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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 />Fee Simple Titleholder Nam <br /> <br /> <br />Date Received <br /> <br />5'+ <br /> <br />I <br />I <br />I <br />Zr-?~~J.;/I<! "5.3:5"1./2 I LOT# I ~ +7 I <br />PARCELlD#IJ/'2~- 2/-~J/)-u..z/t.?t? - fX)~() I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <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 />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />159.29 jq~ <br />I <br /> <br />SUBDIVISION <br /> <br />I <br /> <br />D NEW CONSTR c=J <br />D INSTALL D <br />DSFR D <br />D BLOCK D <br /> <br />17e;" ~... AfPi' }& <br /> <br />I SQ FOOTAGE I <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />DESCRIPTION OF WORK <br /> <br />.39 's' <br /> <br />D <br />D <br />D <br /> <br />S <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />..11.....11..11.....11....1...11,................111................111...111.....1111...........'11.............1111......1111.11111111...11.1111 <br /> <br />OTHER I <br />STEEL D <br /> <br />~~ ';JeeJr 11~~l S~,'~ <br /> <br />HEIGHT I I <br /> <br />OTHER I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />BUILDING SIZE <br /> <br />D BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <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 />i/.r50. e6!- <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 />BUILDER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Il-ItJme -.z:;.",lJI(eJl/ernBn+ je('(Ac.A~ <br />! Y I N I ' FEE CURRENT I Y I N I <br /> <br />License # I e.CC osgzz7 <br /> <br />I~ cl <br /> <br />t-J-11 J ~... ) '1 <br /> <br />rlJ (",,"-lev- I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address J Y ~ T7 <br /> <br />ELECTRICIAN <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 />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <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 />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />11'1'1111111111 1111111111111111111"1,,"111111111111111'11111111,'1'11111111'1111111"'111111....111111111".111111'..'11111"'I'llllllllllrllll <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 /> <br />1IIIIIIIJ~~IIIIIIIIIIII...IIIIIIII..Jl~III~11111111111I..~IIIIIII..~IIIIIIIIIII..~IIIIII..IIIIIIIIII~~I~IIIIIIIIII,.IIIII..IIIIIIIIIIIII~~IIIIIIII <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 (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />