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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 />09r-~ <br /> <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address I 5 11Lt <br />Fee Simple Titleholder Name I <br /> <br />(n~ ~Vt ~ .L'Vli:\\, <br />I <br /> <br />Owner Phone Number <br /> <br /> <br />Owner Phone Number I <br /> <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />IS71~ <br />I <br /> <br />~%\ <br /> <br />b."" ~ti <br /> <br />LOT # <br /> <br />111, t~.,." I <br />~ Zi:::. <br />. <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />I <br /> <br />o NEW CONSTR 0 <br />D INSTALL D <br />DSFR D <br />o BLOCK D <br /> <br />I ~'h\~'~ \ K(L~Q.~ <br />1 <br /> <br />I SQ FOOTAGE I <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />G2f <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />1$ <br /> <br />o ELECTRICAL 1$ <br /> <br />o PLUMBING 1$ <br /> <br />o MECHANICAL 1$ <br /> <br />o GAS ~ ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br /> <br />- - <br /> <br /> <br /> <br />AJ~L~ <br /> <br />15q1/ U=> 301 ~~ c..;~,r::-J <br /> <br />BUILDING <br /> <br />PARCEL 10#1 l \ . '2."". 2..\ -O'::>\~ - OL'\).:'), 1)\ "'1(J <br />RE: -.2..}J v (OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />ADD/ALT 0 SIGN D MOVE D <br />REPAIR <br /> <br />COMM 0 <br /> <br />FRAME D <br /> <br />~1 ?111...:) ....~ <br /> <br />IL0u <br /> <br />AMP SERVICE <br /> <br />DEMOLISH <br /> <br />OTHER I 'R!.-~OljF <br />STEEL 0 OTHER I <br /> <br />I <br />I <br /> <br />~. M~~ l)~A~ I <br />t- 03. O'.L;:l. Dl <br /> <br />t:\... \"3Sl.-. .~ <br /> <br />HEIGHT I <br /> <br />.. .___"_1lllIll <br /> <br />o <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />D <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />COMPANY <br />REGISTERED <br /> <br />aosa.3 <br /> <br />I <br /> <br />PLUMBER <br />SIGNA TURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onsite, 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 onsite, 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 /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />DNO <br /> <br />.. <br /> <br />.-- <br /> <br />- <br /> <br />r;ntV~t' ~~~E~TCh ~'0J? f <br />License # I (lee. 05/ 6 U ~ <br /> <br />Y/ N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />--. <br /> <br />... --- <br /> <br />---M_.III_"_ll--"~.~-1IiiIIIIIIIIIII <br /> <br />-' <br /> <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. (A/C upgrades over $5000) <br /> <br />(l..qel\t~Qt \~e OOI\\ta~~m Q~ ?o'tolet 0\ "'\\ome~ \\or the owner) would be someone with notarized letter from owner authorizing s.ame <br /> <br />'!t"$Z(Frool {)f ApplicatIon On\~) <br />Service Upgrades Ale <br /> <br /> <br />Driveways-Not over Counter i' on ~ub'ic roao'INa'ls..neeos RQ\N <br /> <br />Fences ~?\o\JSuNe~IFoo\a~e) <br />