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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 />Date Received <br /> <br /> <br /> <br />Owner's Name -/ e s <br /> <br />Owner's Address I 5508' <br />Fee Simple Titleholder Nam~ <br /> <br />5-k-.e-e ~ <br /> <br />I <br />I <br />I <br />LOT # 1;)..0, 'c7-I/1/QI <br />PARCELlD#II/- d.-.6 '-d-I-OO/O - /0/00- a/Cfo I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <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 />550'6 <br /> <br />rh <br /> <br />S~e-~ *- <br />I <br /> <br />B <br />D <br />D <br />It <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />E3 <br />D <br />D <br />~_vu.eV{ 01 c\. <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I ~f' - '5\-\, ~51 e_ <br />STEEL 0 OTHER I <br /> <br />I <br />I <br /> <br />111....11...1......11....................................,.11111111,...........11.............111...............11.11.....11111111....11.....,..11 <br /> <br /> <br />DESCRIPTION OF WORK <br /> <br />ski <br /> <br />BUILDING SIZE <br /> <br />HEIGHT I <br /> <br />D BUILDING 1$ <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS C(j <br />FINISHED FLOOR ELEVATIONS I <br /> <br />q 00 ~ cP!!-- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />O ..w.R.E.C. <br />.- ~. <br />.-,- \ <br />....----------...... ) <br />~~ / <br />./ to }O /' <br />~11 ~/ <br /> <br />DNO <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />...11111111.......1..1111.11........1111.........11.11.11..11.111.1111.....11'.......1111...111...111.......11..11.....1...'11.................... <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <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 />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address i <br />OTHER · ~-:Z~ <br />SIGNATURE . _ <br />Address I 5S-cY6' <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />(~v ) <br /> <br />COMPANY <br />REGISTERED <br /> <br /><(fV-. S\v€e.,A J 2- 1.",11". A- 33)Yo. <br /> <br />Y/N <br /> <br />RESIDENTIAL <br /> <br />111"111"'1""111'1111'111'1111"'1"11"11""'111'11'1111'11111'111'1111"11"11111'11111"111"'111111'"1111"111111'11111111111111111111111 <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 onsile, 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 ~ NEW construction. <br />III. III. III I. III. III II I ~ IIII ~ ~ I 1 I ~ ~ 111.11 ~ 111.11.11 ~ II ~. 1 111.111111 tl.lll. III. .111111111111111111 ~ I11I111III1 ~ 1111 i 11111. .11 ~ IIII ~ I1I111I1II11111 i <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 Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER TH.lL.COUNTER PERMITTING (Front of Application Only) <br />~ Sewers Service Upgrades NC Driveways Fences (Plot/Survey/Footage) <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br />