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<br />Owner's Address I 3 i?S q? <br />Fee Simple Titleholder Name I w Y:t <br /> <br />City of Zephyrhllls Permit Application Fax.813-780-0021, 1lf- V <br />BUilding Department '* '() <br /> <br />'0000 0"0." fu, '.,m".. ~ I ~. [ L <br />~( '-iu '%=:::'" T3-~lIS'-.-Vl:b~ <br /> <br />r-l ao ~ ~ I Owner Phone Number I I <br /> <br />1 Owner Phone Number I I <br /> <br />I <br />~ I LOT II I I <br />PARCEL 101110;). . all ..}..\ . oo~,4 .'() OtlOO ..caool <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />813-780-0020 <br /> <br />Date Received <br />(i.if~~~.~'-," <br /> <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address ~ <br /> <br />I ~8 Sl\-&' <br />I <br /> <br />D <br /> <br />\4.o.[)~ <br />I <br /> <br /> <br />D NEW CONSTR CJ ADDIALT D <br />~ INSTALL CJ REPAIR <br /> <br />PROPOSED USE 0 SFR CJ COMM D OTHER I P ~50~ <br /> <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D O.pHE~ r <br /> <br /> <br />DESCRIPTION OF WORK ~ ~ (?C'DL <br /> <br />BUILDING SIZE I I SQ FOOTAG~ I ' · I HEIGHT ~ <br />~~~~}fi.~iff'i":::!PP"~~~~?~i!:~~~!L_~~~~~~?l<:..~~~j <br /> <br />I$d~ tea SO. 00 I <br />1$ I <br />1$ I <br />1$ I <br /> <br />D ROOFING D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />SIGN <br /> <br />o <br /> <br />MOVE 0 <br /> <br />DEMOLISH <br /> <br />(})OV \ <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />COMPANY <br />REGISTERED <br /> <br />,~'''''''~, . D W",O Cb Jfp"....J <br /> <br />(j)~",Ld' r.<t- <br />(i) ~GL\n "~ \~ ~ <br />fa bl/V ~~ -<:>~ <br />DNO V"l.\:;' \~ pe.; LIJL~I <br />j]j ~o\ <br /> <br />. <br />ENT YIN Y <br /> <br />L~nse 1/ I c;:t I Y Sid 7ill <br />\~~ Ele~L:~~~c. I <br />Y / N FEE CURRENT Y I N <br /> <br />'~"'". L/ir: j'loo n S.,. 7 ~u~ <br />r~~E!A (~.LJ~~ <br />J L~nse# I00C IsI%7pl <br />I <br />I <br />I <br />I <br /> <br />OTHER <br /> <br />o <br />D <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PLUMBING <br /> <br />o <br /> <br />MECHANICAL <br /> <br />VALUA TlON OF MECHANICAL INST ALLA TlON <br /> <br />D <br /> <br />GAS <br /> <br />SPECIAL TY D <br /> <br />Acldre.. <br /> <br /> <br />FLOOD ZONE AREA <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Acldres~ <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />L!..LlU <br /> <br />FEE CURRENT <br /> <br />L:!:.L!i...J <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />L!..LlU <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />Addre.. <br /> <br />~'~~~~~~~~~~'&~~-cl'~;a~:'l~~;'.'M=-3'~.Ji:;-~~~~~~J:J:~~~rlJ:~ <br /> <br />License # <br /> <br />RESIDENTIAL <br /> <br />Attach (2) Plot Pians; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onsrte, 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 8. 1 dumpster <br />All commercial requirements must meet compliance. <br />Allach (2) sets of Engineered Plans. <br />....PROPERTy SURVEY required for all NEW construc1ion. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />~~.:i~~~~~~~~~.'~~~~~~~'~~~~~.m~~.:'b:;;~n~~.E~~.m:.;;o,:~~:.mi; <br />Directions: <br />Fill out applicetion completely, <br />Owner & Contractor sign back. at application, notarized <br />If OYer $2500, a Notice of Commencement is required. (AlC upgrade. 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 Appllcetion Only} <br />Reroofs Sewers Service Upgrades NC <br /> <br />Driveways <br /> <br />Fences (PloVSurveyIFootage) <br />