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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 />~(2J L.. '1 . ~C)(P <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name I~ UD T€N\Pu; -, <br />Owner's Address I' CCh -..... 5fo ~ Srt . ~ I" ~ l~:\.e( C'w..L n.. 3~....., <br />Fee Simple Titleholder NamJ <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 5'2>":>5 ~LU) St-. 6.ph41 \-\\ ~ \S, FL 3 ~Sl..\ 1- .... <br /> <br />l-uo.-l..Pw'\~ V~ IlCij-' I PARCELlD#1 <br /> <br />D NEW CONSTR D ADD/All D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR 0 COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I <br /> <br />DESCRIPTIONOFWORK I~I 4... n~ ~ ~ I"t\et<.l-~Lot'\ po\e.. \()QCli'4\.o W f\~ ~a..t'\ pclt"\Ll , <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I <br /> <br />..........,.,...."....,..............,....:................................................................,..................................... <br /> <br />o BUILDING 1$ <br /> <br /> <br />~ ELECTRICAL 1$ <br /> <br /> <br />o PLUMBING 1$ <br /> <br /> <br />o MECHANICAL 1$ <br /> <br /> <br />o GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />ltr> <br /> <br />CKJ <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />ROOFING <br /> <br />o <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br /> <br />-~ <br />'''-'' <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />DYES <br /> <br />DNO <br /> <br />11.....1111.........111.111..11.....11.............................111............,.....111...11...11................11........11.11............11 <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />r?e...e.~ 8 e...ch-t. LW. I:r\ L # <br />LI f cy N I FEE CURRENT 10/ N I <br />License # I i 444 <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <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 />Address <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 />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />1111111111111"1111111111111111"1111"1111111111111"1111111111"111'111111"'1111'.11111111'1111111111'111IIIIIIIIIIII,IIIII"lllllrIIIII1111It' <br /> <br />IIII.JIIII~~IIIIII.~IIJIIIIIII~~IIIIII~IIIIII~~IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII~IIII~III~~IIII~~IIIIIIIII1111~111~~IIIIIIIIIIIIIII~~11111111111 <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 NC 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 />