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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 />1\ erLH.ulc <br />10 thSt-r.( d- 2H ~i <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number L <br /> <br />2?) 3 7 71] <br />3'':::9- q C) '7 <br /> <br />IS70 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />lP Z0'2 /0 +h Sf. <br /> <br />JOB ADDRESS <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br /> <br />E3 <br />D <br />D <br />C-e-n 0.: . <br /> <br />PARCEL ID#I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I IN .;-fc<- / I <br /> <br />I I <br /> <br />1111111.....11111'111111.11111'1111111""'11111111111II'frlll"IIIIIIIIIIIIIII"'III'IIIII'II"'IIIIIIIII""1111111'1111111"'111111111'11111111 <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br />(HoO I <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />SQ FOOTAGE I <br /> <br />) DQ~,O---\ ~ ~ <br />I HEIGHT I <br /> <br />D BUILDING 1$ I <br /> <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA DYES DNO <br /> <br />11I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111I11111I1111I111111111 <br /> <br />:~~~~~RE i'~L{ ;.~~= M)[X(q?(:J!.:; Y/" I <br /> <br /> <br />Address . License # I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />License # I <br /> <br />I1111111111111111111111111111111111111111111111I1111111111111111111I1111II111111II1111111111111111111111111111111111I11111111I1111 <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!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ELECTRICIAN <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 />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 CUR,RENT <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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />