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<br />I I <br /> <br />813-780.0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />",\:~IJ~ \J~ H~'1Y {-9 <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Addres <br /> <br />Fee Simple Tille <br /> <br />Fee Simple Title <br /> <br />'I <br />: 38'fJ S <br /> <br />I <br /> <br />LOT# I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />WORK PROPOS <br /> <br />DESCRIPTION 0 <br /> <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />I <br />I <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONST <br /> <br />~UILDING SIZE <br /> <br />HEIGHT I <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C <br /> <br />D BUILDI <br />D ELECT ICAL <br />0 PLUMB NG <br />D <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />c=J GAS ~ <br />FINISHED FLOO ELEVATlm!s " <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />ONO <br /> <br />Address <br /> <br /> <br /> <br />I~ (C;('tva.LA... 7ooL~ .___all, <br />I Y' N Y-'" ~ CUR;ENT Ii"'?, N I~ <br /> <br />License # I LeG oSf( I J tf <br /> <br />ELECTRICIAN <br />SI~NA TURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />. FEE CURRENT <br /> <br />Y1N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br /> <br />License # <br /> <br />PLUMBER <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 />MECHANICAL <br />SI~NA TURE <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 />COMMERCIAL <br /> <br />OTHER COMPANY I <br />SIGNATURE REGISTERED I Y I N I FEE CURRENT <br /> <br />Address Ii '. ..' I' License # I I <br /> <br />111111111111111~1111111111111111111'11111111111111111IIIilllllllllllllllllllilllllllllllllllllllllllllllll1111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sl;lts of Building Plans; (1) set of Energy Forms . <br />Minimum ten (10) working days after submittal date. Required onslle, Construcllon Plans, Sanllary 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 onslle, Construction Plans, Sanitary Facllllles & 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 /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />Fill out appllca on completely. <br />Owner & Con ctor sign back of application, notarized <br />If over $2500, Notice of Commencement Is required. (AlC upgrades over $5000) <br /> <br />.., Agent (for the ntrt:lctor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing <br /> <br />OVER THE COUN R PERMITTING (Front of Appllcallon Only) <br />. Reroofs Sewers Service Upgrades AlC Driveways <br /> <br />