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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 />OWner phone Number <br /> <br />OWner phone Number I <br /> <br />OWner phone Nu~~r I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder NamJ <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />JOB ADDRESS <br /> <br /> <br />!v'AJ(/~ P <br />I <br /> <br />D NEW CONSTR C=:J' ADD/All D <br />D INSTALL c=J REPAIR <br />PROPOSED USE D SFR 0 COMM D <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D <br /> <br />DESCRIPTION OF WORK I? - roo/' - S l'"'\ ,~la.. d 5 '-i .e... <br /> <br />~~~~,'~~, ~:~~".), ::.~~ 1.,:."",!".. ~~ ~~~~~, I,......."""'....." ,I".. .~~.~~.!,"""""""",... .1."","""""""" , <br /> <br />W BUILDING 1\/ 0.5 COM /~4/t.~ VALUATION OF TOTAL CONSTRUCTION . <br /> <br />D ELECTRICAL 1$ I AMP SERVICE t=J PROGRESS ENERGY <br />'-\ /616v 9JU-- B~-6\<:: .{o p~ <br />D PLUMBING 1$ I ~ ()D.J'Y"\Jl-.A-- <br /> <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br /> <br />D GAS [ZJ ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES <br /> <br />SUBDIVISION <br /> <br />~7-: irA' r R 535(,// LOTti <br /> <br />PA~~ELlD#1 04 - dlo- ~\ -0000- 06\OC>.. OOa-O <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLIsH <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />I <br />I. <br />I <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br /> <br />COMPANY <br />REGISTERED <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 />Y/N FEE CURRENT <br /> LIcense # <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <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 />111111 t I' 1'1 r I' 11111' 111'1111' 1'11111111111" 1111" 1111' 1111' 11'"111"111111' III'" 1'111111'111'1'1" II11 r 1II11I I" I1I1I r, IIII1I r 11111 r I111111I I <br /> <br />Address <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 onslte, 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 onslte, 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 />. . 11111111111111111. . 111I . ~ III ~ I1I11 . I1111111 . . ~ ~ I11I . .",1 . ~ I1I11I1I1 . II1111 ~ ~ III . I1III1I . i II1III i II i .111 i I i IIIII i I i 11I1 i I i I i ~ III i Iii i Iii i i II i i I i I 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. (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 />