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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />t-aX-lSl j-flSU-UULl <br /> <br />tr~lICf <br /> <br />DatEI' Received <br /> <br /> <br />I). ttJ ~/I~ <br />I'f- fl filE. <J-t4 'TiE <br /> <br /> <br />Owner Phone Number 'bios - 559- <:>5? 1 <br />I ~V-s -19 7 ~ 5' ?Y7 <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />OWner's Name ~v/e. <br />Owner's Address 17 '2 t.( J <br />Fee Simple Titleholder Namel <br /> <br />IYZ <br /> <br />JOB ADDRESS <br /> <br />lOT # <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />OTHER I f/IIeK1#v- <br />STEEL D OTHER I C(jNl!..t'tL~ <br /> <br />~ rn/J2r 5(::" t<lff <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br />~/(i4{~ <br />f 0 LJ . ;) . f--IC'lL--- <br />{11VJ- _ C k. <br />-} 10 ~ /1 ..c)I <br />~ \r;:) <br /> <br />W.R.E.C, <br /> <br />D <br />D <br />D <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Wa4~ <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I #<In< E a..J' fJt;"-;e:: <br />I Y I N I FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />111111111111111111111111111111111111111111111111111111111111I11111111111 , 1111111111111111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans wi Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans wi Slit Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />II) 111111111111/ 111111111111111/ 111111111111111111111111111/ 11111111111/ 11111111111111111111/ 11111111111111111111111111111111111111111111111111/ II <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 Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />License # <br />