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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 />4-5- <br />'t:. <br />Lnoq <br /> <br />Owner's Address <br /> <br />~ lt1l~ \~ J t lLs:.- <br /> <br />Owner phone Number <br /> <br />Owner phone Number I <br /> <br />Owner Phone Numb~r I <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder NamJ <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I ~+ 1-0'1 <br />I C-<l4. YI\J Iii W <br /> <br />SUBDIVISION <br /> <br />MCc(lt. ~V1LLf <br />~ lL.-Lc; I PARCELlD#1 <br /> <br />LOTti <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I <br /> <br />E3 ADD/ALT D <br />REPAIR <br />D COMM D OTHER <br />D FRAME D STEEL D <br /> <br />,~&IA-<<- I (LI2A Cc ~\Of)..J ~~~ <br /> <br />SQ FOOTAGE I I HEIGHT I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLIsH <br /> <br />~ll rJlC..- L~ <br />OTHER I <br /> <br />I <br />I <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTiON OF WORK <br /> <br />BUILDING SIZE <br /> <br />.11...11.....,...111............11...11..111..................11..1111111111.......111...........111..'1.11111""111"111'1'11111'1111111111111" <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />..111..111...11111111111111111111111.....1.1.,1111111.11....111....11,...'..11..111..11.....'..111111.11....11...'111111111..11.......'..11....111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />!~~~$ <br /> <br /> <br />. . <br /> <br />I <br />J2D <br />I <br /> <br />10 ')10 hM tt..~'i.-(L I ML l ~ ~ <br />I {jl N I FEE CURRENT I tf} N I <br /> <br />License # 06 () <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <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 />11111111111" II 1111111' 1111111111111111' 1'11111111111111111" 11111111111' 111'111111'" 1111' 111'1111111111111' 1111' II" II' r 1111111111111111111111' <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 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 />1111111111111111111111111111111111111111111111,11111111'11111..11111,1111111111111111111111111111111111111111IIIIIIillllllllillllllllilliilllllllli <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. (Ale 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 (PloUSurvey/Footage) <br />