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<br />.. <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />:/t0611 <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />~O( <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <1) i s <br />Owner's Address I .C, ~ ( (, c..~ fo ( v J . <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I ~~/~ <br />I <br /> <br />G,~ <br /> <br />blvd. <br />I <br />B <br />D <br />D <br />We::tbr <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I ~Ol <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PARCELlD#1 () ;2 -;;Z~ -.:2..1 ~ 00 It) ~ () 2....'-100 ~ V <9 ;)....0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />e6 <br /> <br />SQ FOOTAGE I <br /> <br />LI~ <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />..11..11....111.....11.........-..................1111..1.1. .................111.111......111.....11.......11......111...........11................ <br /> <br />D BUILDING 1$ <br />D ELECTRICAL 1$ <br />~ PLUMBING 1$ <br />D MECHANICAL 1$ <br />D GAS 0 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C <br /> <br />5oo~OO <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING D SPECIAL TV D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />BUILDER <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 />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 />~~Lhla :> <br />I 1'3 g74~ CR '5~ 6. <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Address <br /> <br />License # <br /> <br />I c..F~/4-;)' Slto a. <br /> <br />MECHANICAL <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 />OTHER <br />SIGNATURE: <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />11111111111111111111111111I111I11111II1I1I11111111I1II1IIIIIIIIillllllllllllllllllllllllllllllllllllllllllll111I11111111111111I111 <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 />III111I1IIII1111111I1111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111 <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 Driveways Fences (Plol/Survey/Footage) <br /> <br />Address <br />1111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br />