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<br />813-780-0020 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Date Received <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />I <br />I <br />1 <br />I~\~=y~ \'~\\ \ ~ I LOT# kJM I <br />PARCEL 10# 13'-\ -~"2> -0\ -CJ:::M~ ~~%lJ ~C)~-m <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />~ NEWCONSTR ~DD/ALT D SIGN D MOVE D <br />~ INSTALL L:l 'REPAIR <br /> <br />PROPOSED USE D SFR D COMM D OTHER ~-=\\~\~\'f\ <br /> <br /> <br />::::,::':::~:::N ~~ im~~~~~C:~:E~~R~(\ti\- ' <br /> <br /> <br />BUILDING SIZE I I SQ FOOTAGE I ~S \ I HEIGHT I I <br /> <br />~'/'~"'."""'.".,.."'....""."....".,.....".,".".,....."".,..,.,..,.......""."........,..........,...,..,.""""""."", <br /> <br />~ BUILDING I$~~~a -1\01 VALUATION OF TOTAL CONSTRUCTION <br />~LECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY--2>'7Q. ~~ <br />1$ I <br />1$ I <br />D GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />"'"'' '~"""'" ""'~'''~~'''''''''''' '~n, ':' "":"''4~;'~'"~~''' "~\'~,'~~~ <br />BUILDE ("" C04PANY *1 ~. l-t- ""1 <br />SIGNAT RE ~ ~ REGISTERED N I FEE CURRENT N I <br />D S << ~V\.J;:. License# ~,~~\\~~ <br /> <br />-\,-:: '( ~ <br /> <br />OW",,', Add,... 1:J~-::'\.si\N~'{lQD. <br /> <br />Fee Simple Titleholder Nam <br /> <br />Fee Simple Titleholder Address I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />~ N~.1..-n \-'c:i ~T':l)1 <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />D <br /> <br />PLUMBING <br /> <br />D <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br /> <br /> <br /> License # <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />1111111"111111111111111111111111111111111'11111111111111111111111111111111'11'111111111111111111111111111111111111111111'11"11111111'111111'1111 <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 />11111111111111111,.",11.1"111111111111111,,.,1111111.111111.11,1...1111111111111111111111111111111,11111111111111111111,,1,11,111111111111111111 <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 Driveways Fences (Plot/Survey/Footage) <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br />