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<br />I <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />I- ax -H 1:$-1 HU-UU:ll <br /> <br />Date Received <br /> <br /> <br /> <br />.---y-\ <YI iS€ e.LY ~ Poo'-G,48ANA- <br /> <br />E"I.-AND P"fL~ I PARCEL 10#1 <br /> <br />[Rj NEWCONSTR D ADD/ALT D <br />D INSTALL CJ REPAIR <br />PROPOSED USE D SFR g) COMM D <br />TYPE OF CONSTRUCTION [K] BLOCK CJ FRAME D <br /> <br />DESCRIPTION OF WORK I y ~ I..... C ~~ .l>-. 0111.-'( <br /> <br />BUILDING SIZE I Ho 'f. ~ ~ I SQ FOOTAGE I ~ 7 f.o I HEIGHT I I <br /> <br />,......."...II..,rl........II.......'....II'II.....'.1'...............'111....11..........11'...111....11....1111.....111..1111'111......11...111. <br /> <br />IpJ BUILDIN(ll 1$ VALUATION OF TOTAL CONSTRUCTION <br /> <br />@ ELECTRICAL 1$ AMP SERVICE D <br />. f'lOC- ~OU~d b.!-:j <br />1$ ~\ ('e.- (bAk'. ji.,Joc, <br /> <br />1$ <br /> <br />c=J GAS I~I <br />FINISHED FLOOR ~LEVATIONS I <6 <6 ~. 0)-. <br /> <br /> <br />1/- z. C) & <br /> <br />OWner's Name ~; j-\Ol'-l€ c..ofL '?O/z';"TIO.-"> - LGNNIUZ. <br />· Ii 'co '"I' . \.J...)c..-r-6\40l2..6 BL\,,'lJ c>T,-;::~ J <br />Owner's Add~ess " lO . 1'\ c..,. \ W <br /> <br />Fee Simple Titleholder Namel I <br /> <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />[3J <br /> <br />PLUMBING <br /> <br />1:<1 <br /> <br />MECHANICAL <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I ~ i .~ - J'1S \ <br />Owner Phone Number I <br /> <br />LOTI I <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER 1 <br /> <br />I f?'V.- <br /> <br />-+Ol.o~ ~ <br />bl*Y'. FI Q.. I~~. <br />{2rvJ\ ~ <br /> <br />ROOFING <br /> <br />CJ <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA _ DYES ~NO <br />~\A"D t\lqlo(p <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br /> <br /> <br />t.k,)"'"l IE" c..(:)? P <br />N FEE CURRENT <br /> <br />License # <br /> <br />License # Ec.... \ 'SOC) 'i ~~Io <br /> <br />I A f2. ilc\-,-, (l... . S c....\"\ L ~ 1'1 1'14 ~ ..Y~ <br />I 6Y N I FEE CURRENT I (J) N 1 <br /> <br />License # I Cf"Coy t 7';" I I <br /> <br />I~~~~rr~~ I <br />_Y I N _ FEE CURRENT .....:!.J.. N <br /> <br />License # ~ e /11"~ ....~ ib I <br /> <br />I <br />I <br /> <br />YI N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <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. (A1C upgrades over $5000) <br /> <br />** Agent (for the c~ntractor) or Power of Attorney (for the owner) would be someone with notarized letter from oWner authorizing same <br /> <br />OVER THE COUNTE!R PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not <<!lver Counter If on public roadways..needs ROW <br />