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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 />pate Recqived <br /> <br /> <br />'\'\\ \- \) <br />Owner's Address I\'-s.~~ \' ~Q;)\\'"Sb0Q. U <br />Fee Simple Titleholder NamJ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br /> <br />PARCEL 10# <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />F <br /> <br />D <br />D <br /> <br />OTHER <br />STEEL <br /> <br />I\- \\~r0..,"~"'\ ' <br />o OTHER I <br /> <br />,~ <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />B CK <br /> <br />SIGN <br /> <br />o <br /> <br />DEMOLISH <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE I I <br />TIIIII..I.IIIIIIIIIII.IIII..IIII.I.IIIII.I"..IIII""11111111111111111111111111111111...1111111...1111111111111I11IIIII11111111111111111111111111 <br /> <br />1$3~~\~ :\~ I <br />1$ I <br />1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />~ <br />~ <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY D WR.E.C. <br />-..3\{Q ~\ <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D <br /> <br />PLUMBING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />ELE <br />SIGNATURE, <br /> <br /> <br />;~~::'~~~~Rst-~'J,=\ I <br />License # 1'\. \S~"\ '\ ~ <br />.~\ <br /> <br />Address <br /> <br /> License # <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />1111111111111111111111111"""'1111111111'1'1111111,11'1111'1111111111111"11111111111111111111111'1"11111111111111111111111'11'1"111111111'1111 <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 onslte, Construction Plans, Sanitary Facilities & 1 dumpster <br />COMMERCIAL 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 Facilities & 1 dumpster <br />All commercial requirements must meet compliance, <br />SIGN PERMIT Attach (2) sets of Engineered Plans, <br />....PROPERTY SURVEY required for all NEW construction, <br />111111111"1,,, 111111.1 ,.",1111111111"1111,.,1111111,,.,,11111111111,111111111.1111111111111111111",111111111111,..,11111111111.1..11111111"., <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 NC Driveways Fences (Plol/Survey/Footage) <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br />