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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 /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />---1, 7 -f) l <br />C nfL/' ItS k ~ / lIS <br />I 3?()tj~ JI-}, A-ve/JL/e <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />Owner Phone Number <br /> <br />Owner Phone NUmbef.:,[,' sca ?IiRMIT SeRVICE <br />I 813-788-5314 <br />Owner Phone Number <br /> <br />LOT # <br /> <br />'I <br /> <br />q /tiJr <br /> <br />- <br /> <br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I <br />,1""""'111111111111""""""""11"""'1111111111111111111"""11111111111111111111111111"""'11"11111111111111111111'11"""1111111 <br />en <br />~ <br />o <br />o <br /> <br />I <br />I <br /> <br /> <br />: VALUATION OF MECHANICAL INSTALLATIONY ? ~ <br /> <br />D <br />I <br /> <br />JOB ADDRESS <br /> <br />J 9 ()'lI s#- Ave <br />2.ep A l{r Iki '! Iff <br />- <br /> <br />PARCEL ID#I <br /> <br />SUBDIVISION <br /> <br />I <br />El <br />D <br />rn <br />roO/YJ <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />WORK PROPOSED <br /> <br />~ <br />OCJ <br />D <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING <br /> <br />D <br />D <br />D <br /> <br />/ J-nU -cJ/ - ocJJd- cJdJOcJ- ocYIC) <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />I <br />00 <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />~. <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W.R.E.C, <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />ROOFING <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />~.jfL{!~ ~l-tui~ J 50 >.,.Q I <br /> <br />(, If If 0 Ftl rI- /<!.L/l1 R rI <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />~a~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />j) U/L lvi, <br /> <br />- <br /> <br />-?,..,. v" <br />j~ <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />~k (tr!~ hRJ- <br />no V\l\.eck. <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />D <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br /> <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Address License # <br /> <br />111II1I1III11IIIII11111111I111111111III1111111111II111II1111111111I1111111111I1111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIilllllllllllll <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 onslte, 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 />I1I11I11111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111I11111111111111111 <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 Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />