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<br />813-780- 020 <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleh <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-81 j-l/jU-UU::!l <br /> <br /> <br />Fee Simple TltJeh Ider Address I <br />13'1b36J fY7qAJOI4- ~, <br />l2eph r J+c:.'5 h-t s {'no,NOf I <br /> <br />P. F t:::rre. I <br />I...3Cf03..? mq,.uOfL -'!:Jr <br />Ider Nam~ <br /> <br />B <br />D <br />D <br />I <br />1.lt..9 · X <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSE <br /> <br />o <br />o <br />o <br />o <br /> <br /> <br />PROPOSED USE <br />TYPE OF CONSTR <br /> <br />DESCRIPTION OF <br /> <br />BUILDING SIZE <br /> <br />LOT ## I \ ~ <br /> <br />. PARCELlD#I/2 -ZlD -21-oOSD - DOD 00 - 0/2.0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE G8J <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />Er <br />D <br />IKl <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />A.: inQV'~ l+) t:JlY>. <br />LIS. oS ' I <br />SQFOOTAGE <br /> <br />Abo 17;0;...) <br />. . <br /> <br />I <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />c=J GAS D <br />FINISHED FLOOR E EVATIONS I <br /> <br />BUILDIN <br /> <br />ELECTRI <br /> <br />BUILDER <br />SIGNATURE <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 />I <br />I <br />I <br />I <br />D <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />Owner phone Number 8 13 7 B 9 <br />Owner phone Number I <br />Owner Phone Nu~b~r I <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br />D <br />D <br />D <br /> <br />DEMOLIsH <br /> <br />OTHER I <br />STEEL D <br /> <br />ON ~c..k. <br /> <br />HEIGHT I <br /> <br />OTHER ./ <br /> <br />I <br />I' <br />I <br /> <br />-- <br />a+- <br /> <br />H<:)f..);)E <br />I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />t=J <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br /> <br />A tach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />nimum ten (10) working days after submittal date. Required onslle, Construction Plans, Sanitary Facilities & 1 dumpster <br />A tach (3) sets of Building Plans; (1) set of Energy Forms. <br />M nimum ten (10) working days after submittal date. ReqUired onslle, Construction Plans, Sanitary Facilities & 1 dumpster <br />A commercial requirements must meet compliance. <br />A ach (2) sets of Engineered Plans. <br />.. 'PROPERTY SURVEY required for all NEW construction. <br /> <br />r4;7tJ7/1Le.tf7AJ/uJV <br />Y / N I FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />1 <br />I <br />I <br />I <br />I <br />I <br /> <br />License # <br /> <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Directions: <br />Fill out application ompletely. <br />Owner & Contract r sign back of application, notarized <br />If over $2500, a N tice of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agent (for the cont 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 Applicalfon Only) <br />Reroofs S ers Service Upgrades AlC Driveways Fences (PloVSurvey/Footage) <br />