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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />r-ax-o '''-/OU-UUL: I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />/:)- 7~.2. y)3 <br />YIS . </re' 7?CC <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />5"()SO J"tlt ~lvd <br /> <br />LOT # <br /> <br />PARCEL ID#I <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />//- Z'-2J(}o/O-2/C/-06- ()361 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />~ <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I MS-I-a..R.i <br /> <br />~/ci(lll <br /> <br />1111,11......11111111...111111...1111.1.1.1111...,1111...1111...11...1111111...........1111....1111.11..111111111111"'1'111'1111111111""111111' <br /> <br />1$ ,:) /00 <br />1$ <br />1$ <br />1$ <br />c=J GAS 0 <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />o <br />p~ <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />SQ FOOTAGE I <br /> <br />/01 C (I <br /> <br />D <br /> <br />c=J <br />c=J <br />c=J <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />'111"1111''''''1''''1'1'111''''''''''1'''1'111''111''11"'1111'1111,'111'1""'11'111"""'1111'1,,,1111"""'I,..,."III"'P"'II'IIIII"'II'" <br /> <br />:~~~~~RE! ~l!L <br /> <br />Add~ss ~ <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />5 z. .)D <br /> <br />-I~€OWIlf.JL <br />Y / N I FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />11111111111' 1111I11111111111111111111111111111111111111111111111111111111111111111111'" 1111111111111111111111111111111111111111111111111111111111 <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 onslte, Construction Plans, Stormwater Plans wI Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlslonsfiarge 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 onslte, 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 />111111111111111'11'1'11'111'1111"'1111111'111'11'111'111111'111111'111'111"'IIIIIIIII'llliillllllllllllill1IIIIillillllllllllllllllllltlllilllll <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 Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways"needs ROW <br />