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813-~80.ooio City of Zephyrhills Permit Applic,atlon Building Department Fax-813-780-0021 6-22-07 Owner Phone Number Owner Phone Number I Owner Phone Number I Date Received Owner's Name l~K. ~e~-CSmI#\ ~ l~d.J:>...cr. ~ll~ Owner'sAddress /p.()~~ ~OOOl.,. :r~,v(\e. fL.~~\A~~ Fee Simple Titleholder ~amel I JOB ADDRESS Fee Simple Titleholder Address 'I . '14~~'~ ~ I PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK I B o o 2P-p~'-'l (h" \ b ~L LOT t# I I PARCEL 1Dt# Ilt.\ - ~ ~a...l- CO, 0 - a \ -1 00-- C'lC)9 D (qsT A1NED FROM PROPERTY TAX NOTICE) SIGN D MOVE D '&l vd . SUBDIVISION WORK PROPOSED ~ D D I t(\~~ I AD DIAL T REPAIR COMM FRAME D D D ~vb~ I DEMOLISH OTHER I STEEL D OTHER I I I I lOC Amo SQ FOOTAGE I DESCRIPTION OF WORK l:!UILDlNG SIZE HEIGHT I ~ I I. I I I . I I . . . I I I I . I I I I I . I I 1'1 I I ." I I I I I. I I I I . ._ ~ I I I I . I I I .1 I . . . . . . I . I I I . . I I . I I I . I I I . . I I . . I I . I . I . . . I . . . . I . . . I . . . . I . . I . . . . I I . . . . . I . . . I . . . . . . . I . . I I I . . I . . . . . D BUILDING VALUATION OF TOTAL CONSTRUCTION r> ELECTRICAL AMP SERVICE \ co C>ZJ PROGRESS ENERGY .D W.R.E.C D PLUMBING ~~~ VALUATION OF MECHANICAL INSTALLATION Address I I 'i~lw p-p. ~~ ~.k.. I I Y/N FEE CURRENT Y/N BUILDER SIGNATURE ELECTRIClA SIGNATURE <---h-- 1~ \.L:> fL ~ I COMPANY REGISTERED r~~ Q)N License # I 9.~CAJ. I License # -:I:i1 '-.- FEE CURRENT 1& N I License # JEc\~\~~/I~Y(t I I I I I I I FEE CURRENT Y/N PLI)MBER SIGNATURE ~~ COMPANY I REGISTERED YI N Address ME. CHANICAL I SIGNATURE . Address I OTHER I SIGNATURE Address I License # 1III111111111I11I11111I11I111I111I II II' 1IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIi 11111111111111111111111111111111111111111111111111J IIIII11111IIIII RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date, Required onslle, Construction Plans, Sanllary Facilities & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance, Allach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction, 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 Directions: ' ' ' ' Fill out appllcallon completely. Owner & Contractor sign back of application. notarized If over $2500, a Notice of Commencement Is required, (AlC upgrades over $5000) .., Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing OVER THE COUNTER PERMITTING (Front of Application Oniy) Reroofs Sewers Service Upgrades AlC COMPANY REGISTERED Y/N FEE CURRENT YIN License # COMPANY REGISTERED I YI N FEE CURRENT YIN COMMERCIAL SIGN PERMIT Driveways Fences