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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department ..--,. <br />I hc..rr"nCLD <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />/ Owner's Name ,J 1-1 A'/ f<- <br />/ Owner's Address I 374-;;.3 W E 6 (., ~ W (J(J I) l) Ii.' . <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />/SUBDIVISION <br /> <br /> <br />W/)O <br /> <br /> <br />LOT # <br /> <br />77 <br /> <br />/' JOB ADDRESS <br /> <br />I <br /> <br />D NEW CONSTR [=:J ADD/AL T D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D <br /> <br />/DESCRIPTIONOFWORK I eN CJ..,.() s.~ <rx/sT/rJC:. SCt2-eef'J QDOtvl <br /> <br />/BUILDINGSIZE Ill.,4 ;i~ ftQ FOOTAGE LI rl.. ~ HEIGHT 1C!.lA.rr~te-ld.{ f '~ll <br />1111111"I",rlllllllllll"'lllllllr""",,1111111111111111"111111111111"1'1'1111111"111111111111111'11111111111111111111'11111111111111"'1'1 <br />1$ oJ> <br />d-tJOIJ -- <br /> <br />WORK PROPOSED <br /> <br />O-J.b- '-Of~O~ OC/{)(J() - O' 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />MECHANICAL <br />/ SIGNATURE <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License # I <br /> <br />111111I1111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111 <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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />License # <br /> <br />ELECTRICIAN ! <br />SIGNATURE <br /> <br />Address <br /> <br />.------~ <br /> <br />~ <br />.- <br />,/' <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />(\J 0"f\JL-- <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 />. '0 <br />1'..; r\.L. <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 />