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<br />813-780-0020 <br /> <br />3 Received <br /> <br />oer's Name <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />OWn" Phon. Numbe' l <br /> <br />Owner Phone Number l <br /> <br />Owner Phone Number <br /> <br /> <br />mer's Address (p 1/ ~ <br />Ie Simple Titleholder Name\ <br /> <br /> <br />ee Simple Titleholder Address 1 <br /> <br />IOBADDRESS ~ 1~ tJDr~}p.Ile. Dr, 2~p~~L~ <br /> <br />SUBDIVISION ls~~~^: frJ~" aI 5; Ju.rcJs PARCEL 10#\ b.~ - ~ -.,2./-0IfO .DNX>b -ILCfD <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br /> <br />E3 <br />DSFR 0 <br />~OCK rn" <br />a.JJ ~ ~ ,0," <br /> <br />o <br />o <br />o <br /> <br />B <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />3~~"~ <br /> <br />J <br /> <br />LOT # <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION' <br /> <br />o <br /> <br />I <br />r;-1; ~fS:OD <br />o <br />~~/ <br /> <br />W.R.E.C. <br /> <br />elf BUILDING <br />d ELECTRICAL <br />0 PLUMBING <br />0 MECHANICAL <br />0 GAS <br /> <br />1$ <br />($ <br />1$ <br /> <br />~ <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br /> <br />: <br />: <br />I <br />I <br />I <br />Add~" ~ : License # I I <br /> <br /> <br />OTHER ... COMPANY rVe..iet \?ifr^CD(Jor1si/ -=r11(' - I <br />SIGNATURE- - - -_- -~ REG""""ED I Y IN_ FEE CORRENT L Y I N <br /> <br /> <br />, " "~~~~~~, ,\,\ ;:/, ~ J,,~1 r:t:~ '" f.1/" 1:~ d:. f,':J.,'" ,~~( "'" ! , "'" """"'" "~,::~,~ ""I, :" ~~, p,. ,~~e;,~, g <br /> <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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 onsite, Construction Plans, Stormwater Plans w/ 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 />11111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY d'OTHER 4/~(f\- ~u~'" f.1Y\ <br />FLOOD ZONE AREA DYES @o <br /> <br />AMP SERVICE <br /> <br />ROOFING <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />PROGRESS ENERGY <br /> <br />LPe k f ~;~,^l'O II ~'\ ~;J :1- f\C <br />I Y / N I . FEE CURRENT ( I Y / N I <br /> <br />License # I c 6 (l D {a fJ:l 0 \ <br /> <br />\ 4~ (J _\a.S5 ~l~-\-('~e.. <br />I YI N I FEE CURRENT I Y/N I <br /> <br />License # I E~ -Ooo'l..?CO <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br />