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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />t-ax-tll;:l-(tlU-UULI <br /> <br />Fee Simple Titleholder Address I <br /> <br />Ave <br />[ W'~ \ \ ~5 <br /> <br /> <br />Owner phone Number I g- ( 5 <br />OWner phone Nu~b~r I~ I 3 <br /> <br />-0& <br />E I,J " <br />Owner's Address I '5 q JOt::; S-' "'- <br />Fee Simple Titleholder NamJ :s~ """- ~ ~ <br /> <br /> <br /> <br />q r '7 <br />660 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />I 315 o~ <br />~121r fll? ' <br /> <br />o NEW CONSTR <br />D INSTALL <br />PROPOSED USE D SFR <br />TYPE OF CONSTRUCTION D BLOCK <br /> <br />DESCRIPTIONOFWORK 1.771 <T4J{ PJI'Ue,~#y rip"''''''''' (.30'" <br /> <br />BUILDING SIZE I I . SQFOOTAGE I I HEIGHT I . . I' <br /> <br />".".""""""""""..,.""""".":."".,,.,""..."""",.",.""",.",."",.,",.,"""'"""",."..""""".""""".,'" <br /> <br />W BUILDING 1$;1; /)00' o..:..~:; ,. I VALUATION OF TOTAL CONSTRUCTION , <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I 1 <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />2p r h 'I ~ ~: t' <; <br />PARCELlD#1 tJ.. d< G 02! 6G 4 6 6<:'> (1lO () 15:0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o SIGN D MOVE 0 <br /> <br />o <br />D <br /> <br />LOT i# <br /> <br />/.s- <br /> <br />SUBDIVISION <br /> <br />~"'\"'" t4 cJ-<.. <br />/27./lOJ>171 <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED <br /> <br />B' <br />o <br />D <br /> <br />DEMOLIsH <br /> <br />I <br />I <br />I <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER .1 <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />cd <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />~ <br /> <br /> <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br /> <br />Address <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 />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />I <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />11111111111111 11111"11111111'1'11111'11111111111111111'111111111111I111II1111111I11I1111111I11111II1111I111111111I1111111illllllllilllllllllllll <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 onslle, 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 onslte, 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 />111111111111111111111111111111111,11111111111111111,11l'II,!IIIIIIIIIIIII,llllllllllllllliiilll.lillilllllli1IIIIililllljllllilllilliiliiiiiliiliii <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 Driveways Fences (PioUSurvey/Footage) <br />