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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Co \ l'Z-- <br /> <br />~ <br />C C'n ~..;--\/ <br />Fax-813-780-0021 <br /> <br /> <br />Date Received <br /> <br /> <br />Owner's N~me <br />Owner's Address I S ~ 41 ~ <br />Fee Simple Titleholder Name I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />~rJ. ~~ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />PARCELIDlI D 2 - ;U" - ZI- bOlO - 028'00 - 0010 <br />(OBTAINED FROII PROPERTY TAX NOnCE) <br />SIGN D MOVE 0 <br /> <br />~ <br />o <br />1KI <br />11 <br /> <br />I <br />E3 <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br /> <br />COMM <br />FRAME <br /> <br />Fee Simple Titleholder Address I <br /> <br />I tdl ~ \ (?)~ ~L3D& QU-.. - \,.-D\- t1-3 <br />IDr;ff-watlol P~<;e 1L <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />BLOCK <br /> <br />u.n.,' +- <br /> <br />Tow" l-\-oY'\er <br />SQ FOOTAGE 15) () I <br /> <br />LOTlII <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />I <br />D <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br /> <br />1$ <br />r <br />1$ <br />1$ <br />O'f <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br /> <br />-~,.- <br /> <br />orJ BUILDING <br />~ ELECTRICAL <br />[K) PLUMBING <br />[KJ MECHANICAL <br />D GAS <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />,0 <br /> <br />PROGRESS ENERGY D W.R.E.C. <br />NOC ~u:..c~ic.-~ ~M <br />vI dT\- _ <br />'f\ .ec+n c C~ ,_ <br />()we V"lOD~eo-.\ Co.... \ Cs d- <br /> <br />ROOFING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />D <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />qvY' (1 U;)\. \ - '1/1..:/00 <br />OONO <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br /> <br />:~:':"~~E 1# ~ <br /> <br /> <br />Address . <br /> <br /> <br />:'~~~I;:L!4ft( ~ <br /> <br /> <br />Address <br /> <br /> <br />~~~u.. ! 1/4 ~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <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 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 />Address <br />_.. - <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />COMPANY <br />REGISTERED <br /> <br />(2..r"" "" <br />Y/N <br /> <br />I Co~~ ~RrlENT'T" f 'y / N <br /> <br />License III I <br /> <br />~~ <br />I Y/N <br /> <br />rn~ <br />I Y/ N I <br /> <br />FEE CURRENT <br /> <br />License III <br /> <br /> <br /> <br />tv: II r"ru"rJ <br />FEE CURRENT <br /> <br />License III I <br /> <br />~ e,''l (a.... ~,.A- <br />~N I FEE CURRENT I <br /> <br />License f. I <br /> <br />I R~~a^ ~o{..~ <br />I Y/ N I FEECURR <br /> <br />License f. I <br /> <br />Y/N <br /> <br />Y/N <br /> <br />~ <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 /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades A1C Fences (Plol/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysnneeds ROW <br />