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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 />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I '.ol3Y <br />m~-\J <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />9tk ~T. <br />Sub <br /> <br />~r'\v.\\~ F I 33SLtd LOT # 5 <br /> <br />PARCEL 10# I 09- 9 \0 9- \ 01 ~O O<J~ OQ S:-o <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />I <br /> <br />D NEWCONSTR D ADD/ALT ~ <br />D INSTALL D REPAIR <br />o SFR D COMM 0 OTHER <br />o BLOCK D FRAME 0 STEEL D <br /> <br />IQt"MAiA.-*Qt"~ (Z:;-)\AI'.vo-ov>~ [rMav-r) Sl~ .-hs S/~ <br /> <br />I SQ FOOTAGE I I HEIGHT I I <br />Ib._~IIR~lhd ---IR___~U-I~ nIIIlR IIlIIIIIl- _~~..m...IIIIHI/IIlIll <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br /> <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br />---- <br />~ BUILDING <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />-- <br /> <br />1$ 900 <br />I <br />o ELECTRICAL 1$ <br /> <br />o PLUMBING 1$ <br /> <br />o MECHANICAL !$ <br /> <br />o GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br />/ <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />t--J 0 ( <br />I-.fJ L <br />g\~ Uy,- t:\ppl\C- ~.. <br />( . t ,,-,..\\2;.:..:-101 _ <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />ONO <br /> <br />Address <br /> <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address l <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY !-r-(2;o{?lLAL. fLocf:t/J~ ~ <br />REGISTERED I (V N I FEE CURRENT l'VN <br /> <br />License # Iaq-c (.:J/ 0([0 <br /> <br />Ybu <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address I. <br /> <br />.tl- .-...- __.J>... -.-. I _.,.. III --w........_1 <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 /> <br />COMPANY <br />REGISTERED <br /> <br />FEE CURRENT <br /> <br />License # 1- <br />lItil~- ~I~I llI1r- <br /> <br />Y/N <br /> <br />Y / N <br /> <br />......~l._ <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />rDi~ecti~;"""'utn~............."" gill. -.... ~. _....... ........___ ....."___.NIl., 111I........ <br /> <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 lhecontractor) 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 Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />ImtmlllllIB <br />