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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address I <br />393'12. <br /> <br />9rl-II /J <- <br /> <br />LOT# I <br /> <br />PARCEL 10#11)" - J-l, -;) J - 0300 D -OOODO - 0 '35"0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />I <br /> <br />E3 NEW CONSTR D ADD/ALT D <br />INSTALL D REPAIR <br />PROPOSED USE D SFR 0 COMM D OTHER <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D <br /> <br />DESCRIPTION OF WORK I /.(t?1'" jJf}f(o - rroNf ()nVC c;Afcr<f'O".J <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I . . <br />1111111111111".""111111111111111111'111111""11111'1111'1111111'11111111111'11111'11111111111111111111111llltlllllllllllllllllllllllllll.11111 <br /> <br />DEMOLIsH <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111I1111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111I11111111111111111I111111I11I111111 <br /> <br />COMPANY I I <br />REGISTERED Y I N FEE CURRENT Y I N <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />Address I hIs Lj 7')1 I 0 7.'~ License # I I <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 j 1I1111 i 1111111111111 <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 onsUe, Construction Plans, Sanitary Facllilles & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms, <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facllllles & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />***~PROPERTY SURVEY required for all NEW construcllon. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of appllcallon, notarized <br />If over $2500, a Notice of Commencement Is required. (A1C 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 />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br />o,;} <br />(CJsf ;)L(1J-. <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <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 I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />OTHER <br />SIGNATURE <br /> <br />DuJk ~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />rtj50"; (t)NCre-rC;- <br /> <br />I Y I N I FEE CURRENT I <br /> <br />Address <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />