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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 />4/ /J! C /2/0- <br /> <br />SUBDIVISION <br /> <br />PARCEL 10# I \- <br /> <br />OWner Phone Number <br /> <br />OWner Phone Number 1$3/ 3 - '> t}. - '/5 if 51 <br />OWner Phone Number I I <br />I <br />I <br />I <br /> <br />-- Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Nam~ <br /> <br />C' <br /> <br />" <br /> <br />Fee Simple Titleholder Address <br /> <br />c)/J/-; 1P/jJ6~e- V :z~Lt;z7~ 335')/;21 <br />I <br />D ADD/ALT D <br />D REPAIR <br />D COMM D <br />D FRAME D <br />I ?~LA:~~ ~~- -- I <br />SQFOOTAGEI /15 rT I <br />, . <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />. ~ ' ~* ' . L." "r ( . t~ ,~~ . ~ ~_ T,~. ~ ;. <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />"-- <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />1$ '-.-- <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <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 />D <br /> <br />W.R.E.C, <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />11............11'111.......11...1111......11.111..................111..............11..11.................'1...11.............1.111.11111...11.11. <br /> <br />- BUILDER !.. Q ~~J2 ~ <br />SIGNATURE V JJ~~~ t7~~ <br />I' <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Q .u 2j22-l'/) ) <br />I Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <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 /> <br />Y/N <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />11"".'1111'1' 11111""IIIIII""'IIII""IIII",nllll'"r,tl"IIIII'1111111111""'111111111""111111'.""11111111....111111111.11'1111111"'1 <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 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 all NEW construction. <br />IIIIII~.IIIIII.IIIIII..IIIIIIII~IIIIII.~.IIII..III~..I11111~~.~~lllliJ~.IIII~~~.IIIIIIIIIIIIIJIIIIIIIIIIIIII1IIIIIilllllllllllllllllillillllllllli <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. (Ale 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 />