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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Dale Received <br />:nn:n: <br /> <br /> <br /> <br />Fax-813-780-0021 <br /> <br />:p1ID3 <br /> <br />\"\".L:> ._"'... ,-.... rD -f(:"-~ 1J-~ <br />Owner's Name I' \~" '-~ <br />Owne.'sAddress 11>" Of 60/" ~ 1d).../ ~~~,'J.R,J3tJ';/ <br /> <br />Fee Simple Titleholder Namel I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number 1 <br /> <br />Fee Simple Titleholder Address 1 <br /> <br />1505~,>6o-U-~~., Z~L~,~, <br /> <br />1 I PARCEL IDS I 11-.).4 -~- (;)o{)o-D/5co - fX)/O <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />B NEW CONSTR c=J ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH <br />INSTALL - [:E:J~REPAIR~ <br />PROPOSED USE 0 SFR 0 COMM 0 OTHER <br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL D OTHER I <br /> <br />DESCRII'TION 01' WORK 1'-:S€9~ -I;; d~~5 "'- ~L::l~\ ~'i'"'-' b-..- . <br /> <br />BUILDING SIZE I - I SQ FOOTAGE I . - I HEIGHT I ,- <br /> <br />~~:~~"""" 'i;" :;,'; ~~:~:""""'" ~~~~~:~~ ~~ ~~~~ ~~~::::~~""'.""""""""""""""""'" , <br /> <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />o MECHANICAL 1$ <br /> <br />o GAS 0 <br />FINISHED FLOOR ELEVATIONS 1 <br /> <br />I <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />,I C. / 1r6YYl <br />~l{~ ~ <br />VALUATION OF MECHANICAL INSTALLATION {;/J-J Itt1 . <br /> <br />ROOFING <br /> <br />o <br />I <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />Address <br /> <br /> <br /> <br />Address <br /> <br />COMPANY ,- <br />REGISTERED <br /> <br />R~~fyz;~J?C( I <br /> <br />License # I~ .AC- 1..:<.5 ()Cj J' l I <br />b<Cl z:- i <br /> <br />j <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL I <br />SIGNATURE _ <br /> <br />Address I <br /> <br /> <br />OTHER I <br />SIGNATURE <br /> <br /> <br /> <br />!1I11............ <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br />1111111111 <br />RESIDENTIAL <br /> <br />Y/N <br /> <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 onsile. 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 />J 11111111 J I J I Jill J I J I Jill J J' J J I Jill J I J I J 1111 J I J J 1111111 J J 1111111111 Jill J 1111 J 11111111111111111I111I1111111I1111111111111111111I11111II111I11111111 <br />Direcllons:: - _ <br />Fill out application completely. <br />Owner & Conlractor sign back of application. notarized <br />If over $2500, a Nollce of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agent (for the conlractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMtTTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Driveways-Not aver Counter if an public roadways..needs ROW <br /> <br />Fences (PloUSurvey/Footage) <br />