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<br />(0 \ \3 <br /> <br />Fax.813-780-0021 <br />l) (l', t- d., <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address S ~ 111 ~ <br />Fee Simple Titleholder Name I <br /> <br />~~. S"~ <br /> <br />OWner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />IlP'7 ~ '3 f6cw-0u..- (JOeY- ~ ~ '-o\- 44- <br /> <br />I Dr; t.f- wacs101 Pk4se 1L I PARCEL 1011 D 2 - .1(. ~ 21 ~ bOlO 0 lIS' 00 ~ 00/0 <br />(OBTAINED FROM PllOPERTY TAX NOnCE) <br />D ADD/ALT D SIGN 0 MOVE D <br />D REPAIR <br />CJ COMM D OTHER <br />CJ FRAME D STEEL <br /> <br />L.tn.,'+ TDW('\ l-\-o""er <br /> <br />SQFOOTAGE Is) () I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />e:l <br />D <br />IKl <br />11 <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />BLOCK <br /> <br />PROPOSED USE <br /> <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />r;gJ <br />CXJ <br />00 <br />rKJ <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br />D GAS ~ <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />BUILDING <br /> <br />LOT' <br /> <br />DEMOLISH <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />W.R.E.C. <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />~ <br /> <br />D <br />~OL ~J.u::,\.1.:::. ~c.c:. <t~~ <br />\?\ at+- _ P'-'- <br />Z\~,c~\ - <br />rN2c.~tco..\ Ca.. \ CS ~ <br /> <br />_ Am C9J'-\ - 'llltJloCa <br />(X] NO <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />MECHANICAL <br /> <br />ROOFING <br /> <br />OTHER <br /> <br />DYES <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />/Z;u "".:lA Lc,~ ~./. I '1:,,~ <br />L Y I N I FEE CURRENT I 'y I N <br /> <br />License . I <br /> <br />L~~FEE~/N <br /> <br /> <br />License ., I <br /> <br />w: II la. ^" J <br /> <br />FEE CURRENT <br /> <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License ., <br /> <br />~ ~"l I 0111< -'.rJ- <br />~Y'N I FEE CURRENT I Y/N <br /> <br />License ., I <br /> <br />(t~rn4" flo(}t;.~ <br />I YI N I FEECURRENT Y/N <br /> <br />License ., I <br /> <br />RESIDENTIAL <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 Fadlities & 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 Fadlities & 1 dumpster <br />All commerdai requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />-"PROPERTY SURVEY required for all NEW construction. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <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. (A1C upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someon~ with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades A1C Fences (PloIISurveylFootage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />