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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit ApplicatiQJ)\S(.'() '?~"=:~i""" S-:-:,,;,~x-813-780-0021 <br />Building Department f,1 :.: - ;'(;t.!j:: 14 <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />5a me a <) (LbD v.e <br />Sarnp_ a ~ ab()v~ <br /><;?-+h ~+ r~+ <br />I <br /> <br />B <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />Date Received <br /> <br />WORK PROPOSED <br /> <br />B <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK LR e.. - r 00+ <br /> <br />BUILDING SIZE 46 '/. 3D I SQ FOOTAGE I/;}..DO HEIGHT I <br />1111'1111"11"1111111"111111'111'11111111"111"1111I1II 11'1111111'1111'lt"III'lt'IIII"P'II"'llft"III'III'11111'111'111,11111111,11111111111 <br /> <br />1$ '5500. (J"b <br /> <br />1$ <br />1$ <br /> <br />~ <br />FINISHED FLOOR ELEVATIONS I I <br />11111111I1111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111II1I11I11111111111 <br />Lis,~~,tiI~ill~ ,5Z,~~ <br />License # I Ol:;l (;13 I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />Address License # I <br /> <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111 <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 />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 <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />I <br />:=J r,f ,1 <br />LOT # Igil9~ <br />PARCEL 10#11 J - ~- ;(/- QG (D - 0 3400- 0 I fX) I <br />(OBT "INED FROM PROPERTY TAX NOTICE) <br /> <br />~ SIGN D MOVE D <br /> <br />D <br />D <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />15130 <br />I <br /> <br />SUBDIVISION <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I 11./ u m, I? () tY1 <br /> <br />I <br />( Cbt=' <br />I <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />~ <br /> <br />PROGRESS ENERGY <br /> <br />D <br />p-..Joc.. ./ <br /> <br />W.R.E,C. <br /> <br />D <br />D <br />D <br /> <br />D <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA C, DYES <br /> <br />~NO <br /> <br />GAS <br /> <br />ROOFING <br /> <br />D <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <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 />