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<br />Owner's Name ~ll1a Owner Phone Number <br /> <br />,,-esAddm.s I :i;-/)q t~b:k, 1t~Uf~~.'Phon.Numb,,1 <br /> <br />Fee Simple' Titleholder Namel __ ~ ~ Owner Phone Number I <br /> <br /> <br />Fee Simple Titleholder Address I Sa me. <br /> <br />JOB ADDRESS I ,3~q_ ;j?k71;.2QtliJh; ~339fD . 1 LO" 13?3 <br />SUBDIVISION ~t;/01 fJ d fv.I' (PARCELlDOI dl.lf-';zh ~ /- Gl1gtl- 6&x\1-3J3 V <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />F;(j NEW CONSTR E3 ADD/ALT 0 SIGN D MOVE 0 <br />D INSTALL REPAIR <br />PROPOSED USE 0 SFR 0 COMM 0 <br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 <br /> <br />DESCRIPTION OF WORK I L-4/fJt1 i a I1d ~reM t( ()D #1 <br /> <br />I SQ FOOTAGE I 2$'L/7I:t I <br /> <br />0b(j()~ <br /> <br /> <br />City of Zephyrhills Permit AppliCatiOn <br />Building Department +_c-~.~. <br />/?Js:D lb"M ( ~ vrc e.. <br /> <br />Phone Contact for Permlttin / ? 7. <br /> <br />I OA-U IlJ-' uv UV'" I <br /> <br />813-780-0020 <br /> <br />Date Received <br />11111111111 <br /> <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />AMP SERVICE <br />l~ JoS \0 .o~:> <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />~ <br />f'.)Oc. / <br /> <br />W.R.E.C. <br /> <br />GAS <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br />o <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />BUILDING <br /> <br />G2f ELECTRICAL <br /> <br />o <br /> <br />D <br /> <br />D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />~NO <br />1 ~~'.?ef- !i>kt 1Io/~ <br /> <br /> <br />License # I n b <br /> <br />f1f~I'1t~ Jk/~ <br /> <br />License # I n fa. <br /> <br />[Zf:rr-,~~tJkH;~ <br /> <br />License # In /~ <br /> <br />Address <br /> <br /> <br />...... <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 I <br />SIGNATURE <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y IN <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />11111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsionsllarge projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. <br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stormwater Plans wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />SIGN PERMIT Atlach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I i 11111111111111111111111111 <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. (AlC 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 NC Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />