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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 />JOB ADDRESS <br /> <br />Fee Simple Titleholder Addrass I n \ a <br /> <br />1~~5C) <br />I fI\d <br /> <br />\-4 HI Sf <br />I <br /> <br />E3 <br />D <br />D <br />=-r <br /> <br />~~~~~tl'O <br /> <br />Owner Phone Number t3 \~ - l8P) - 530 I I <br />Owner Phone Number 18'13 -lr~--5ROI I <br />I <br />I LOU I n \ a I <br />PARCEL I!>> I " - 2lo- 2\ - COle)- 0 '1300 - () do <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE 0 <br /> <br />~;"~~~i..::."'''''' <br /> <br />Owner's Name <br /> <br />Owner's Addrass <br /> <br />Fee Simple rltleholder Name I n I ~ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />D/ NEW CONSTR <br />G2r INSTALL <br />o SFR <br />D <br /> <br /> <br />ADDlAL T <br />REPAIR <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br /> <br />TYPE OF CONSTRUCTION <br /> <br />COMM <br /> <br />OTHER <br /> <br />~t <br /> <br />BUILDING SIZE I 1 SQ FOOTAGE HEIGHT <br />~-~~~~~:E'.1;!ir::~~~~~~lf..g~~ra~~--=-~~~~~~~~~~~~~&~~sl;:;;;:~~~~~11;,.~~~.J:: <br /> <br />BUILDING IS~d . Cr~() ,00 I VALUATlONOFTOTALCONSTRUCTlON <br /> <br />D ELECTRICAL 1$ I AMP SERVICE ~ PROGRESS ENERGY <br /> <br />o PLUMBING 1$ I <br /> <br />o MECHANICAL 1$ I <br /> <br />D GAS 0 ROOFING D <br /> <br />I <br /> <br />DESCRIPTION OF WORK <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALlY 0 <br /> <br />OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />FLOOD ZONE AREA <br /> <br /> <br />License # <br /> <br />~~~~'4f~~~~-:'"::"~~-=-~~'!~~~~~'~~~~~i~:-- - <br /> <br /> <br /> COMPANY <br /> REGISTERED <br /> COMPANY <br /> REGISTERED <br />Addrass <br />PLUMBER <br />SIGNATURE <br />Addrass <br />MECHANICAL I COMPANY <br />SIGNATURE REGISTERED <br />Addrass I <br />OTHER I COMPANY <br />SIGNATURE REGISTERED <br />Addrass I <br /> <br />~ <br /> <br />~~:~~~~-=-""'-::-':::;;:'~--~~:";':~'~~~~~~~~~~~~~~~~~~~~~;"~:~L~~~:~~~ <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 Facil~ies & 1 dumpster <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set cl Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Sanitary Facil~ies & 1 dumpster <br />All commercial requiraments must meet compliance. <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />---PROPERlY SURVEY required for all NEW construction. <br />$L';;~~~~~~~~~~~~~~-=-~.:r.~;a4t~~~~~~~~~===.~~~~;;:~~'t.~~~~~~~1:...~'5.~ <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commenc:ement is raquired. lAIC upgrades over $SOOO) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner au1horizing same <br /> <br />OVER THE COUNTER PERMlmNG (Front of Application Only) <br />Reroofs Sewers Service Upgrades AIC Fences (P1otlSurveylFootage) <br /> <br />~"-3>s_ .:>~ <br />License # lEe \ 3aJ 135~ I <br />f P~L~~:;NT~A<.-{g) ?5~~ <br />License # I C,f>r -Il./S-W Itd' <br />I <br />I <br />I <br />I <br /> <br />I.....!.L!i.... <br /> <br />FEE CURRENT <br /> <br />L.:!:.Ll!..J <br /> <br />License # <br /> <br />I.....!.L!i.... <br /> <br />FEE CURRENT <br /> <br />l...YL!:U <br /> <br />License # <br /> <br />Driveways-Not over Counter if on public roadwaYSuneeds ROW <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Buiiding Department <br /> <br />Fax-813-780.{l021 <br />