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<br />813-780-0020 <br /> <br />Datj, Received <br /> <br />Owner's Name I <br /> <br />Owner's Address <br /> <br />Fee Simple TiUeholder Name I <br /> <br />City of Zephyrhills Permit Application <br />BUilding Department <br /> <br />Fax-813-780.()(J21 <br /> <br />I <br />N eubect <br /> <br />Phone Contact for Permitting D D - I <br /> <br />Owner Phone Number I (R /3 ) <br /> <br />d ' Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />I <br />q ~Li -7J/tJ/P <br /> <br />I <br />;J;""Jean <br />I ."5QDJ GreeVlbriar <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 5CfOd- <br />I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS 1 <br /> <br />0 BUILDING <br />D ELECTRICAL <br />0 PLUMBING <br />D MECHANICAL <br /> <br />Green hriar (j , <br />I <br /> <br />B <br />D <br />D <br />shu.Hev <br /> <br />I <br /> <br />PARCELlD#IID--.:2{,; - ),1- 010.0 -- OO()OD -OSg / <br />(OBTAINED FROM PROPERTY TAX NOllCE) <br /> <br />1058/ <br /> <br />LOT # <br /> <br />ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH <br />REPAIR <br />COMM 0 OTHER I <br />FRAME 0 STEEL 0 OTHER I <br /> HEIGHT I <br /> <br />r=1- NEW CONSTR <br />o INSTALL <br />D <br />D <br /> <br />ihllrr{{tLYlt' <br /> <br />I sa FOOTAGE I <br /> <br />SFR <br /> <br />BLOCK <br /> <br />I <br />I <br />I <br />I <br />CJ <br />I <br /> <br />DNO <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o <br /> <br />o <br /> <br />WRE C <br /> <br />PROGRESS ENERGY <br /> <br />AMP SERVICE <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />ROOFING <br /> <br />OTHER <br />DYES <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISlEREO <br /> <br />Y IN FEE CURRENT U'..!!:U <br /> license # <br />Y/N FEE CURRENT L:!.!..!:U <br /> LIcense # <br />YI N FEE CURRENT U'..!!:U <br /> Ltcer\se # <br /> <br />Address <br /> <br />ELECTRICIAN 1 <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNA TURE <br /> <br />Address \ <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />L:!.!..!:U <br /> <br />YI N I <br />License # I <br />I ~~ 1,~riURE:f L:!.!..!:U <br /> <br />ltcense# I C f(.~ OStJ;J.3j <br /> <br />FEE CuRRENT <br /> <br />Address <br /> <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />tJR.. <br /> <br /> <br />AltaC~) Plot I'>la~ (2~s~1 of BUilding Plans. (1) set of Energy Forms <br />M'irllmum ten (1 O} working days after submittal date, Requrred onsite, Construction Plans, San~tary Facltihes & 1 dumpster <br />Attach (3) sets of Building Plans. (1) set of Energy Forms <br />Minimum ten (10) working days after submtttal date Reqwred onsite, Construction Plans, SanItary Facilities & 1 dumpster <br />AU commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans <br />--'PROPERTY SURVEY required for all NEW construction <br /> <br />Directions: <br />FIll out appllcahon completely <br />Owner & Contractor Sign back of application. notanzed <br />If over $2500, a Notice of Commen cement is required. (A/C upgrades over $5000) <br /> <br />Agent (rOr the contractor) or Power of Attorney (for the owner) would be someone with notanzed letter from owner authonzmg same <br /> <br />OVER THE COUNTER PERMITTING (Front of AppltcaliOn Only) <br />Reroofs Sewers SeNlce Upgrades Ale <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Fences (Plot/SurveylFoolage) <br />