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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received ~ '" ?:iJ- 0"1 <br /> <br /> <br />Owner's Name e..r t!!.....-~ <!... <br /> <br />Owner'sAddress 167/0"c... ~ a....LJ- ~ ,Q. <br /> <br />F,e Simple Titleholder Namel (\ <br />J.- '€.. ~ ~ +!.!D14'€-r ~ v r l ~.\n "'~ 20'" ..Q. J <br />Fee Simple Titleholder Address I <br /> <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />I Owner Phone Number I <br /> <br />.~ k ~~ Owner Phone Number I <br />o , arT <br /> <br />SUBDIVISION <br /> <br />It 3o:g ~a..(/ ~&.) Z~r- ~,':1-Q( <br /> <br />.J((+- I PARCELlD#1 ()3_~Ic_;).I-eDto-O(j/cD-DtDOD <br />~~d (OBTAINED FROM PROPERTY TAX NOTICE) <br />NEW CONSTR ' ADDIJ([b D SIGN 0 MOVE 0 DEMOLISH <br />INSTALL REP)Jr(' <br />SFR [k;}- COMM 0 <br />BLOCK D FRAME D <br /> <br />LOT # <br /> <br />\1/4- <br /> <br />, <br /> <br />JOB ADDRESS <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />o <br />o <br />to&. <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />j..fL{ 1... <br />I <br /> <br />a r+' f.l :,...... <br /> <br />SQ FOOTAGE I <br /> <br /> <br />HEIGHT <br /> <br />~ ELECTRICAL <br /> <br />1$ ~ Ocz t,. cf)C> I <br /> <br />1$1 <br />. I / .;;;L~. w ~ . <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br />11111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111I1111111111111I11I1111111111111111 <br />If\Ltm"f~~/N~~J~1 <br />License # I ~ J.;zsO ~ 1'1 I <br />IM~~ I <br />I Y/ N I FEE CURRENT I Y/N I <br />License # I e=-c... /3DO /~ f 3 I <br />~ (~ I <br /> <br />Y / N I FEE CURRENT Y / N <br /> <br />Add".. r'" I I <br />~I~~~~~:L !. ~ \ ~ ~::~"= Y I N ~ ~RRE", Y I N <br /> <br /> <br />Address License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address I License # I <br />1111I1111111111111111111111111111111111111111I1111I11111111111111111111111111111111111111111111I11111111111111111111111111I111111111I1111111111111 <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 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 />11111111111111111111111111111111111111II11111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111 <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 />AMP SERVICE D <br />~~ <br />~ ' <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.RE.C. <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />o \o...t c.b).,. S 0 <br />\> <..) ~v) <br />v\-li:.t. 3'>' SO <br />. I '7. <br />l <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />PLUMBER <br />SIGNATURE <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 />