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<br />Date Received <br /> <br /> <br />~ /z-o <br /> <br /> <br />.0.-813.780% ~ ~ <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Owner's Name <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder ~ame <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address 'I <br /> <br />. /=Do a <br />I <br /> <br />st.k s-+ <br /> <br />LOTN I <br /> <br />SUBDIVISION <br /> <br />PARCEL 10#1 <br /> <br />\ l ~~~-a{-()OIO-RfYJCJ- ()~3l) <br />(qST AINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN 0 MOVE 0 <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />a <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />OTHER I f::' (l 0 -\ ' <br />STEEL D OTHER I <br /> <br />B <br /> <br />PROPOSED USE 0 <br /> <br />TYPE OF CONSTRUCTION' 0 <br /> <br />DESCRIPTION OF WORK 12u.. - fI~ ' , <br /> <br />BUILDING SIZE I ' ,I SQ FOOTAGE I' ,I HEIGHT I I <br /> <br />...............................'...........;........,...........,......................:.........................................................,' <br /> <br />CJ BUILDING 1$ ;) SO o. I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br /> <br />D GAS D ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />~~:~~~:III' ~""'17~I"".:'';I~IIIIIIIIIIIIIIIIIIII.III'~~~::.,i'l'1"""'11"""1"""'1"","""""""1""""'1'I <br /> <br /> <br />.'GNAllInE -=-- ;?-~ 7 A. . . . .""STERED Y / N FEE C'-"RENT Y / N <br /> <br />Address _ ~,." License # I <br /> <br />ELECTRICIAN I I COMPANY I <br />SI~NA TURE , REGISTERED Y I' N ' FEE CURRENT Y I N <br /> <br />Address I License #1 I <br /> <br />PLUMBER I COMPANY , I <br />SIGNATURE , REGISTERED Y I N FEE CURRENT Y I N <br /> <br />,Address I License # I <br /> <br />I <br />I <br />I <br />I <br /> <br />D <br /> <br />W.R.E.C <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT, <br /> <br />YIN <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />I YI N I' <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />License # <br />111111111111111111 II II ! III I 1I11I1111111111111111111111111111111 i 111111111111111111111111111111111111111111111111111111111111111111 <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 onslte, 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 onslte, 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 />.*, Agent (for Ihe contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner aulhorizlng salTl'" <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Oniy) , <br />, Reroofs Sewers Service Upgrades Ale <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />Driveways <br /> <br />Fences (PlotlSurvey/Footag, <br /> <br />