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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application i', 30 . : 1. \ <br />Building Department ---\ : :; U <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />Phone Contact for Permitting <br /> <br />OWner Phone Number ~ <br /> <br /> <br />/ Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />3, lQS- <br /> <br />Owner Phone Number I tl ~ ~ I (L{ . toC( V) I <br />OWner Phone Number 13S 0- < a- {JUl 'S0Z.0S-1 <br /> <br />: <br />I <br /> <br />I <br /> <br />LOT # <br /> <br />/ OWner's Name <br /> <br />/ JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />~D~ q-tV1 ~~e..-A- <br />I <br /> <br />D ADD/ALT 0 <br />D REPAIR <br />o COMM 0 <br />o FRAME 0 <br />(' If'(\~ \ ty\ \L ~ Q <br />I I SQ FOOTAGE I I <br /> <br />111111"1111'1'..11""11111111..111'1111"'11'1111111111111111'11'11"111111'1"11'1111"111'11..11111"111111111'11111111'11'11"11111"11'11"1 <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />o <br />o <br />LriIDtJ <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PARCEL ID#I i I - 2<0 -d, \ - 00 ~ 0 - 0 l'feD - ooLt () <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />I DESCRIPTION OF WORK <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />/ D BUILDING 1$ tt'5"Q - 0 D I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII.II~IIIIII111I11111I111111111111111111111111111 <br /> <br />/ :~~~RE m~f1y AffM~ I ;~~::~~A. ~rr mClmR€NT VIN I <br /> <br /> <br />Address E- I License # I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License # I <br /> <br />1111111111111111111I111111111111111I111111I111111111111111I111111111111111111111111111111111I11111111111111111111111I1111111111I11 <br />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 onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11I11111111111111111111111111111111 <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 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ELECTRICIAN <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 />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />.T" <br />,II <br />" <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />