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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit ApplicatiOn <br />Building Department <br /> <br />rdA-O I,)"" OU-UUL I <br /> <br />Date Received <br /> <br /> <br />" ' - <br />I-A 1/ I ....) <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder NamJ <br /> <br />WORK PROPOSED <br /> <br /> <br />riAtVl<L S':. Zeplly e 1-1/11.5. FL. LOT # <br /> <br />I PARCEL ID#II 'I- ')6 - 2 J - 6270 ... t> Ol>i>C - aD Bo <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o ADD/ALT D SIGN 0 MOVE D <br />D REPAIR <br />c==J COMM c=J OTHER <br />D FRAME c=J STEEL 0 OTHER I <br /> <br />~~~ - ~ iZlc:~'<<.J.'c:..,,"L ;r1e;?6 <br /> <br />I HEIGHT I I <br /> <br />II..'.................,....,...,..,.."..,.....,...".,."....,.."".."...""....".,."..,',....,."."......,.."......".".,.",."........ <br /> <br />I <br /><; b Lfb ( <br /> <br />'I/' 'II, <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />BUILDING SIZE <br /> <br />o BUILDING 1$ <br /> <br /> <br />D ELECTRICAL 1$ <br /> <br /> <br />D PLUMBING 1$ <br /> <br /> <br />o MECHANICAL 1$ <br /> <br /> <br />DGAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />c==J <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />~ PROGRESS ENERGY <br /> <br />AMP SERVICE <br />IIN ~r/~ <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />$"VO - -- <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY c=J <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />"..1......,.,..,...,..,...,......,."..,."....,',.,'..."...".""..",.,."".""""".,.,',...,""",.,."...".,.........,...,........... <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />111111111111111111111111111111111111111111111111111111'1'11111111111111111"'111111111111111"111111111111""'111111"111111111111111111111111111 <br />RESIDENTIAL <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Address <br /> <br />~c~ 71~ <br />..3? i{DS- O~ f/~ <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />jJLpll,q. <br />I Y7 N I <br /> <br />~/~.L- <br />FEE CURRENT I Y / N I <br /> <br />License # I ~ K. t!JtJ /5"2- 4 'I <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />IIIIIIIIIIIIIIIIII~IIII~~IIIIII~IIIIIIIIII.IIIIIIJ~III111111111111111111111.111..II.lllllllllillllllllll.11111111111~lllllllllljllllllllllllllllll <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. (A/C 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 />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <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 onslte, 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 onslte. 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 construcllon. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br />