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<br /> 813.780-0020 1 4 1/6
<br /> City ofZephyrhills Permit Application Fax -813- 780 -0021
<br /> Building Department
<br /> N
<br /> Date Received r` ^ 1 Y
<br /> - .. ittii } ,, ; ,;,,.. . r , Phone Contact for Permitting ! J (.�'� _ a� a$
<br /> I .,- t . ^- .^ ^'^ I -: e:..��r!! , �.�j�r:e..r:e r :. s S..Ii:,F! I u t= :
<br /> //�, _ ` _ ` ."• . :. a r. - , ?', e1itl31f "ue.uu.rww, ! L :R!a:4rrr .?
<br /> Owners Name y i Zo ll , cyI (v1�{`Jy-\1 LS i> 14?)- s9 so
<br /> ,-•�. Owner Phone Number
<br /> Owner's Address I t 3 00.1- . SP
<br /> 2 417yrh;`tC 33S Owner Phone Number I J
<br /> Fee Simple Titleholder Name I ,Q( C)-- Phone Number 1
<br /> Fee Simple Titleholder Address
<br /> (�.� n w�:�r•__s__ 1
<br /> JOB ADDRESS ' CJVI / OI r �.� 1 , I III
<br /> LOT # Q
<br /> SUBDIVISION I eak, S 1 PARCEL ID# 11,• pt., -at- of au _ Q J
<br /> I (OBTAINED FROM PROPER TY TAX NOTICE)
<br /> I
<br /> I
<br /> WORK PROPOSED I NEW LONSTR I I REPAIR D/ALT SIGN I MOVE I I DEMOLISH
<br /> PROPOSED USE 1 1 SFR I I COMM 1 1 OTHER I
<br /> TYPE OF CONSTRUCTION I 1 BLOCK I 1 FRAME I I STEEL
<br /> I/
<br /> I OTHER I I
<br /> DESCRIPTION OF WORK I r ia0/1 IQ (,3i/Vio(,xX - (1 r ,/ _ _a Si n s � . _ - '' 1 SIZE I i SO FOOTAGE SZ ( �[ v t/U/ size. � 1iD ., J( j n-u I
<br /> BUILDING S
<br /> t I?:n3ii: ^• s - ! HEIGHT I
<br /> .:,e , :..:u.n„m•:.:u:,:;ISFI . v ia_ tik} tt n" 1tm3iN'° Y; O' u ^ " " "vP[r' €'sE31 „u,.`hi9IE.,::. ice
<br /> .., o., ,,.w::.. ,,: r� fA ° 7 ,�i:i:,;.,” 3 ? r;'? ;;6ti..I;SeI
<br /> BUILDING f$ K ,. ,
<br /> 1a380 1 VALUATION OF TOTAL CONSTRUCTION
<br /> I 1 ELECTRICAL I$ I AMP SERVICE I 1 PROGRESS ENERGY 1 I W.R. E.C
<br /> 1 PLUMBING IS I ,r t[�
<br /> 1 MECHANICAL IS I VALUATION OF MECHANICAL INSTALLATION /� �l./
<br /> I GAS 1 1 ROOFING 1 1 SPECIALTY I I OTHER rr �-
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA f IYES 1 INo
<br /> _ _ ,r ire n -., ! r , irn - . 'as a i mind? s',??. r isB=' nmr+ i Inrh !
<br /> _ :.. ,? .. ti.?til.. ' • ' °IHI'm!tIW::.., 51 ., ' ?e ?r. : ; "a•v
<br /> :'.;n. er. ?± pl: � I" R
<br /> !�^^?I >t R^
<br /> � .� ,: . �.. _�.......`I.. .. � 'rR :t ::s Irt .(�. t? r!? I; 98! ±FlIl9iR ?t3 ??Ig ?
<br /> BUILDER - — COMPANY T .4}gWH.e j; �
<br /> SIGNATURE �I
<br /> Address ' REGISTERED Y/ N vFE r ' I1
<br /> FEE CURRENT ,/ ` Y /N
<br /> � ∎ "1_v.s , ' - To / ( v 5`F7
<br /> •� ��� v l Q License #
<br /> ELECTRICIAN I COMPANY 1
<br /> SIGNATURE
<br /> REGISTERED f Y/ N . 1 FEE CURRENT 1 Y/ N 1
<br /> Address 1 1
<br /> I L tense #
<br /> •
<br /> PLUMBER 1 COMPANY I
<br /> SIGNATURE
<br /> REGISTERED I Y/ N i FEE CURRENT 1 Y/ N 1
<br /> Address
<br /> 1 License #
<br /> MECHANICAL I I COMPANY I I
<br /> SIGNATURE
<br /> REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I
<br /> Address
<br /> License #
<br /> OTHER I
<br /> SIGNATURE COMPANY I
<br /> REGISTERED ( Y/ N 1 FEE CURRENT 1 Y/ N I
<br /> Address
<br /> "
<br /> i:. .. „; ?.,,,, ,;,,,,:n ? {?t License#
<br /> °: iBiBl .,Bill.. .lif111 111311111/ u:1„a 011a,7!1i3Mi::r r.m,a.,::..,.;..._.. EI Fge„_,: l I LI= aftl{ .,,,,...
<br /> RESIDENTIAL 1 ` set ,En Energy F ' o'^^ v^• r• wd• u ..Jlu.�.•:,.nu6,t}1Yilii..r�f.V u o•.m nu�I Uiael� �ia"� ^''min .'n u••r•:.lii'�;• c`: „• ": }
<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 /> COMMERCIAL 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 /> SIGN PERMIT Attach (2) sets of Engineered Plans.
<br /> ""PROPERTY SURVEY required for at NEW construction.
<br /> iD f` rect ii onssl+ RiiiSS• r;? D7-'; i;l Y.:€: f.,:'! 9.": Spi7; iitS'. Iai44: 9fit9' i17pY, l4ii?!!!! Ai9flil3filit'. I” R1w'•:'! 1{ f4 !Sfiia[is9i;t!!:; {7i::.:'E[i': ;{ @It;:ri #ip;il:{tniii7C!! ".' i "":
<br /> Directions:
<br /> Fill out a �f! LR_: 6..i, E".> rE: IR;,.,:! 13t{ i!> fiW3i!" .:Y.;BfeA;;lvlltu..r:ii3':i.i'1 r:'3ti9ii<[I;it ?;:NSI! ,,,
<br /> application completely.
<br /> Owner 8 Contractor sign back of application, notarized
<br /> If over $2500, a Notice of Commencement is required. (A /C upgrades over $5000)
<br /> +' Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (Front of Application Only)
<br /> Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
<br /> Driveways -Not over Counter if on public roadways needs ROW
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