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<br />813-780-0020 <br /> <br />-# ro3D~ <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 <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />~v/le 5:~ <br />( B :5f.rL -e. f- <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address <br /> <br />1$ /):)0 -fD ~CJ cJ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />0 BUILDING <br />0 ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />t.f~ r:;3 /'bin sic~e. f- <br /> <br />LOT # <br /> <br />PARCELlD#11 tf- 24-2.1- 0010- Ol2-tJ:> - 0 010 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br /> <br />I <br />B <br />D <br />D <br /> <br />D <br />D <br />D <br /> <br />D <br /> <br />MOVE D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />SIGN <br /> <br />DEMOLISH <br /> <br />OTHER I re- - roof <br />STEEL D OTHER I <br /> <br />SQ FOOTAGE I <br /> <br />HEIGHT I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />W.R.E.C <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />~(!~ <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />I horn ~ OWn e.y- <br />I Y / N I FEE CURRENT <br /> <br />License # I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <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 />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />I Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />11II111111I1111I1II11111111111111111111111111111111I11I11111111 i 11I1111111111111111111I111111111111111111111I11111I111111111111111 <br />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 />1111I111111I111111111111111111111I11111111111111III1111111I11III1111111111111111111111111111111111111111111111I1111I11I111111111111111111111111111 <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 Driveways Fences (Plot/Survey/Footage) <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br />