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<br />Owner's Name <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department ;-;-) <br />vase 0 <br /> <br />-3 <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />de - / () <br />Own.'sAdd<e.. 13'1512:::7 md ~ ~f <br /> <br />Fee Simple Titleholder Namel S '/l <br /> <br />Fee Simple Titleholder Address I c5::t mp--, <br /> <br />JOB ADDRESS <br /> <br /> <br />LOTti <br /> <br />1/~,7 <br /> <br />1. <br />I ~()bd eslz1k5/ <br /> <br />E3 NEW CONSTR C]../ <br />INSTALL rn <br />PROPOSED USE D SFR 0 <br />TYPE OF CONSTRUCTION D BLOCK 0 <br /> <br />DESCRIPTION OF WORK I ~Ylfe..rtoY' RC'yYU)de.'/ <br /> <br />BUILDING SIZE I/~ I )t 37 I I SQ FOOTAGE I SlY'Y'? HEIGHT I <br /> <br />~ II111 ~~I~~;~~ ' , , , I , I , 'i~ . , ; ~ ~ I; ~ I.' ~ . . , , , I , II i II , I P ~~~~I~~;~I~ I~~ ~~~~~ ~~I~~~~~~~I~~r , . . . . II , I , , . . , . . . . II , . . , , 1111111111111111 <br /> <br />00 ELECTRICAL 1$ I AMP SERVICE ~ PROGRESS ENERGY D W.R.E.C. <br /> <br />LJQ PLUMBING 1$ I ~ ~ <01 <br /> <br />D <br /> <br />D GAS D ROOFING 0 SPECIALTY D OTHER r~ r0 ~>> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES i ~~~V\" ,c.(J <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />~ JLI()- Ot)Da:1./ ~ <br />OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />License # I <br /> <br />25;' , <br />fif!l5 III ~~~~":: I ~~<; I !t1!L1f1; <br />2f{7W 411 B/EW;;~ ,€~ u,,'"ss# I <br />I COMPANY I <br />REGISTERED <br />I <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <br /> <br />I <br />@ <br />I <br />I <br />I <br />I <br />I <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />~/N <br /> <br />Address I <br /> <br />MECHANICAL <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />~~I ~~# <br /> <br />11111111111111111111111111111111111111111111111111I111II111111111111111111111111111111I11111111111111111II111I1111111111111111111I11I1111111111111 <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 />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 />1I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />Y/N <br /> <br />FEE CURRENT <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 />