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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department D <br />ra&C-O <br /><3'/3 <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <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 Name <br /> <br />SUBDIVISION <br /> <br />Fee Simple Titleholder Address I t.5t:l1?Je. <br /> <br />l09sn /:zit.- ~ ~~J4 FL 33SZf2- ~ <br />PARCELlD#1 /1- 2~ -eJ-j-tJO/o -O/!S()()c:Jt)/Q <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN D MOVE D <br /> <br />D <br />D <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />/ <br /> <br />DESCRIPTION OF WORK <br />I <br /> <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />11 /Uh/h//4YU <br /> <br />BUILDING SIZE <br /> <br />r <br />I HEIGHT I <br /> <br />111111111111111111111111111"'1111111111111111-'..1111111111111'11'1"'111'1'1""11111111"1111"1'1'1"'1111111111""""1""""'11,--'-'11'1 <br /> <br />~ BUILDING 1$ )OOf) ~ I VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY 0 W.R.E.C, <br />0 PLUMBING 1$ I ~r~ <br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION ~ <br /> ~we- <br /> - (:::oL <br />0 GAS D ROOFING D SPECIALTY D OTHER -\.JJC" <br /> DYES ~NO ~b.DD <br />FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA - ~fu. ~ <br /> <br />Address 131007 <br /> <br />ELECTRICIAN <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />klev(j , <br />Ltxtlie D~ "fJr!;/~ fi ;,~s-it <br />I COMPANY I <br />REGISTERED <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />ldf&Y/~~u~/r :g{a~m~ <br /> <br /> <br />License # I I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />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 />~~I ~~# <br />111111111111111111111111111111111I111111111111II111111111I11111111111I1111111I1111I111111111111111111111111I1I1111111111I111111111111111I111111111 <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 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 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 />111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111I111111111III111111111111111111111111111I111111111 <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 />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />