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<br />813-7110-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Fee Simple Titleholder ~ame <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />./ Owner's Name <br /> <br />./ Owner's Address <br /> <br />/ JOB ADDRESS <br /> <br />Fee Simple Titleholder Address .1 <br /> <br />I 35)f,03 <br />I <br /> <br />, . . I .! <br />\*6.-ve, 2-ep~'1 rh;,/s- A a... ( LOT#QIIl 111-/1 i? <br /> <br />I PARCELID#U-2."-n2 J- 6<<1 /0 --~ 7C(J-O/otJ <br />(qaT AINED FROM PROPERTY TAX NOTICE) <br />D NEW CONSTR D ADD/ALT 0 SIGN D MOVE 0 <br />D INSTALL D REPAIR <br />PROPOSED USE 0 SFR 0 COMM 0 OTHER I <br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL D <br /> <br />.-/ DESCRIPTION OF WORK W }:: rJr)ouJ S. ,5 r:: O..cwG on Ft-a., eOOfYI <br /> <br />PUILDING SIZE I . I SQ FO~AGE I If;, rJ . I HEIGHT . . <br /> <br />I ~ . .. . . . . .. . . . . . . . I . . . I . . . .. . . ... . . . .. , . . . . ; . . . . . . . . , . . . . . . . . . . . I . . . .. . . . . . . . . . . , . . . . . . ;.. . . . .. . . . .. . . . . . . . . . .. . . . . . . . , I . . . . . . , .. ... . . . . . . .. . . . ... 1 <br /> <br />/0 BUILDING '1$ fo}ODO'OO VALUATION OF TOTAL CONSTRUCTION <br /> <br />1$ <br /> <br />D PLUMBING 1$ <br /> <br />o MECHANICAL 1$ <br /> <br />o GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br /> <br /> <br />o <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />.0 <br />L01\\~ <br /> <br />W.R.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />o <br />I <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br /> <br />SIGN PERMIT <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />Address I License # I I <br />11111 11111 11111 11111 11111 11I11 11111 III! I111I1111II111111I1I1111111111111111111I i 11111111111111111111111111111111111111111111111111] 1I11I11111I1III <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms . <br />Minimum ten (10) working days atter submittal date. Required onslte, 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 />I t 111111111111 t 1111111111111111111 t 1111111111111111 t 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111.11111111 <br />Directions: ... ! <br />Fill out application completely. . <br />Owner & Contractor sign back of application. notarized <br />If oyer $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 <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Oniy) <br />. Reroofs Sewers Service Upgrades AlC <br /> <br />BUILDER <br />SIGNATURE <br /> <br />mad' E '1'~ <br />3?s(oU'3 (sI-~r.f <br /> <br /> <br />qo;-, /1 <br />COMPANY <br />REGISTERED <br /> <br />\-\. (/n-w.. OD....:'\~ <br />I Y / N I FEE CURRENT <br /> <br />Y/N <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 />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />YIN <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI 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 />I YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />Driveways <br /> <br /> <br />'-- <br />