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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 />Phone Contact for Permitting <br /> <br /> <br />lsfY5- .?".() l <br /> <br />c- <br />Owner's Name \ <br />Owne'. Add",.. I r 1':<, li':. ~\, ~f' \ C\.\\( \ <br />Fee Simple Titleholder Nam <br /> <br />~-( \ ,,~ <br /> <br />Owner phone Number <br /> <br />Ie' <br />Owner Phone Number 4 \ tJ) <br /> <br />Owner Phone Numb~r I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I "1 /~ r~ "6 <br />It' <br />v' V <br />" I, \ \ <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />i ([' i ..) I LOT ## I <br />\ <br />PARCELlD#ISLJ-;l.S--cx/- 0/60- 00000 - 0020 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />WORK PROPOSED <br /> <br />B <br />o <br />D <br />1'<00 <br /> <br />'r\, (;h \(j\)(\ <br />\~\)('\ \ " <br />B <br />D <br />D <br /> <br />SUBDIVISION <br /> <br />ADD/ALl <br />REPAIR <br /> <br />D <br />o <br />D <br /> <br />DEMOLIsH <br /> <br />COMM <br />FRAME <br /> <br />OTHER I <br />STEEL 0 <br /> <br />OTHER I <br /> <br />I <br />I <br />I <br /> <br />DESCRIPTION OF WORK <br /> <br />t-/r <br />I <br /> <br />G'/:- /--r-WI'C' <br />SQ FOOTAGE I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />11.......11.....111.1,........1......11111.........11.,......111.11.......11.....11.'111.....1,.......111.1111.'......11111111,...11111.11111,.... <br /> <br />0 BUILDING 1$//t.?10~' I VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL 1$ I AMP SERVICE t=J PROGRESS ENERGY D W.R.E.C. <br />0 PLUMBING 1$ I <br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111....111111111111111111.1111111111111111111111111........111....,1".111.,1..1.........11..11111.111.1111....1...111111111111111111".11111 <br /> <br />f /~ ~ <br />BUILDER .,/ . . /"/ <br />SIGNATURE ~if . . ~ z.t/ <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />I ~::"VJe (."T~.y' OP <br />I 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 />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <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 <br /> <br />11""""111., 111."11111111"""111111.11"1"""""'1111111111111""'111111111111111111111111111111111'1"'111111111I11I11IIII1111II1II111 <br /> <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 onsite, 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 />111111111111111111111111111111111111.111111. II. 1.11111 &". . I1111I i 111111I11111111111111111111111 & I i II i 11II i I ~ I11II i I i 11I1I11I i ~ III i ~ ~ i & I ~ i i III i i Iii i <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 Driveways Fences (PloUSurvey/Footage) <br />