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<br />813,780,0020 <br /> <br />~ Sf ~ ( Fax,813,780,0021 <br /> <br />WI )../0;J <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br /> <br />D~te Received <br /> <br />Owner's Name <br /> <br />e. Owner Phone Number 1;5'2.-:: I 'i -1,.000 <br />St"Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />It.f <br /> <br />, I <br />I <br />I <br />I <br /> <br />1-3Cf-2.~-21- ~llC- <br />0,::<.:<,:0 - ';:02..\ <br /> <br />'<'Lj _;)$, 2..1,,<.),,-,..(0 <br />L<:'.)O 0 - Q.) Z "t-.. <br /> <br />Fee Simple Titleholder Address <br /> <br />~"~ <br /> <br />,,-> cJov. e.- <br /> <br />~ ~ ; c.c.J( <br /> <br />I <br /> <br />D NEW CONSTR ~ AD DIAL T 0 <br />D INSTALL [2(] REPAIR <br />PROPOSED USE 0 SFR 0 COMM 0 OTHER I <br />TYPE OF CONSTRUCTiON 0 BLOCK 0 FRAME 0 STEEL 0 <br /> <br />DESCRIPTiON OF WORK I ;.\-k"',',,,- ~ rt".'-OIi~Ar",,", <br /> <br />BUILDING SIZE ~ I SQ FOOTAGE I 5~C:l (; l.t> I HEIGHT I 1- I <br />~~~iIIIttIJOIlUlltlDftllllmrllflfYft~YftlIftIlfl~lftIumtlftlltfJIffJIURI~UftUmlIJIIJUIIfU <br />~ BUILDING fS 'ilOC. L."'C..'C I VALUATION OF TOTAL CONSTRUCTION <br /> <br />~' ELECTRICAL Is ~()I C C 0 I AMP SERVICE ~ PROGRESS ENERGY D <br /> <br />'gJ PLUMBING IS ~ C ,2 c () I (j) ,.tJ a2> )J Oc!- <br /> <br />~ MECHANICAL 1$ '5 (::rOC' I <br /> <br />o GAS 0 ROOFING 0 <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />JOB ADDRESS <br /> <br />3'1C;a <br /> <br />33~1 <br /> <br />SUBDIVISION <br /> <br />..:J\p. <br /> <br />Ar-+<:. c+.. ~ ~; l\5 <br /> <br />PARCELID#IS4-2.C-Z.1 -Cco~c:: - Cooo<=>- L.~'2..0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED <br /> <br />LOT # <br /> <br />SIGN <br /> <br />D <br /> <br />DEMOLISH <br /> <br />MOVE 0 <br /> <br />- <br /> <br />OTHER I <br /> <br />WREC <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Add ress <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />If:) li-'C; ( 1.I'7~" I <br /> <br />Oft/)~e<yy P/I <br />I COMPANY <br />REGISTERED <br />I <br /> <br />OTHER <br />SIGNATURE <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R,O-W Pennit for new construction, <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Pennit for subdivisions/large projects <br />Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Fonns. R-O,W Penni! for new construction, <br />Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Stonnwater Plans wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />~ROPERTY SURVEY required for all NEW construction, <br /> <br />Address <br /> <br />RESIDENTiAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />Pa.Vt.~c -{- .s''''''r..s~ CJ"J j"c.. <br />I YI r/ 1- FEE CURRENT ~ <br /> <br />License # I ~ C&c'C>{, 1~'Z- I <br /> <br />r=1<.....t/~L / +--- <br />FEE CURRENT Y I N <br /> <br />'^-J lC..-e...\~ <br />Y IN <br /> <br />License /I I \'= (, 0 0 0 '1.0 1 51 <br /> <br />I 7~~lf ~:'!u~~~ Pti::!JIAJ l;) I <br /> <br />License # I CFc J $t:L 6 ~ 9' ^- I <br />~& /V AI Y '-.:> I <br />I()) I N I FEE CURRENT ~ <br /> <br />License /I I ~ VV'O 0 (<{ t.-t l. {J <br />I <br />I <br /> <br />L- <br /> <br />YI N <br /> <br />~ <br /> <br />FEE CURRENT <br /> <br />License # <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. (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 (PloUSurveyIFootage) <br />Driveways-Not over Counter if on public roadways. ,needs ROW <br />