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<br />APR/10/20C7/rUE 01:19 PM ZEPHYRHILLS BUILDING <br /> <br />FAX No, ,S13-780-0021 <br /> <br />p, 001 <br />Fex-e13-780.o021 <br /> <br />813.78l>-OO20 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fee 81mple Titleholder Add....,. I <br />JOB ADDRESS Jfj~l~Jd Artlt <br />SUBDIVISION I ?tnecre.s1 I <br />WORK PROPOSED WNEWCONSTR ,8 ADD/ALT D <br /> . INSTAll REPAIR <br />PROPOSED UU D SFR CJ COMM 0 OTHER I <br />TYPE OF CONSTkUCTtON ,0 BLOCK D FRAME D STEEL D <br />DESCR.."ON OF WORK I 0~d f>flW'J..lJK~ce :2. 4~. S- <br />BUILDING SIZE I, , I SQ PooTAGE I ,I HEIGHT I <br /> <br /> <br />e.- <br /> <br />Owner Phone HUIilb8; <br />owner Phon. "umber I' <br />OWner Phone ,Number L <br /> <br />OM Rece~ed <br /> <br />, Owner'5 Name <br /> <br />, OWYwr's Address <br />Fee Simple Tltlehalcier Nam.1 <br /> <br />DEMOLISH <br /> <br />OTHER I C# Hl"oP <br />. <br /> <br />1 , <br />I.N'; IJ (./~ ",/Vii. <br />J <br /> <br />,l' . -::z I I 'j) D VALUATION OF TOTAl CONSTRUCTION /"__/ <br />D , ELECTRICAL ' I' AMP seRVICE D PROGRESS I!Ni!ROY 0 w~A ",", "'\ <br /> <br />.~ =~ :: V,,"^_OF"E~_AUA~ON...,~ <br /> <br />,0 GAS 0 ROOFING D SPECiAlTY ~ OTHER FC-H.t.c.. r,,AcJIitI,f/I" <br />FINISHED FLOOR ELEVATIONS I l FLOOD ZONE AREA DYES ONe <br /> <br />I1II I 1111111'1111111111111111111111111111111111I1111I11111111111 111111111 I 11111 lllllllllliilll illlllllit hili IIlil illllll ili ii ii i 1111111 III i Uli i Ii <br />, ' <br /> <br />BUILDING <br /> <br />l <br /> <br />,l <br />I <br />l <br />J <br />J <br />I <br />I <br />] <br />COMPANY I ~fer fence ~ ] <br />REGISTERED _ N _ FEE CURRENT IN. <br /> <br />Address C711~ U'IA-it n~ ~ ~.t'{~ UC8IllIe# I J <br />11111111111I111;;':'11I 111I11I111111;;;;11 I II I Ililllllllllllllllllllllliliilllllllliilillillllllillllllli.lllll <br />RESIDENTIAL A1taoh (2) l:'!ot PllIn.: (2) .... of Building Plans; (1) HI of Enwgy Forms .' <br />Minimum ten (10) working days aftllr N>mitIiIII dale. Requlllld 0neIte, CoriIlnKltion Plll/lf;. Sanllary Fac:lllies & 1 dumpew <br />COMMERCIAL A118ch (3) sets of BuIlding Plans: (1) HI of EneFIW Forms. <br />MInImum ten (10) wortdng d8ys der aubmlllal dale. Requi;ed oneHe, consinicaon Plails, S...1iary F~ & 1 dumpster <br />All COIMlen:llll requlfemenl$ "'118I ",e" comptlllnce. <br />81GN PtmIIlT AIlac:h (2) 8e16 of Engtneenld Plans, <br />.'~opeRTY SURVEY required for all NEW llOlllIlM:ilon. <br />1IIIIIIIIIIIIIIIIIIIIIIIlIi 1111' 1111111111111111111111111111111111111111111 II i 11111 i 1111111 111111 i III i 111111111 II i 1111111 i i I11II i i I il illlllllll ill <br />Olnlot'-: ' ' <br />FII out appllQlUon completely. <br />OWner & COt'IlrlIClor sign back 01 applicallon. nolBrlzed <br />If over 12500, . NotiGe of Co",,,,'__ .. requlRld. (AIC uPO...... aver t5ll00) <br />,.. AlIent (for lhe contractor) or P_ of AIIDmey (for the owner) would be Somlllln8 with nolIIrlzed letter;ram _ IIUthorizing 18IIle <br />OVm\ THI! COUNTER PE_llT..O (Front of AppllclllIion Only) <br />Reroof8 S_ SllIVloe UpgnIdllll A/fJ Fences (PIoIISunltylFolllaae) <br /> <br />BUILDER <br />SIClNATURE <br /> <br />COMPAMY' <br />FlEGISl1!RED <br /> <br />YI N <br /> <br />FII! C\JMI!NT <br /> <br />, LYL!LJ <br /> <br />Adcha. <br /> <br />Uc:en14l t# <br /> <br />,ELECTRICIAN <br />sIGHAl'URE <br /> <br />COMPANY <br />REGlSTEN!D , <br /> <br />VI N <br /> <br />FE!! clJUlEifT <br /> <br />LWU <br /> <br />Add..... <br /> <br />License" <br /> <br />l' <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGI8lliRIO <br /> <br />Y I N I F&Ii CUMENT <br />License' ,r <br /> <br />L.YL!LJ <br /> <br />Add_ <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />_~ED <br /> <br />Y/N <br /> <br />Fa CURRENT <br /> <br />l...11lLJ <br /> <br />Addre" <br /> <br />~ ~ ",-"--- <br /> <br />/l"ttU. <br /> <br />I <br /> <br />UClin5e# <br /> <br />I <br /> <br />OTHliiR <br />SIGNATURE <br /> <br />~Not _ Counter If on p~ic road_YSnneede ROW <br /> <br />:,. <br />