> 0 <br /> <br />21 sf <br /> <br /><; I- "7 - /-//Ir <br /> <br />I <br /> <br />PARCELID#I/2. -Ub -2,1-002-0- 6120{) -0970 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />LOT # <br /> <br />I <br />B <br />D <br />D <br />~6 6~:'Ji;;_ <br /> <br />BUILDING SIZE I I SQ FOOTAGE r I HEIGHT I <br />lTT"fTTT"mTllllll , , III , , . . III . I1II , , I . III , , , , I . . III , IIIII , , , I11II . III , , I , I11II , . IIII . I1I1II . I , 11 . IIII , , , 11I1I , , IIIII , I I11I . IIIII , IIIII r , . III r I , I II <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />ADD/AL T <br />REPAIR <br /> <br />D <br />D <br />D <br /> <br />DEMdLlSH <br /> <br />DESCRIPTION OF WORK <br /> <br />E3 <br />D <br />D <br />I ~15i'f/'" <br /> <br />SFR <br />BLOCK <br /> <br />COMM <br />FRAME <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />1$ ~ 2 0 0 I <br /> <br />D ELECTRICAL 1$ I <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 1 FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111'111111111111111111111111111111111111111111111111111111I11111I111111I111111111111111I11111111111111111I111111111111111I111111111 <br /> <br />BUILDER ~ ~~ // COMPANY V1>~ ~;I./f <br />SIGNATURE ;:c./~' ~P/ REGISTERED FEE CURRENT <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />License # <br /> <br />1111II11111111I111111111111II1111111111I1111I11111111111111I11111I11111111111I1111111111111111111111I111I111111111111111111I11I11I <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 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 ali NEW construction. <br />I1111111111I11I11I1II1111111I1I111111111111I111111111111111I111111I111111II111111I11111I1111111111111I1111111111111111I1111111I1111111111111111111 <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 />Address <br />111111111111111 <br />RESIDENTIAL <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 />