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<br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Depar1menl <br /> <br />Fax-813-700.0021 <br /> <br />Owne,.. N_ <br /> <br />I?IJ <br />I /II <br />I <br />I J?Dl-iCd A!a.fO(l:r (Z.,O. I LOTtI I I <br />I PARCELIDtJI il.- U- ll-o(X() -OtIq(x)-oo~OI1 <br />(OIn'-~..-rtTAXN01lCEl ~)J <br />E3 NEWCONSTR fa. ADO/ALTO SIGN 0 MOVE 0 DEMOLISH r G <br />INSTALL c::::J REPAIR <br />PROPOSED USE 0 SFR ~ COMM 0 OTHER <br />TYPE OF CONSTRUCTION 0 BlOCK CJ FRAME 8 STEel 0 OTHER I <br /> <br />DESCRIPTIOHOFWORK LAoO ~ r,iU SOJeiJJk.Ui..'.- <br /> <br />I sa FOOTAGE / 6fXX) Fr~ HEIGHT I <br /> <br />OwnllI'aAclcha ~ w~ SW4w~ Ave. <br />Fee SImple TIlIehoIder ....1 <br /> <br />Owner Phone Number <br /> <br />Owner "'- NUIIlber 1 <br />Owner "'- NUIIlber I <br /> <br />Fee Simple T1UehoIder AckI_. <br /> <br />JOB ADDRESS <br /> <br />SUBDMSlON <br /> <br />/r <br />~ <br />(00 <br />Lff-frl5 ~ <br />j}ct. t.j( <br />,..- <br />r~",. <br />I.) <br />Of -- >, <br />W.R,E,C, ~ <br /> <br />~li~~~~~ <br />S}5\1- Otu <br /> <br />WORK PROPOSED <br /> <br />BUILDING SIZE <br /> <br />D <br />D <br />D <br />I:B. <br />o <br /> <br />BUILDING <br /> <br />I VAlUATION OF TOTAL CONSTRUCTION <br />I AMP SERVICE <br /> <br />1$ I <br /> <br />rl ,,-~ 3. OD I VAlUATION OF MECHANICAL INSTAlLATION <br /> <br />o ROOFING ..8l SPECIAL TV 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES <br /> <br />ELECTRICAL <br /> <br />1$ <br />1$ <br /> <br />CJ <br /> <br />PROGRESS ENERGY <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />GAS <br /> <br />ONO <br /> <br />:=RE I <br />Addreaa I <br />~I <br /> <br />Addru. I <br />PWIIBER I <br />SIGNATURE . <br />Addreaa I <br /> <br />=~I I:~ <br />::;: 12 ~'fdJl~ ~ <br />AddNaa _~Uk(;!'_~~. I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I...!.L!U <br /> <br />FEE CURR&HT <br /> <br />L:!.!!L.I <br /> <br />License II <br /> <br />COMPANY <br />REGISTERED <br /> <br />I...!.L!U <br /> <br />FEEC~ <br /> <br />L:!.!!L.I <br /> <br />License /I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I...!.L!U <br /> <br />FEE CURRENT <br /> <br />L:!.!!L.I <br /> <br />License 1# <br /> <br />I...!.L!U <br /> <br />FEE CURRENT <br /> <br />L:!.!!L.I <br /> <br />RESIDENTIAL <br />COMMERCIAL <br /> <br />AIlach (2) Plot Plans; (2) sels of BuHding Plans; (1) set of Energy Fonns <br />MinimlA'n ten (10) working days 8II8r submittal dale, Required onsite, ConslruclIon Plans, ~ Facilities & 1 dumpster <br />AIlach (3) seIll of Bulking PI_; (1) set Of Energy Forms. <br />Minimum ten (10) working days 8II8r submittal dale, Required onsite, ConslrucIion Plans, ~ F8CiIilies & 1 cUnpster <br />AU commen:i81 requir8menls must ~ c:ompIi8nce, <br />Alt8ch (2) seIll of Engineered Plans, <br />'H'PROPERTV SURVEY required for all NEW construction, <br /> <br />SIGN PERMIT <br /> <br />D1rect1_: <br />Fill out .pplication completely, <br />Owner & Contractor SIgn back of appIicetion, nol8tized <br />If....... $2JOO,. ~ of C--1CtlIMnI1a ....uhd. lAIC ~....... $1000) <br /> <br />H Agent (for the c:ontnK:Ior) or Power Of AlIOmey (for the 0Ml8l') would be someone With nota1zed IlIlIer from _lIUlhorizing _ <br /> <br />OVER THE COUNTER PERIIlT1ING (Front Of Applica1ion Only) <br />Reroofs Sewefs Service U~ A1C Fences (PIotISurveylFoolage) <br /> <br />Dltvewaya-Not over Counter if on public roadWays, ,needs ROW <br />