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<br />813-780-0020 <br /> <br />. I <br /> <br />City of Zephyrhills Permit Application <br />Building Departmenl <br /> <br />{f 11 q{ <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Name <br /> <br /> <br />/$IJvct, <br /> <br /> <br />Dale Received <br />::nnm <br /> <br />Owner"s Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />a SoU) liiL <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number 1 <br />, <br /> <br />Fee Simple Titleholder Address <br /> <br />/,9/~ ACtlf <br /> <br />~C'I2. <br /> <br />JOB AUDRESS <br /> <br />lOT # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />I <br /> <br /> <br />D NEW CONATR 11 C:=J ADDIAL T <br />[B- INSTAll f4ot:>clI. D REPAIR <br /> <br />PROPOSED USE 0 SFR u:zr COMM <br /> <br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME <br /> <br />DESCRIPTION OF WORK ~ ocf2 ~..L-+~//o -h-G'<Y\..- <br /> <br /> <br />BUILDING SIZE I . I SQ FOOTAGE I " 1 HEIGHT I l <br />lTIT1Tf1TrrTTlllllllll"IIIIII'IIII.III.,.III1.IIII1IIII1II1III. i "11'"1,1",11"".,,.,,11,,.,111,.11,,11,.1,.1,11.111.,11,111.,,1111111.,11,,11 <br /> <br />1$ I <br />1$ I <br />1$ I <br />1$ ~, ~S>O.08 1 <br /> <br />D GAS 0 ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111I K 111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111I11111I1II111111I1111111 <br /> <br />:I~~~RE I ~::~= I Y I N ~ CURRENT Y I N I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />PARCELlD#1 O.;2..-.J.." -;U-D-O/O -O:2..c/cJo - OD~ <br />(OBTAINED FROM PROPERTY TAX "'OTICE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />D <br />D <br />D <br />o <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />"ELECTRICIAN I <br />SIGNATURE " <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />license # <br /> <br />COMPANY I' <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />~ <br /> <br />License # <br /> <br />Address <br /> <br />15o~fu.(\~ ~~Ull[~e~ <br />I YI N I FEE CURRENT I Y/N I <br /> <br />license # I~JY\ (b J ~ % { <br /> <br />OTHER COMPANY I <br />SIGNATURE REGISTERED Y I N I FEE CURRENT Y I N <br /> <br />Ad"'... I I u,,~. . I I <br /> <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111II111111I111111I1II11111I1I111I1 <br />RESIDENTIAL Allach (2) Pial Plans; (2) sels of Building Plans; (1) sel of Energy Forms <br />Minimum len (10) working days after submittal dale. Required onsile, Construction Plans. Sanilary Facilities & 1 dumpsler <br />Attach (3) sels of Building Plans; (1) set of Energy Forms. <br />Minimul1llen (10) working days after submlllal dale. Required onsile, Construction Plans, Sanilary Facilities & 1 dumpsler <br />All commercial requiremenls must meel compliance. <br />Attach (2) sels of Engineered Plans. <br />'''~PROPERTY SURVEY required for all NEW construction. <br />11)111111111111111111)1111)'11111111)11)1)111)1))11111IIIIII111I11I11111111111111111111111111111111111111111I11III1I11IIIIIIIIII11II1111I111111I11 <br />D.reclJomii: " <br />Fill oul applicalion completely. <br />Owner & Conlractor Sign back of application. notarized <br />If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agenl (for the contraclor) or Power of Allomey (for the owner) would be someone wilh nolarized leller from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Foolage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />