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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 />Owner's Address <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />cri20Y'\ <br />GV'l'f'{\ !S\.Ope..- DYiv-t-1 <br /> <br /> <br />Date Received <br /> <br />D NEW CONSTR D <br />[Z] INSTALL D <br />PROPOSED USE 0 SFR D <br />TYPE OF CONSTRUCTION 0 BLOCK D <br /> <br />DESCRIPTION OF WORK I VY1 0 b \l L h OVVle., Se.. + ~ <br /> <br />127 X YU SQFOOTAGEI/Zft; 9 <br />TITIII.IIIIII",."I'IIII"'II""I.'III.'III"'III.'I'I111"11111111'1'1111111'1111'1111'1111111111"111111"1111"111"1'11'11111111111111111111 <br />D BUILDING 1$ 35,000, OlJ I <br /> <br />D ELECTRICAL 1$ /5DO ' 1\ 21 I <br /> <br />D PLUMBING 1$ 56 () .0 D I <br /> <br />D MECHANICAL 1$/500 ,oC) I <br /> <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111111111111111111111111I111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111I1I11111111111111 <br /> <br />~~::~~~ ~$':rdFEcjCU,!JT ~1rYl)' N ~J.t <br /> <br /> <br />Address License # I I <br /> <br /> <br />~:;:'~~~:N~~ ~~:~: IIII@N I FEECU"'''T I~'N ~ <br /> <br /> <br />Address _ _ License # I I <br /> <br />SIGNATURE ~ ~:~~ IB.,C:td~1.cu!.!!1J I"",'N <br />PL"::::" lm5~ ~d( - L-? - U~"". I : <br />:,~~~~~:~ ~~:~~~ IA&~N me"",,"T 1-" I <br /> <br /> <br />Address _ _ License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE , REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address I I License # I I <br />1111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111I1111111111111 <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 />**uPROPERTY SURVEY required for all NEW construction, <br />11.'11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 <br /> <br />ADD/All <br />REPAIR <br />COMM <br />FRAME <br /> <br />I <br />I <br />I <br />LOT # I 22 Cf I <br />PARCELlD#~' 25' 2J.. 0/76-00000- 22'1 () I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o SIGN D MOVE 0 <br /> <br />o <br />o <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address <br /> <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER ll'YJobt'IL ~^M.I' <br />STEEL D OTHER I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C, <br /> <br />. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <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 />