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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />.tb-- :> Z 0 ~ 'i 1. "3 <br />.Jf'~BI 0 <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />.... Ph.on"...S.~,~~ct !,~~ ~e~!!lin9.. II,.. <br />...,:i~!!_.!'!m.., ......... l'..' ffl_~'.~Mlftlln~jt!:!!~II,IJ'j <br />'Co:-oE <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />BLOCK <br /> <br />ADD/ALT <br />REPAIR <br /> <br />I <br />I <br />I <br />I LOT # I ~ I <br />PARCELIO#U L--~..... 21.- cor 0- bO IOD-DlqD <br />(OBTAINED FROM PROPERTY TAX NOnCE) <br /> <br />D SIGN D <br /> <br />D <br />D <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />OWner Phone Number I <br /> <br /> <br />OWner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br /> <br />/:X;J->. <br /> <br />~ ~7- <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />.sa~ <br /> <br />SUBDIVISION <br /> <br />fJ J.--J I. <br /> <br />C IL~J r <br /> <br />I <br />B <br />o <br />o <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />COMM <br />FRAME <br /> <br />OTHER <br /> <br />STEEL <br /> <br />I <br />D <br />-\::;l,. <br /> <br />OTHER 1 <br /> <br />o <br /> <br />.~ (-l' (l <-I<.. l:b ~ i. .,dot.i) ) <br /> <br />BUILDING SIZE I sa FOOTAGE I I HEIGHT <br />;;m"*::~I":{!!P;!;~=ilHm~J;W~i!!l~r.4iiilm~ll;#m~I~~j!~=lllnf!~ml~ilm=!mi!m~i;Uimml.mi;m!!;m;~!!dl;lil;mll'lli~;;itmlj;;jll"m"#:aIlDiRi~!~~;~lit,;~;mfm;inm'i~;;lmjl~~_!HqmM!#;~mlilm;",h.m#l#Ui!m!j;r";m;~.un~l <br /> <br />rn 1,;t1't~ ~B - I <br /> <br />o ELECTRICAL 1$ , <br /> <br />o PLUMBING 1$ I <br /> <br /> <br />1$ I <br />D ROOFING 0 <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />DESCRIPTION OF WORK <br /> <br />s . (...{. <br /> <br />J; ~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WR.E.c. <br /> <br />o <br /> <br />GAS <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />fJl~'/ <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />DYES <br /> <br />DNO <br /> <br />~*ji;;iii!i:!~i!:1~b!l!~1;~jljiii..~i;~l!im~jl5;!1E;~iliji~l~~!1~~a.~mi~mj~miilimt:mm~~ii!ii;i;jlljll:~j~1iiiiilg~lImiWl:llnllJlmP.U~D~IlUj:ilmJli*~lmUP.:litmflilij;mli~IiIl~I~i~mmgmm~lm3ImIGUlml;Ii;11mmgm~"U~III~~ill~lmIU:11l <br /> <br />BUILDER COMPANY <br />SIGNATURE REGISTER ED Y/N FEE CURRENT ~ <br />Address License # <br />ELECTRICIAN I COMPANY <br />SIGNATURE REGISTERED YIN FEE CURRENT ~ <br />Address I License # <br />PLUMBER I COMPANY <br />SIGNATURE R EGISTE R ED YI N FEE CURRENT ~ <br />Add ress I License # <br />MECHANICAL I Y / N FEE CURRENT I Y/N I <br />SIGNATURE <br />Add ress License # <br />OTHER , H D..-vl <C. j)~ to T <br />SIGNATURE 1c0 N 1 FEE CURRENT lO2.tU <br />Add ress License # Il" :ze 0'-1' ,fJl$ I <br /> <br /> <br />i!*ia*$:*tl!!!=;~imli:~lm~!;!;i!lUf;;m~d!WEiUi~l!!ml;ilr;!.m;!;li!manUhmlr:~I!;iMimUnRr.mlffiiWl!iilm;I1l;r;im$mt;ma.nmaa;;;;;mim!~m!mim!iUi'lHUrdr.;iimh!!;!i!lRff!:!qIUl;;ilU~ml;;r.i!!!ilmn;lmniWiligmii!i8!i;";;ff~JiilWhl <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 on site, Construction Plans. Sanitary Facilities & 1 dumpster <br />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />liiim:i.';iIJUi~iUl~ltit;;ml~Diillliiiiliiimi!lill~i!lliimIIHim:liimliill!iJ!IllmlillliUllllllmJiWifiIHinflliiIUlillm:llm;J:ml~muIGm~;lm=mlll:llill:ill~ml~mlmmIUillS;lm~gI9IID:llmiillmlDliililiilil~Umn::lmlnllmmmmnlillmmlHiIljlJlliiWlill~IUiil <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Com men cement is required. (AIC upgrades over $5000) <br /> <br />Agent (for the contrac;or) or PO\<Ver of Attorney (for the o'Mler) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />., j~~~bi.ii' iiO" . ~i"'rs". SelVice Upgrades AlC <br /> <br />..:,~t~'~~.Not~ ......'.' r if on public roadways .needs ROW <br /> <br />'."0. ........ -.:11 v... '. ~i! <br />.,........--.. o;~ ~ : <br />. ;..~'\?~A ~ tItIhcA '\ ",' .~. ,.,01 ! <br />~ .'.0....... .,..." t..............~, ~ "'~'''~".. .....11I <br /> <br />Fences (PloUSulVeyIFootage) <br />