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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building DeplIItment <br /> <br />Fax-ll13-780-0021 <br /> <br /> <br />D.ReceIved <br /> <br /> <br />Phone Contact for PermlltIn <br /> <br /> <br />WORK PROPOSED <br /> <br />E3 <br />D <br />D <br />~"'Q II <br />I <br /> <br />NEW CONSTR <br />INSTAlL <br />SFR <br />BlOCK <br /> <br />II _ , <br />'1 1-4f<l'~ '70 <br />Owner Ph_ Number i" enill1, El- < ,. .?'Id,1 <br /> <br />Owner Phone Number . I <br /> <br />I <br />(<Dad. bp~15) Fl- 33911 I LOU ,. I <br />I PARCELIDlJI"f-),-5 - 21 - OI5{)~ IJ/)(){) 0-' (;{)(D I <br />(OBTAMD..- -.nY TAIlIlOTlCEI <br />D AOOIALT rn SIGN D MOVE D <br />D REPAIR <br />D COMM <br />D FRAME <br /> <br />Wcu.\ S~ n <br /> <br />8QFOOTAGE I <br /> <br />DEMOliSH <br /> <br />Ow,.,.. Neme <br /> <br />Owner'. Addrn. <br /> <br />F.. Simple TItleholder Neme I <br /> <br />JOB ADDRESS <br /> <br />F.. Simple TItleholder Addre.. I <br /> <br />~ 7'ij'1 <br />I <br /> <br />Ga.11 <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />D OTHER <br />D STEEL D <br /> <br />"(T~~" <br /> <br />I <br />OTHER I I <br /> <br />(f(~) L<)ii:il.el"~c&<t <br />e..oYl;LQC-ll<M-- <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />0 BUILDING IS 960. ()j) <br />~ ELECTRICAL IS )DD,DD <br />0 PLUMBING IS <br />0 MECHANICAL IS <br />0 GAS D ROOFING <br />FINISHED flOOR ELEVATIONS I <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D PROGRESS ENERGY <br /> <br />o <br /> <br />W,R.E,C, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTAllATION <br /> <br />Addre.. <br /> <br /> <br />OTHER <br />DYES ONO <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />I :;:-Y1V1WaJ; 'Ie. L/ohHf'41 fy5kM0/ n.~ . <br />I Y I N I FEE CURRENT j' C!1!!D <br />Ucenaa . I I <br />I Ir!!fl. ~Vatj:(!;Jig~SyS.Jenf.s <br />~ License. I E CI?.f)O~ 31 <br />I I <br />L!L!L.J <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br /> <br />YIN <br /> <br />FEECUARENT <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Addrn. <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />AddrH. <br /> <br />Ucenaa . <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />L!L!L.J <br /> <br />Addre.. <br /> <br />Ucense . <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />L!L!L.J <br /> <br />AddrH. <br /> <br />Ucenaa . <br /> <br />RESIDENTIAL <br /> <br />All8ch (2) Plot PIlInlI; (2) .... of Building PI8ns; (1) set of EIl8l'llY Forms; R-o-W Parmtt for IIN construdlon, <br />Minimum ten (10) working days 8Iler aubrnitl8l date. RequIred ensile, Construction Plana, Stormwatar PI..,. wi SItt Fence Inst8lled, <br />Senilary F8CIIllIe8 & 1 dumpster; Slte Wor1< Parmtt for aubdiYlalonallarge projecls <br />All8ch (3) complete.... at Bulldlng Plana plus e Ute Safety Page; (1) set of Energy Forms, R-o-W Pannit for IIN conatruc:tion. <br />Minimum len (10) working d8ya elter subrnitl8/ date, Required onatte, Construction Plans, Stormweter Plane wi SIK Fence Inst8lled, <br />Senllery Fsc;jJ1lIe8 & 1 dumpeter, Slte Wor1< PerrnII for allIIN projects, Aft commercl8l requirements must meet compliance <br />All8ch (2) _ of Engineered Ptans, <br />'-"PROPERTY SURVEY required for all NEW COIllItrucllon, <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Direction.: <br />Fill out application complBlely, <br />Owner & Contractor slgn beck of appllcallon, nol8IizBd <br />If over 52500, e Notice of Commencement I. required. CAlC upgredea over $5000) <br />- Agent (for IhB oonlr8cIor) or Power of Allomey (for IhB owner) would be someone with nol8rizBd letter from owner 8Uthor1zlng same <br />OVER THE COUNTER PERMITTING (Front of Appllc8llon Only) <br />Reroots Sewens Service Upgrade. Ale Fences (PIotlSurveylFootage) <br />DrIve_p.Nol rNer Counter If on public l'll8dw8ys..needs ROW <br />