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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />r-ax-o 1.:)-/ OU-UUL I <br /> <br />I <br />I <br /> <br /> <br />Fee Simple Tltleholde, Add"",' 1 ! <br /> <br />I~~~ ~~'-\ ~ . ~ Lo..1 I <br />I'~ \) \. 1 PARCELlD#I~')~~-~\~CD~,(J\jf\D\)..O()f\ C) I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o NEW CONSTR r=J ADD/ALT D SIGN D MOVE D <br />D INSTALL Cl ~ <br />PROPOSED USE D SFR ~ ~ D OTHER <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I I <br /> <br /> <br />;;~~~;;;~~ r~" "I, ~ ~~,,~i.~~;'~~! ,,~,~~~c~~;~{~~-:.," ...1..,,,,,,, ......,,'~..~ <br /> <br />D BUILDING 1$ ~<3\)~ <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />\D -C7D-O(P <br />-.--:- \f'(\ \) \\" '-Q ~ Cd <br /> <br />0-" <br /> <br /> <br />Ze <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />t=:'tL ~>,(lL''''''''/ <br /> <br />ROOFING <br /> <br />o <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />I I I , , , I I I , . ,., , . I I I I , I I I I I I , . . I , , . , , I . I I , I' 1 . I . , I . . . I , I . I , , I I I , I . I I , I I I , . I I I II' I I . I I . I I , . I . . I I I , I . I I II r I I II , , ~ I . I , I I I , , I I , . . I , , , I I I , I , I . I I , , I , , . I . I <br /> <br />COMMERCIAL <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />Add,e.. ~ ll<en"" I <br /> <br />~::":TURE ~~~"-~~ ~~=~~ 1~~~~~~N'i'v/N I <br />"'" ~~~~~" \:::'~~~, ~7:., ~ ~,~ ~,~"""""""",!,""""""'" '" ~~:::,~ ".,', ~~~~;:;::"""""",,! <br /> <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivislonsllarge projects <br />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 />Attach (2) sets of Engineered Plans. <br />H"PROPERTY SURVEY required for all NEW construction. <br />1I1111111111111111111111111111111111111111111111111111111111111111I111111111111111111I11111II11111I111111I11lllllillilllllllllllllllllllllllllllll <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 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 <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> LIcense # <br />Y I N FEE CURRENT <br /> LIcense # <br />YI N FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 />SIGN PERMIT <br /> <br />Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadwaysooneeds ROW <br />