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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 />Owner's Name <br /> <br /> <br />~ <br />-J(...~, <br />I <br /> <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br /> <br />~ <br />~I/t,,- <br /> <br />&"t;1 ((/.1 <br /> <br />Phon.Conla"fo,P.~lttin. [!I) ~ 3"t't!/ ~ <br />... . m-::erm:':::"~u;ber .. 1 ~;;;: 11I;;11_00.111 <br /> <br /> <br />Owner Phone Number I I <br /> <br /> <br />Owner Phone Number I I <br /> <br /> <br />I <br />I <br />I <br /> <br />Date Received <br />_m!;;fl_~mI!!!IIlI .. <br /> <br />Fee Simple Titleholder Address I <br /> <br />I (P;rl S- f{bborr ~rk-h~ /j,,: I LOT# I <br />I :;,/ vCr CJtJc( tlrl(P: A PARCELID#I 6~ - ,~&~ J-f -- O:Mb-t;JtXVb - DCCl5 <br /> <br />~ (OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />D NEW CONSTR CI ADD/AL T D SIGN D MOVE D <br />D INSTALL D REPAIR <br /> <br />D SFR D COMM D <br /> <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br /> <br />I d.'Tl~ I~~ B1e(o;we, <br /> <br />~ SQ FOOTAGE I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />BUILDING SIZE <br /> <br />OTHER I <br />STEEL D <br />\ <br /><;{d0A1 (- <br /> <br />I HEIGHT I <br /> <br />PROPOSED USE <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />.___"1_"'_,,,,.__111__11'.",_,,,,,_"'_'1'_"'_11_I_~'_"'_'II_'I'_"'_"'_'I_"'_"~'II__"'UIU <br /> <br />D BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br />D GAS D ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA <br />_1IRBiIi~___~_OO~~""~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />w.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br /> <br />OTHER <br />DYES <br /> <br />~ <br />DNO ~"7~'::;'" I\, <br />:) ,~ -t ?5..~'" <br />'2iJ~ <br /> <br />Address <br /> <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />License # <br /> <br />~c..f3 d- <br /> <br />ELECTRICIAN <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 />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N 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 />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />l!11I-111-,II"""""""'I_OIII___III_,II_n___!'n".....''''''_.__1_1I--1I_~III_III_III_III__'111!!!1111!!11 <br />RESIDENTIAL 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 />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />""PROPERTY SURVEY required for all NEW construction. <br />----~---_:Iii__"II00__00---M_,___II_~_II'_H~~__~_~_BIIIl!IIIIIIIII_~IRII_ <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 <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on pUblic roadways..needs ROW <br />