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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 />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br />I G.>. 18~/~~ .(.-t-\ ~-e-r <br />~ \f~,,"e-eze.... <br /> <br />Rl3-/~B-S e)~O <br />Owner Phone Number I if 13 "L...J (p 9~ JOCJ 2 & J DI <br />Owner Phone Number I I <br />I <br />I <br />I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />LOT # <br /> <br />4Cf <br /> <br />I PARCELlD# I 62,- 2.." .-2) - 0 I <( tJ - ~ - () cf <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D NEW CONSTR 0 ADD/ALT D SIGN 0 MOVE D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM 0 <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br /> <br />LY7rtet)\417cp--- C)~ q ~ '110' S~d, <br /> <br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I <br />TnTTTTrrrrrrnTmTTTTflllllllllllllllllllllllllllllllllllll' . . 11111111111111111111111111 , , , 1111111111111111111111 . 11111111111111111111111111111 , <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER I <: '^ ./' A ~ "if () .e:l-. <br />STEEL D OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />D BUILDING 1$ l ~ 78 /os- I <br /> . <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br />D GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br />,...-, <br />~' 1L.~~.~vAV>' <br />. V" ,. ~,D-b/~' U <br />vJ~ <br />~lJl <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br /> <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />OuJ~ <br />FEE CURRENT <br /> <br /> <br /> <br />~~ <br /> <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License # I <br /> <br />1111111111111111111I1111II1111111I1111111111111111111111111111I111111I1111111111111111111111111111111111111111I1I1111111I1111111I1 <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 all NEW construction. <br />11.'11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111 <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 AlC <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <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 />PLUMBER <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 />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 />Address <br />111111111111111 <br />RESIDENTIAL <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 />