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<br />JOB ADDRESS <br /> <br />I <br />I <br /> <br /> <br />Fee Simple Titleholder Address I sam L I <br /> <br />I '5'i5f!A-!fM M_, ~!Jrb./~ FL 335'12 I lOT" 1/- 5" I <br />I OaR. PARCELlD#1 OJ--X-c)/--O()l(D-{b"&JtJ-<<J1 () I <br />Ef (OBTAINED FROM PROPERTY TAX NOTICE) <br />NEW CONSTR D ADD/ALl 0 SIGN 0 MOVE 0 DEMOLISH <br />INSTALL D REPAIR <br />PROPOSED USE 0 SFR D COMM 0 <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 <br /> <br />DESCRIPTION OF WORK I CtJ/<..crele d;/~~ <br /> <br />BUILDING SIZE I / ~ I ~ 1# 7 I SQ FOOTAGE I j Ol/ If HEIGHT 1 <br />1I",IIIIII'"IIIII"IIIIII"'I.'IIII',111111"'lllllrrll111"111'"11""1111111'"111"111"'"11""111'11111'"'"11"'II""lt""II"III""III,,"IIII,111 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />~Pe(/J'lif S?tlt <br /> <br />Phone Contact for Permittin <br /> <br />Fax-813-780-0021 <br /> <br />tk~ 101. <br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />Fee Simple Titleholder Name <br /> <br />Owner Phone Number <br /> <br />ner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br />STEEL 0 <br /> <br />OTHER I <br /> <br />[X] BUILDING 1$ 02 I' Oa:J. 00 VALUATION OF TOTAL CONSTRUCTION <br /> ~ <br />D ELECTRICAL 1$ AMP SERVICE PROGRESS ENERGY D W.R.E.C. <br />D PLUMBING 1$ <br />D MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br />D GAS 0 ROOFING SPECIALTY 0 OTHER ~O <br /> FLOOD ZONE AREA DYES <br /> <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />License # I <br />111111111111111111111111111111111II111111111I11111111111111111111111111111111I11II1111111111I11I111111111II11IIIIIIIilllllllllllll <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 onsite, 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 NC <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />License # <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 />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Address <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 />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />