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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 />JOB ADDRESS <br /> <br /> <br />Date Received <br /> <br /> <br />. <br /> <br />/p- 7-Z-~~ <br />~ Ccv~ T~rh er-lrTio~ <br />I r~D hrrJ.EPo. AJiE~ ~~ <br /> <br />Owner's Address <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br />(!, ",-z- <br />ner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />B <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I vuS <br /> <br />BUILDING SIZE I /0' '-f-~' SQ FOOTAGE ~ S. P. HEIGHT I 8'" "!. <br />Ir,rl!>,"'I')"IIIIIIIIIIIIIIIIIIII'-"""II'."'II'"1111111111111111111111111111111111111111111111'11111111111111111111111'111'1111111111111111 <br />~BUILDING :$ cJ-, f99'~ : VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL $ AMP SERVICE 0 PRpGRESS ENERGY D W.R.E.C. <br /> <br />/ A~~9~ /. i CO')\"' of' <br />~---... c.rC~s~ <br />VALUATI OF MECH STALLATION <br />lNt71"Js0 <br /> <br />~/~-z1~ 'l- <br />rf:JI-I K '- <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />SIGN <br /> <br />o <br /> <br />DEMOLISH <br /> <br />OTHER I Nt5 ~-n:;:,C 1'1:1 -,lAe> <br />STEEL 0 OTHER I <br /> <br />PLUMBING <br /> <br />1$ <br /> <br />1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />D <br />D <br /> <br />ROOFING <br /> <br />I <br />I <br />o <br />I <br /> <br /> <br />MECHANICAL <br /> <br />SPECIAL TV D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />w ' ~"f5t!!:. <br /> <br /> <br /> <br />Stlv1T~J::t:.wC . <br />Y <br /> <br />c.~c oq-J895" <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License # I <br /> <br />11I1111I111111111111111111111111I111111111I1111II111II111111II111111111111111111111111II1II1111111111111111111I11111II111111I11111 <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 />II.IIII!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1I1111I11111111111111111111111111I111I111111111111111III11111111II111111111I11I11111I11111I11 <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 />Address <br /> <br />e <br /> <br />License # <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Address <br /> <br />~l ;;~~~ <br />J <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />PLUMBER <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 />MECHANICAL <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 />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />