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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building gepartment <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Nam~ <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 />31tfoO <br /> <br />Ave <br /> <br />.2:;f4} ~ <br /> <br />JOB ADDRESS <br /> <br />I LOT# I <br />/22 62../000C{) 4 9t}(){)Oa) <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN 0 MOVE D <br /> <br />PARCEL ID#/ <br /> <br />SUBDIVISION <br /> <br />I <br />B <br />D <br />D <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />WORK PROPOSED <br /> <br />B <br />o <br />D <br />I <br /> <br />t=O\cG <br />I ~fv <br /> <br />w:MeE I 9:2. / ' <br /> <br />.................1111......11111111.....1111...............11.11.........11.11........11.111.....................,......................,.11111111 <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />D F~~I~ 1$ /~S99 t)O <br /> <br />., <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />o <br />D <br />D <br /> <br />DEMOLISH <br /> <br />I <br />o <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />I <br />I <br />I <br /> <br />HEIGHT I 6' <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />D <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <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 />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />I ACme ultJll'iYI It) -t:/lC <br />I (y/ N I FEE CURRENT -, Y/N <br />License # I 31 g{ <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 /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />1.111"1"111111'111'11"111'111'111"1'111111'11'111'111111'1'1111'1111'1'1"'111'111'111'111"11'111'11'"1'1111'11"1111"'..11..'11"1"1".'111 <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 all NEW construction. <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />111.lllll~IIIIIIIII&IIII&III.III~IIIIIII.IIIII.II.II.11111111111111.11111..I..II~IIIIIIIIIIII~llljlllj.lljlljlll~lill.llj.II.~II~li~~I~llllllillli <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 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 NC Driveways Fences (Plot/Survey/Footage) <br />