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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 /> <br />Owner's Name ~ ' <br /> <br />Owner.s Address I 39tJ,9y <br />Fee Simple Titleholder Namel <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />/ly~ <br />I <br />B <br />D <br />D <br /> <br />I <br />I <br />I <br />I <br /> <br />PARCELlD#1 1d--dV -;). \ - C5b~~ ' DD~Ob.- c.JU.(D I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number L <br /> <br />Owner Phone Number [ <br /> <br />/J;) J!-- <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I ~-;;(7/)fLj <br />I <br /> <br />s~ <br /> <br />I <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />~ <br />D <br />D <br />I <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />f;/;-,]//.SY /-,1,o'Gf- <br /> <br />BUILDING SIZE I I SQ FOOTAGE I VtJ HEIGHT I 6'/ {) P' <br />1'111111"1111111'1111111111111'1111'111'111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />D BUILDING 1$ I <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 /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES CJNO <br /> <br />111111111111111I11111111111111I1111111111111111111111111I1111111111111111I1111111111111111111111111111111111111I11I1111111111I11111I11111111111111 <br /> <br />DESCRIPTION OF WORK <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 />~W~ <br />BUILDER .. / L- / <br />SIGNATURE /" <br />, <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />~,/,1j~ c/eWey <br />I YI N I FEE CURRENT I Y/N <br /> <br />Address <br /> <br />License # <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address License # <br /> <br />111111111111111111111111111111111111111111111111111111111111111I111111111111I111111111111I111111II1111111111IIII11111111I11111111111I11111I1111111 <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 />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onsile, 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 />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 NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />