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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Dato Received <br /> <br /> <br /> <br />Owner's Name <br /> <br />I <br />I <br />I <br />a'-vb. I LOT # I I <br />PARCELlD#1 0'3- z.~ - 21- O()IO -05 500-00~ <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />1374J ) <br />I <br /> <br />E1.LA-~~ <br />I <br /> <br />B <br />o <br />D <br /> <br />DESCRIPTION OF WORK b:1V STPrL.L r I e.E:- <br />II <br />BUILDING SIZE SQ FOOTAGE <br /> <br />~'IM.'1Il!lI!IIl!Kll!!l!l!:l!l!Illl!l!I!IlIlI:~~___III_i1~ ......__ --~=~-"""_~I:I'!IIB!'I!I!II!ilIIiIi--_IlII!IIII'______ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />~ <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE 0 <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />I <br />I <br /> <br />0':'':' ~ In:. I <br />(kLJN.7tI/lJw~ <br /> <br />ALJ'r.zM S'"'S~ <br />I HEIGHT I <br /> <br />VJ,n+ <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION f$~ IJ 000. ~ <br />0 GAS D ROOFING D SPECIALTY [J2(' OTHER F,12.f:. ALA-Il.,^,. <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO <br /> "\ crl\ <br /> <br />-- <br /> <br />~~ <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br /> <br />Add_s ~ <br />~,:i.~RE .... .. ..,.. :.... s:::: :rn':.":.: Y N "" cu"", '-I <br />Address 115 c) 'N I L5tllltC. @LV)). C45Sft.B~'t R-License # - 1=000 l 07 <br /> <br />ll'!illffiGun:r~~~m~;J;I~n~~:R\.'\:MIIJ.l.uMlllll~"0IIiIl!IIl0'lUlllBlEl!llllllDm!IMKI=--llRa~~99i11111i1!1.1lmiRlltll!!lllllllillr.llll~lllF~oM~~.mrG:l_.~9D1!1lfi1i1!1L!! <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date_ Required onsile, 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 onslte, 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 /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />ifti1i!1HFiHiIlHf:_mrrJ,'F.fII!RlIH'DIIiRlMI'FJlnU~gRiHMIRlW;I:m!ifiIiAl&1l!Fl!illiM~!J!~~Mi!1IP.rd!1i1l1i1U~lmH~~!il(~_I!II!liIimi~~II!III,~ll/lU!~M!IIiiiilimR8I~~II!ii~Ufilll'-l~~[~.~ <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 Attomey (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 AlC Fences (PloVSurveylFootage) <br /> <br />. .~ <br />Driveways-Not over Counter if on publiC roadways..needs ROW <br />