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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-B13-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />I ~-l tt ( <br />I <br /> <br />Owner Phone Number I r '? -16 1 i....J <br />Owner Phone Number I rB ~ f <(), ~ 4775 <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />'Di~ <br /> <br />\1. <br /> <br />I <br />B <br />D <br />D <br /> <br />DESCRIPTION OF WORK (e.l~(.o.i<. Co'fJJQ.",~~{ ~i'{ H~tJJk[ RC!..lll.c..,- <br /> <br />I ~, ~ I '~OIOb <br />BUILDING SIZE SQ FOOTAGE L..1.;jOv, ---- HEIGHT I' <br />11111'1""11111'11111.'111,,1111'11111"'1111'1"1111"'III"IIIIIIIII,rllllll'llllrllllllll'IIIII"11111"1IIIIIIII"tll,IIII"IIIIII,IIIII"'11 <br /> <br />1$ I <br />1$ d-6C>, - I <br />I I BUILDING SHALL COMPLY WITH <br />$ ALL APPLICABLE BUILDING, <br />ELECfRICAL, PLUMBING AND <br />1$ 1"i 00,- I VALUATION OF MECHANICAL INM~JRttAL CODES <br /> <br />GAS D ROOFING D SPECIALTY D OTHER i~v\l~6 L..~tf)l\~K. <br />r-l r-J::::> -r UN) \':::> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA L-jYES L- NO <br /> <br />1IIIIIIIIIIIIIIIIIIIIIIIIIIIilllllllllllllllllllllllll11I1111I11111111111I11111111111111111I11111I11111111I1I111111I11I1111111111I1I111I11I1III11I <br /> <br />PARCEL ID#I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />0 BUILDING <br />csh ELECTRICAL <br />0 PLUMBING <br />Q MECHANICAL <br /> <br />LOT # <br /> <br />D <br />D <br />D <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br /> <br />I~\.\<.t W\1<t. <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <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 I <br /> <br />1IIIIIIIIIIIIIIIIIIIIillllllllllllllllllllllllllllllll1111I1111I11111111111II1111I11111111111II1I11111111I1111111111'1111111111111 <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 />**HPROPERTY SURVEY required for all NEW construction. <br />IIIIII!IIIIIIIIIIIIIIIII'IIIIIIIII'IIIIIIIIIIIIIIIIIII1111111111111111111111111111111111111111111'1111111111111111111111I1111111111111111111111111 <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 A1C <br /> <br />o <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />p~ AJf~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />4v {)fv'-/ <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />LIcense # <br /> <br />Hb~ {)v,JiJ~{' <br />I Y/ N I <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />r.}'~r Qv,~(~ 4\(,TtVG <br />I Y / N I FEE CURRENT I <br /> <br />LIcense # I <br /> <br />Y/N <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Fences (Plot/Survey/Footage) <br />