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<br />813-78<Hl020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee SImple TItleh~lder Name I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Tltlehflder Address I <br /> <br />I <d74~ ~~D-o&. ~ - h01" 3'\5 <br />lb,,; +iWODd Pkcse J[: <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />I <br />B <br />o <br />o <br /> <br />ADD/ALT <br />REPAIR <br /> <br />COMM <br />FRAME <br /> <br />PARCEL 1011 02 <br /> <br />WORK PROPOSE' <br /> <br />E:1 <br />o <br />[,g <br />I~ <br /> <br />\OW^ ~"'1eJ <br />SQFOOTAGE I K 12 ~ <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPEOFCONST~CTION <br /> <br />DESCRIPTION OF \NoRK <br /> <br />BUILDING SIZE 1 I <br /> <br />Ut'\: ..\. <br /> <br />~ BUILDIN 1$ I <br />~ ElECTRlbAL 1$ 1 <br />0?2 PLUMBING 1$ I <br />~ MECHAN~AL 1$ I <br />D GAS ):tJ ROOFING 0 <br />FINISHED FLOOR E~EVATIONS 1 I <br /> <br />LOT' <br /> <br />~ 1(., ." ~ 1- 00 I 0- 0 1 g 00 - (Jot 0 <br />(OBTAINED FROM PROPERTY TAX NOTlCE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ScO~ ~lofr 1'\ LlJ"'" tor .(- <br />I Y/ N I FEE CURRENT I Y/N <br /> <br />License' I <br /> <br />COMPANY lJL(l1'l'\ 4i'\ (2eo..c..t"'IS!:L <br />REGISTERED r Y / N I FEE CURREN'r Y / N <br /> <br />Jl\ttach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />~'nlmum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facililies & 1 dumpster <br />ch (3) sets of Building Plans; (1) set of Energy Forms. <br />inimum len (10) working days after submittal date. Required onsile, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requlremenls musl meet compliance. <br />A ach (2) sels of Engineered Plans. <br />PROPERTY SURVEY required for all NEW construction. <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />~ <br /> <br />PROGRESS ENERGY <br /> <br />OTHER <br /> <br />DYES <br /> <br />o <br />~c._ <br />~A-~_ <br />e.lec~" '3u.b <br />~, 0Q..\cS <br /> <br />,KjNO <br /> <br />QacA <br /> <br />W.R.E.C. <br /> <br />~JL~4t'\ Lo"sf. ,. TI1 C <br />r Y / N I FEE CURR~NT I Y / N <br /> <br />License' I <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License' <br /> <br />L ~~~: ~ <br /> <br />U);\ \,'a..., S <br />FEE CURRENT I Y / N <br /> <br />License' <br /> <br />License , <br /> <br />DIrections: <br />Fill out application mpletely. <br />Owner & Contract r sign back of application, ndlarized <br />If over $2500, . N tlce of Commencement Is required. (AlC upgrades over $50001 <br /> <br />Agent (for the con actor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same, <br /> <br />OVER THE COUNTER ERMITTING (Front of Application Only) <br />Reroofs S eni Service Upgrades AIC Fences (PloIISurveylFoolage) <br /> <br />Driveways-Not ov r Counter if on public roadways..needs ROW <br />