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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br /> <br />r=J NEW CONSTR D <br />D INSTALL D <br />PROPOSED USE 0 SFR D <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK I POoL GnG- e Q1.C Io~ <br /> <br />I SQFOOTAGEI -?{po123 I <br /> <br />:$ (y '2- ?S 0 ~ r VALUATION OF TOTAL CONSTRUCTION <br />. \\ Q_\ , <br />D ELECTRICAL $ It ' AMP SERVICE D PROGRESS ENERGY <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111I1I1111I111111I11I1111I1111111111111111111I111111111111111111111111111111I111111111111111I11111I11111I1111111111IIIII111111111111111 <br /> <br />Date Received <br /> <br />b -s-o 7 <br />-rho mas 10m rY\ <br />T p"V) b(;l r LJ Q <br /> <br />~ <br /> <br />Owner's Name <br /> <br />Owner's Address I ;.....J. ~ 'S ~ <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br /> <br />JOB ADDRESS <br /> <br />49 2- hrvt <br />ICour+ SctL<Q("1O-~ I <br /> <br />S-n(Y\ €. <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />BUILDING SIZE <br /> <br />~ <br /> <br />15" <br /> <br />BUILDING <br /> <br />OWner Phone Number <br /> <br />OWner Phone Number I <br /> <br />OWner Phone Number I <br /> <br />LOT # <br /> <br />I <br />I <br />I <br />I <br /> <br />15-2(.0- 2-1-OUJO -0000 <br />(OBTAINED FROM PROPERTY TAX NOnCE) <br />SIGN D MOVE D <br /> <br /> <br />D <br />o <br />o <br /> <br />DEMOLISH <br /> <br />OTHER I (JoUL t:/V~( aSlA.flc.. <br />STEEL 0 OTHER I <br /> <br />HEIGHT I <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />jUbG - <br />~ <br />t f <B ~ "1<- <br />I . <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License # I I <br /> <br />111111111111I1111111111I1111I11111111I1111111111I11111111I11111111I111111I111I111I1111I111111111111111111111111111111I11I11111I111 <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onsite, 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 & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of EngIneered Plans. <br />"'~PROPERTY SURVEY required for all NEW construction. <br />111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111 <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, nQtarized <br />If over $2500, a Notice of Commencement Is required. (A1C upgrades 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 Application Only) <br />Reroofs Sewers Service Upgrades A1C <br /> <br />BUILDER <br />SIGNATURE <br /> <br />I ~.~vu-- <br />I '7/1'7 ASh.5+ 2-h tlls <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br /> <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />IU~OLjJ ljq% <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y I N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Driveways-Not over Counter If on public roadwaysooneeds ROW <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />~ <br />