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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 II r; I <br /> <br />Owner's Name Ja "'" ~<S <br /> <br />Owner's Address I 3 q ~ as:- <br />Fee Simple Titleholder NamJ <br /> <br /> <br />Owner Phone Number ffl3 ')79 <br /> <br /> <br />Owner Phone Number 18! 3 <br /> <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />;;;q 30 C"j <br /> <br />I=)"'\V" <br /> <br />f\.u <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br /> <br />LOT # <br /> <br />PARCELlD#1 i? -;;)LP - 3- ( - 0040- 00100-01'?O1 <br />,.../ (OBTAINED FROM PROPERTY TAX NOTICE) <br />o SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />.....111.......1111...........111.........1111........11...111......................11...11111....11..................1..........1111111.1111111.. <br /> <br />B <br />D <br />D <br />I C\-\s:., O~ - \f)~ <br /> <br />I SQ FOOTAGE I <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />D <br />D <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 />0 BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />[~j'/ ELECTRICAL 1$ I AMP SERVICE ~' PROGRESS ENERGY D W.R.E.C. <br />0 PLUMBING 1$ I <br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />0 GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />...111...1111.1111..111...11.......111...111.....11........111.11...........1111...........11......11....111.11..11..........,...............11111 <br /> <br />COMPANY m~ d__~ <br />REGISTERED ~ Y / N I FEE CURRENT I Y / N <br /> <br />License # I <br /> <br />BUILDER j7f ~ d~ /J/7 ' <br />SIGNATURE .!~~,,~ C -?-V_~ <br /> <br />Addres _ <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 />YI 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 />11111111111111'1111111111111'1'111111111111111111111111111111111111'1'1111111'11111"1111111111'1'1111111111"Illllllflllll'IIIIIIIIIIIII'llllllll <br /> <br />IIIIII~IIIIIIIIIIIIIIIII.IIIII~IIIIIIIIII~~IIIIIIII~IIIIIII.~IIIII.IIIIIIIIIIIIIII.IIII.'III.IIIIIIII~IIIIIIII.IIIIIIIIIII~IIIIIIIIIIIII~IIIIIIIII <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 Fences (Plot/Survey/Footage) <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 onsite, 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 />Driveways-Not over Counter if on public roadways..needs ROW <br />