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<br /> <br />S.13-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />,,,-813-780-0021 * 1 S~ <br /> <br />E <br /> <br />Owner Phone Number <br /> <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br /> <br />Fee Simple Titleholder Address I <br />13r7Z3Y AL'\S.s1\ OCL <br /> <br />I 0 \l~ t..)C:\ €.. ~sso M <br /> <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br /> <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />~I <br /> <br />[Sl] BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br />D GAS <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address l <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />I <br /> <br />B <br />D <br />D <br />I (Le.rv-.o--,,- 't <br />I <br /> <br />z..eP "'1 J' \..\ \ \ S LOT # <br /> <br />PARCELlD# I ,-:;-9(., ~\ 0\ =to c \ '500 0060 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />SFR <br /> <br />I <br /> <br />D ADD/ALT D <br />El REPAIR <br />c==J COMM D OTHER I <br />c==J FRAME D STEEL D OTHER I <br /> <br />(2..:.,pl,~ .Q.. U.~"h--"~ SiU- ~r 5:i<:.("::::C-M/:>i\c...\") <br /> <br /> <br />SQ FOOTAGE I HEIGHT I I <br />1..._ _~_"-__IIIIl~iIIIWIIIIIIIIfl_ <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />DEMOLISH <br /> <br />BLOCK <br /> <br />~u .~R1 <br /> <br />I <br />I <br />I <br />I <br />c==J <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br />D <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~Y100 <br />, <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />c==J <br /> <br />PROGRESS ENERGY <br /> <br />AMP SERVICE <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />r.=;::::=~ c4'L- (2c:oe:-IN c;-, <br />I . IbN I FEE CURRENT I'Y/N I <br /> <br />t.lwtt. License # k(4;7CI5:/ 0 I la <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br />_b- _ - <br />RESIDENTIAL <br /> <br />............ <br /> <br /> <br />1!IlI_..;- <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 />II8IIIIIIHMI _~IU~ __ III......... nIIIlIRlUIRIIlIIIH~IIII~"III--.nuDl1l11111l~IIfIIIII~llRIIl!IlIIllllIlIBB~"" <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. (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />m_ <br /> <br />- <br /> <br />- <br /> <br />Driveways-Not over Counter if on public roadwaysuneeds ROW <br />