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<br />81 :3-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Depilrtment <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Name .~ cJtCPd ~~ <LJ - C ~ <br /> <br />Owner's Address I (P !:? / ?> ~ ~ 13-f2v,Q , <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />7011 <br /> <br />Date Received <br /> <br />Owner Phone Number <br /> <br />OWner Phone Number I <br /> <br />OWner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />Ib8/h A~ ~cf2, <br />I I <br /> <br />D NEW CONSTR rvr <br />D INSTALL D <br />PROPOSED USE D SFR D <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK ~~.~ r~~ <br /> <br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I <br /> <br />[iZ?" ~~,~~;~~" I""" i~:;" ~'~ ~" ~ '~'" i"'" ~~~~~~:~~ '~~' ~~~: '~~~~~;;;,~~"""""""""""""""""""'" , <br /> <br />D ELECTRICAL 1$ I AMP SERVICE ~ PROGRESS ENERGY D W.R.E.C. <br /> <br />~ PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111I1111111I11111I11I11111I1111111111111I111111111111111111111111111111111111111111111111111111111111111111I111111111111111I11111111111111 <br /> <br />::::~~RE IG~;;.~A=~~"-~ <br /> <br />License # I C-6~ j,;I.S'Of/'"/ I <br /> <br />I <br /> <br />:2-~ ~ I :::;P, 3-35 toZ.- I lOT # <br /> <br />PARCELlD#Il9.:J... - .::I..-t, --.;2/-tJO /0. D~ ~cD - DD..::L 'C <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/@ <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 />VALUATION OF MECHANICAL INSTALLATION <br /> <br />JitJ <br /> <br />I <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br /> <br /> <br />License # I I <br />I I I1111I11111 I 11II I 11111111111111111111111 1111111111111111111'111111111111111 11111111111111111111111111111111111111111111111 1111111 <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 onslte, 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 J 11III <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 Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC <br /> <br /> <br />Address <br /> <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <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 />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />~~_'.-:;" <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />