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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 -01 <br /> <br />Owner's Name We- / / e s / e <br />Owner's Address I ~ y ~'I '/ ..(' It s-~ W <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />7/".~/;:: I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />'Z ~ ,'/4, F / .j .1-5'-7" .i... <br />, <br /> <br />PARCELlD#1 / / -~ ~-- d 1- dltVtJ ~ttJ.s/btJ- &~U <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br />D GAS <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W,R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />~~Q...... <br /> <br />BUILDER <br />SIGNATURE <br />Address ~ ~ "/ 2) I!~ c1 ~ /..1: k r/ <br /> <br /> <br />SPECIALTY D <br />FLOOD ZONE (jA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />7/1..'/(r <br /> <br /> <br />License # <br /> <br />Ic~c t!J~7 -r-7 57 <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address License # <br />1I1111111111111111111111111111111111111111111111I1111111111111111II111111I11111I11111111111I1111I11111111111111111111111111111I1111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms, R-O-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster, Site Work Permit for all new projects, All commercial requirements must meet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans, <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />Dl~~~ii~~~':' . . . . . , . . . . , . . , , . . , . . . . . . . . , , , . . . . I . . . , I . . . . I . . , . . . . . I . . , I . . . . . , I . . . . I . . . . I . . . . I . . . . . I . . . . . . , , . . . . . . . . . . I . . . . . , I . . . . . . . . . . . . . , I . I , , I . . . <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 the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVE~:~f;OUNTE~:ERM::'~~,,~'''',:;:;:'"l Fe"" (P'OUSUNeyIFOOlaf" .'::.t;,;; '~,':'j~ ~, "'.~ <br /> <br />D,'vow_Nof ovt~~;tt:~~v~~~:~~rt t2l:::':":~:':~."X .,., ~ <br />