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<br />8~13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />'111""111 <br /> <br /> <br />yilt ('({S P<::tM~'1 <br />M CJ..'{ lu- t- <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date ~eceived' <br /> <br />., <br />., <br /> <br />~~ 1 ~; <br />)! ,,. <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />i~ 'c', -' \ <br /> <br />) ~ '(':, i '\, ~ " ~ ' <br /> <br />Fee Simple Titleholder Address I <br /> <br />3~DLI fV/vtvh f 5z <br /> <br />I <br /> <br />D NEW CONSTR D ADD/ALT D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D OTHER I I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I I <br /> <br />DESCRIPTION OF WORK I ~ Vlfl) ( 5 ~ 1 k<- c 17 ~ h If f- roc> f tJk.V( ('t- s I-c p s J 0 c.J4; <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I wi \' P () <br />TII"""IIIIIII'!""""II"""II'IIIIIII'IIIII"'"1IIIIIIr"'IIIIIIIIIIIIIII'IIII'IIIIIIIIIIII"1111111111111'1111111'1'111111111111111'11111 <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCELlD#162-2[, -2/ -06/0 -()7"CJOO-OQ5"Q <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />D <br /> <br />I <br />I <br />I <br />I <br /> <br />D GAS c;2Q ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111I11111111111111111111111111111111111111111111111I111111111111III11111111I11111111111111I111111111111111111111111111I11111111I11111 <br /> <br />:~~~~~RE~' ------ ~~~~~~~ I ~ ~ m ~~~~ I Y I N I I <br />Address 1330\ () S'(L S-z. 10 130 ( \t~ License # Ice (. 0)7 r~J I <br /> <br /> <br />ELECTRICIAN I COMPANY I <br />SIGNATURE , REGISTERED Y I N FEE CURRENT Y I N <br /> <br />Address I License # I <br /> <br />PLUMBER I COMPANY I <br />SIGNATURE , REGISTERED Y I N FEE CURRENT Y IN <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDING <br /> <br />1$ <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 />5, 2 (P 0 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D <br />D <br />D <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <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 />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br />11II11111111111111111111I111111111111111I1111I11111II11111II11111111111II1111I1I1111111111I1111I1111111111111111111111111111111I11 <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 />1I1111II1111111I1111I1111I11III1111111111111111I11111111111I1111I11111II111111111111I1111111111II1111111111111111111111111111111I11111111111111111 <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. CAlC 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 A/C <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Foolage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />