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<br />813-~ <br /> <br />City of Zephyrhills Permit Application <br />Blilding [)epBrtment <br /> <br />Fax~3-7804T21 # 16~ 3 <br /> <br />Date Received <br /> <br /> <br />Owner'. Narne <br /> <br />Own..... Add..... I ~r/;7 <br />F.. Simple TItleholder Nlmel <br /> <br />&4LL X,.i.J/D <br /> <br /> <br />Owner Phone Number <br /> <br />Owner PhOIlll Number I <br /> <br />Owner Phone Number I <br /> <br />F.. Simple Titleholder Add.... <br /> <br /> <br />WORK PROPOSED <br /> <br />E3 <br />o <br />D <br />1Z,-;?r.c- <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br /> eel <br />, PARCEL 101 <br />E3 ADD/ALT D SIGN 0 <br />REPAIR <br />CJ COMM D OTHER I <br />0 FRAME D STEEL 0 OlHER I <br /> <br /> <br />OEMOlISH <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />I <br />I <br /> <br />Sy<;,~.1 <br /> <br />DESCRIPTION OF WORK <br /> <br />ri>o,(tv.u~ A?':>LU'9N~ rwe~;: ......:\1?P~.5.,,,cv-I <br />sa FOOTAGE I I HEIGHT I I <br /> <br />BUILDING SIZE <br /> <br />BUILDING <br /> <br />Is <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />o GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />o <br />o <br />CJ <br />CJ <br /> <br />VAlUATION OF TOTAl CONSTRUCTION <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OlHER <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED L.Y.L!LJ FEE CURRENT LY.!!:LJ <br /> License # <br />COMPANY <br />REGtSTEREO Lr.!...!U FEE CURRENT L..!.!!U <br /> License # <br />COMPANY <br />REGISTERED L::!L.!LI FEE CURRENT L.:!L.!U <br /> License # <br /> <br />Add..... <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Addre.. I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />Add..... <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Addre.. I <br /> <br />COMPANY <br />REGISTERED <br /> <br />U!...!:!....J FEE CURRENT <br /> <br />OTHER <br />SIGNATURE <br /> <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans: (1) set of Energy Forms <br />Minimum ten (10) woridng deys alIer sullmittal date. Required Q1Sile, eon.truclion PllnI, Sanitay Facililies & 1 dumps1llf <br />Attach (3) sets of Building PIens; (1) set of Energy Fonns. <br />Minmum ten (10) working days - sullmittal dele. Required onsile, Construction PllnI, Saniitwy Facil~ies & 1 dumps1llf <br />AN commerciall9QUif9ments must meet compliance. <br />Attach (2) sets of Engi~ PIlW1S. <br />--J>ROPERlY SURVEY I'8qUired for aU NEW ca18lruction. <br /> <br />License # I <br /> <br /> <br />1>-:-""....2<2:>' J7~- r::-&.>LA:>. LL c.... <br />L.!L..!:L.J FEE CURRENT l.1L!:!...J <br /> <br />License # 15'62<;'-)"'2.<.:)0('... Z2C.oy/ <br /> <br />L..!.!!U <br /> <br />Add..... <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />FiN out eppIicalia1 completely. <br />Ownet & Contractor sigl back of application, notarized <br />If over $2600, a Notice of Commencement Is 19quired. (AIC uPflrades over $6000) <br />Agent (for the contractor) Of Power of Attorney (for the owner) would be someone WiIh notafi2ed 1et1ef from owner authotizing ssma <br />OVER THE COUNTER PERMlmNG (Front of ~ Only) <br />Reroofs Sewers Service Upgrades AIC Fences (PlotlSurveylFootage) <br /> <br />Drlvewaya-Not CNer Cwnter if on public madwaYShneeds ROW <br />