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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 />Date Received <br /> <br /> <br />Owner's Name Jq <br /> <br />Owner's Address I ~S 4- ~ <br />Fee Simple Titleholder ~amel <br /> <br />D(" <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 />(0 3tf~ <br /> <br />5 \ ' l u CV <br /> <br />o C\.ks <br />I <br /> <br />B <br />D <br />D <br />2-g- <br /> <br />Ov <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />I <br />I <br /> <br />( <br /> <br />PARCEL 10#1 D 5 - 2-lo - 2. J- 0 1Z. () -00000 -C) I Cf 0 <br />IQBT AI NED FROM PROPERTY TAX NOTICE) <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <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 />o <br /> <br />MOVE 0 <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />I <br />I <br />I <br /> <br />SIGN PERMIT <br /> <br />I <br />I <br />I <br />I <br />D <br />I I <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111 , 11111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />:~~~~R.E I I ~::::,"::, I Y I N FEE <"'RENT Y I N I <br /> <br /> <br />Address I License # I <br /> <br />I <br /> <br /> <br />I <br /> <br />I <br /> <br /> <br />I <br /> <br />I <br /> <br /> <br />I <br /> <br />'4. Q. I <br /> <br /> <br />Address 13:3D{ 6 5> tl- S- L po ~()K I (r;j I License # Ie (C 65""77';-7 I <br />11111111111111111111111111111111111111 , 1111111111111111111111111111111111111111 i 11111111111111111111111111111111111111111111111111] 111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) Sl;Jts of Building Plans; (1) set of Energy Forms . <br />Minimum ten (10) working days after submittal date. Required onsile, 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 onslle, Construction Plans, Sanitary Faclllties & 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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111.11111111111111111111111111111111111111111111 1111111 <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. (A/C upgrades over $5000) <br />.., Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing sam!'! <br />OVER THE COUNTER PERMITTING (Front of Application Oniy) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />D <br />D <br />o <br /> <br />~ :HANICAL ~ -;O:F1NG <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />t.( ~ q r,Ou <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />1$ <br />1$ <br />1$ <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E,C <br /> <br />BUILDING <br /> <br />PLUMBING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />ELECTRICIAN <br />SI~NA TURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />. FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Address <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 />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER ~ <br />SIGNATURE . <br /> <br />License # <br /> <br />f oft7J((!.~~ Itco I'<~j <br />I Y iN 1 FEE CURRENT L Y IN I <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />Driveways <br /> <br />