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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 />O-Ow <br />E> J' 1;1:. /M /1/ <br />Owner's Address I \.:.s 7//1/3 1 /flY ell..!; /9 Y F <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address <br /> <br />SUBDIVISION <br /> <br />I 3/0'-\? l C,\~C.\ \ -S <br /> <br />I~~I <br /> <br />o NEW CONSTR 0 <br />D INSTALL D <br />PROPOSED USE D SFR D <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK I <br /> <br />JOB ADDRESS <br /> <br />1-\ -.) , <br /> <br />LOT # <br /> <br />PARCEL 10#1 <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />f?L.\.2'5 - d \ - ODq 0 - bOCOe - o'a80 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />o <br />D OTHER <br />D STEEL D OTHER I <br />('sIze ISI ze ') <br />I HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />I <br /> <br />11111'1'11"1111111111"1111'1111111111'111111'1,,111'1'11111111111111'1111111111111111'111"1111111'111111111111111111'1111..1111111'111111111111 <br /> <br />,l ~ <br />\(eJGUL <br />\ ' <br />I <br /> <br />6 {,.J il'\ct c..0 S <br />SQ FOOTAGE I <br /> <br />~ BUILDING 1$ (, ~;s '1, eJV 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 SPECIAL TV D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />BUILDER "'~,. . fJ /J /J ~~' vi <br />SIGNATURE . ~{~)C/~ <br /> <br />Address __ <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />t-\CJ""\~ (.'R.o..,;.....-vz.-.--- <br />FEE CURRENT <br /> <br /> <br /> <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <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 /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <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 License # <br />11I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11I1I1111111I111 <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 />Attach (3) 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 />Ail commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans, <br />-'''PROPERTY SURVEY required for ail NEW construction. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plol/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />