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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Dal~ Received <br /> <br /> <br />w. ~<;c h <br />I S +~ f--....J e <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address :~ 'l ~\ S <br />Fee Simple Titleholder NamJ <br /> <br />uJ <br /> <br />Fee Simple Titleholder Address I <br /> <br />'37 B\.5 <br /> <br />WORK PROPOSED <br /> <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />15' -\-',,- A\J e ~ <br /> <br />I <br />B <br />D <br />D <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCELlD# I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN D MOVE D DEMOLISH <br /> <br />D OTHER <br />D STEEL OTHER I <br /> <br />\:~C -\: ~ 0 "'- . <br /> <br />BUILDING SIZE <br /> <br /> <br />HEIGHT <br /> <br />D <br /> <br />..1111..111.........111.............11......11........11...........1111.....11..11.111................11..11111111..111..11,...111111111..111....1 <br /> <br />BUILDING <br /> <br />1$ <br />1$ ~ !,0C>,1o-o <br /> <br />. <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />L$l. <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WR.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />............11....11.111......11111.11.....111................11111.........111..11...1111.111...111................'11...111111.......11....11.11 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED Y / N FEE CURRENT I Y / N I <br /> <br />License # I Ec. /](X) ~b <br /> <br />COMPANY r~~ ~. E/e~:~v-' C <br />REGISTERED Y / N I FEE CURRENT I Y / N <br /> <br />Address <br /> <br /> <br />:::~;:~~:N!. ~ ~ ~ <br /> <br />Address . <br /> <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />I <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />111""tl,II'11 "11111""1'11"1111'11'111"1111"11111111"111111"'111'11111111'11"111111""'11111'1111'11111"'1111"1"'1111'1"1111""11 <br /> <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date, Required onsile, 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 all NEW construction. <br /> <br />IIIIIIIIIIIIII~IIIIII'III~.II'IIIII'I&IIII'I.IIIIIIIIII.JIIIIIIIII'IIIIII.II~&&IIIIIIIIIIIIIIIIIIIIIIIH.~'IIIllllillllllll~llllllllllli~illllllii <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 Driveways Fences (Plot/Survey/Footage) <br />