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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 />Date Received <br /> <br /> <br />:.If, ~Cj1 <br /> <br />JOB ADDRESS <br /> <br />Owner's Name <br /> <br />Owner's Add.... I ~~S- <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Add.... I <br /> <br />I Y4%'l" ,4RI?!W/;;>"'/ 2:("'",,,,,,, ~ <br /> <br />I I PARCEL 101 _ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />LOTti <br /> <br />SUBDIVISION <br /> <br />(OIITAINED '110M PIlOPEIITY TAX NOTICE) <br /> <br />WORK PROPOSED <br /> <br />ADD/All D <br />REPAIR <br />D <br />D BLOCK D FRAME D STEEL 0 OTHER I <br /> <br />tz-N~L ~11/IG. A;::puqur,<...,- -I7i?t=:' :3-lpFI2~\I"N1 <br />. <br /> <br />I SQ FOOTAGE I I HEIGHT I I <br /> <br />~ <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />B <br />D <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />COMM <br /> <br />OTHER <br /> <br />I <br />I <br /> <br />-o/r,c:-~ I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />1$ <br />1$ <br />1$ <br />1$ 1M", <br /> <br />o GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />o <br />o <br />o <br />o <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />BUILDING <br /> <br />aQ) <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 />D <br /> <br />W.R.E.C. <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY ~OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED ~ FEE CURRENT I Y/N I <br /> Licensetl <br />COMPANY <br />REGISTERED ~ FEE CURRENT I Y/N I <br /> License # <br />COMPANY <br />REGISTERED ~ FEE CURRENT I Y/N I <br /> License # <br />COMPANY <br />REGISTERED ~ FEE CURRENT LrL!L.J <br /> License # I <br />COMPANY ~~~)YhPE~{~fubLC. <br />REGISTERED Y / N FEE CURRENT / N <br /> License # I S-lk'~~lVlI\~llCVI <br /> ~ <br /> <br />Add.... <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Add.... I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />Add.... <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Add.... I <br /> <br />~~HN~RTURE J~~ ~ ~ <br /> <br /> <br />Add.... I <br /> <br />RESIDENTIAL <br /> <br />Attach (2) Plot Plans; (2) sets 01 Bu~ding Plans; (1) set 01 Energy Forms <br />Minimum ten (10) wotking days after sulmittal date. Required onsfte, Construction Plans, Sanita-y Facilities & 1 dumpster <br />Attach (3) sets d Building Plans; (1) set of Energy Fonns. <br />Minimum ten (10) working days after sulmittal date. Required onsfte, Construction Plans, Sanita-y Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets d Engineered PllI'1s. <br />-PROPERTY SURVEY required for all NEW construction. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Dlrectlons: <br />Fill out application completely. <br />Owner & Contractor sig> back of application, notarized <br />If over $2600, a Notice of Commencement Is ..qulred. (AlC upgrldes over $6000) <br /> <br />Agent (lor the contractor) Dr Power of Attorney (for the owner) would be someone wijh notarized I_r from owner authorizing sane <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AJC Fences (PIotISurveylFootage) <br /> <br />Drivewlys-Not over Counter ij on public roadways..needs ROW <br />