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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 /> <br />Date Received <br /> <br />OWner's Name <br /> <br />Owner's Address I c.:, J.. :2 3 <br />Fee Simple TItleholder Name I <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />PI eQ Sa..m f $7: <br /> <br />/Vir <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />7r-piJyrhills J?! 335r2- I LOT # I I <br /> <br />PARCEL 10# I C'J - ~ ~ - ).. / - t>o L 0 - OOj'dO ~ oo...p <br />(OBTAINED FROM PROPERTY TAll NOTICEI <br />0.--. SIGN 0 MOVE 0 <br /> <br />o ~I /I- /~ <br />o STEEL 0 <br /> <br />J/~:i~.()"j <br /> <br />1'/ /r" <br /> <br />(~2?3 <br /> <br />{J/<Q!>4",f s1- <br />. <br /> <br />I <br />B <br />D <br />D <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCll0N <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />B <br />o <br />o <br />I (.O--JJ ::c ,,...2$ <br /> <br />I SQ FOOTAGE ' <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br />BLOCK <br /> <br />AOD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ LJ f'- If, OD <br />D GAS 0 ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />~ MECHANICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />o <br /> <br />W.RE.C. <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLAllON <br /> <br />D <br />I <br /> <br />SPECIALTY 0 OTHER <br />FLOOD ZONE AREA DYES ONO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED YIN FEE CURRENT LY..L!!...J <br /> License # <br />COMPANY <br />REGISTERED YI N FEE CURRENT LY..L!!...J <br /> License . <br />COMPANY <br />REGISTERED YIN FEE CURRENT LY..L!!...J <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />I <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br />--~ <br />MECHANICAL / ~ _ <br />SlGNATU _Oi- ,~-<--- <br />Address 7 i' 0 S Co 11 re oS S S ~. AJ.a..uJ <br /> <br />OTHER <br />SIGNATURE <br /> <br />License . <br /> <br />COMPANY <br />REGISTERED <br /> <br />~,q1 A,I'e. <br />Y I FEE CURRENT LY..L!!...J <br />License' I C It~ ~'1 t ')"Z. ., <br /> <br /> <br />~I <br />I <br /> <br />LY..L!!...J <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />License . <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy FORns <br />Minimum ten (10) worlling days after submittal date. Required onstte, Construction Plans, Santtary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy FOITT1S. <br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commeldal requirements must meet co~fiance. <br />Attach (2) sets of Engineered Plans. <br />--PROPERTY SURVEY required for all NEW construclion. <br /> <br />RESIDENllAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <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. (AIC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMlT11NG (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC Fences (PIollSurveylFootage) <br /> <br />Driveways-Not over Counter if on public roedways..needs ROW <br />