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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 />Owner Phone Number <br /> <br />OWner Phone Number I <br /> <br />OWner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address 1 <br /> <br />S53L{ <br /> <br />DESCRIPTION OF WORK <br /> <br />G-li-J{ <br />1 <br />~ <br />D <br />D <br /> <br />\ <br /> <br />~ ~ I-llUA ./.J..,t ~ -.L. <br />BUILDING SIZE I I SQ FOOTAGE I <br />1111111"'11111111111111""1111"'11111111111111'1'111111111'1111111'1111"1'11111111111111111,1111111111111'11111111'1111111"1""'111111111'" <br /> <br />~[Ud, <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCEL ID#I <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />14 l')D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />\ \ -~lo - d\ - D6\D.. 05,00 _ O-;lS 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />D <br /> <br />D OTHER <br />D STEEL D <br /> <br />I -I '^' ~:H:I / - :.0.-..dr -"J <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />1$ I <br />1$ I <br />1$ IdOO - 00 I <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS 1 I FLOOD ZONE AREA DYES DNO <br /> <br />11111I111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />I <br />I <br />I <br />I <br />ffvJiJ- <br />I <br />I <br />I <br />I <br />I <br /> <br />o <br />o <br />rn// <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W,R.E.C. <br /> <br />PLUMBING <br /> <br />C:,...rv-tY\ CK ..J' t:f ~l" lp <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />License # <br /> <br />Address <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 />COMPANY <br />REGISTERED <br /> <br />IDr~fN~' <br /> <br />L~ Cll J /I/~ ~ <br />FEE CURRENT I Y N I <br /> <br />Address <br /> <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111I111111111111111111111111 <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 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 />1111I11111111111111111I11111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111 <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 />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <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 />