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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 />Owner's Name <br /> <br />OWner's Address <br /> <br />Fee Simple Tltlehdlder Name I <br /> <br />OWner Phone Number <br /> <br />Owner Phone Number I <br /> <br />. Owner Phone Number I <br /> <br />Fee SImple Tltleh~er Address I <br />I iLJ?t.l tp 6~u->~ ~ - Lo \- 3'1 <br />lb,,; +}w0.0d Pkcse J[: <br /> <br />JOB ADDRESS <br /> <br />LOT. <br /> <br />PARCELlDtlI 01 -1(....- ~,- 00 I 0- 0 l,gOo- 0010 <br />(OBTAINED FROII PROPERTY TAX NoncE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />I <br />B <br />o <br />o <br /> <br />ADD/ALT <br />REPAIR <br /> <br />COMM <br />FRAME <br /> <br />WORK PROPOSED <br /> <br />E:1 <br />D <br />cg <br />I~ <br /> <br />u"': .+ <br /> <br />\OI.V^ l-b"'1eJ <br />SQFOOTAGE I g 12 ~ <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />[:;k:) <br />~ <br />~ <br />[;!i <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br />Jtj <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br /> <br /> <br />~ <br />BUILDER <br />.~NATU" . ~ <br /> <br />Address . <br /> <br />ELECTRICIAN I . <br />SIGNATURE <br /> <br />BUILDING <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />D <br />o <br />o <br /> <br />DEMOLISH <br /> <br />OTHER <br /> <br />STEEL <br /> <br /> <br />OTHER I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />tKJ <br /> <br />D <br /> <br />WR.E.C. <br /> <br />OTHER <br />DYES <br /> <br />t-.JQc.. _ <br />~~-"- - <br />E\ec\_ Su.b <br />~~\ CQ\CS <br /> <br />ROOFING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <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 dumpsler <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />~inimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />II commercia' requirements must meet compliance. <br />lIach (2) sets of Engineered Plans. <br />"PROPERTY SURVEY required for all NEW construction. <br />I <br /> <br />D <br /> <br />GAS <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE: <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE: <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />JUNO <br /> <br />lrP\tlt'\ ~i1Sf. , 7:"1 C <br />Y/ N I FEECURR~NT I Y/N <br />License . I <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License . <br /> <br />4~~:, <br /> <br />v;:\ \,'aA\ S <br />FEE CURRENT I Y / N <br /> <br />license ., <br /> <br />So~ ~l-er 1'\ Lo""f!or f <br />I Y/ N I FEECURRENT I Y/N <br /> <br />license. I <br /> <br />lJL{j /1'\ d.I'\ R.eo1.';'\~ <br />r Y I N I FEE CURRENt Y / N <br /> <br />License ., I <br /> <br />Directions: <br />Fill out apPlicatio;comPleleIY. <br />Owner & Contra r sign back of application, ndlarized <br />If over $2500, a otic. of Commencement Is requIred. (AlC upgrades over $5000) <br /> <br />Agent (for the co~actor) or Power of Attorney (for the owner) would be someone with notarized leller from owner authorizing same <br /> <br />OVER THE COUNTEfERMITTING (Front of Application Only) <br />Reroofs ers Service Upgrades AlC Fences (PloIISurveylFoolage) <br /> <br />Drlvewa:~s-Not 0 ; r Counter if on public roadways..needs ROW <br />