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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />l-aX-!SM-1 !SU-UUZl <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />it ~~f S <br /> <br />Date Received <br /> <br />OWner's Name <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I b bY') j u V\ { p ~v <br /> <br />I D'( ('.r -h,00 0 ~ <br /> <br />E3 <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I <br /> <br />C-f- <br /> <br />LOT # <br /> <br />PARCEL ID#I <br /> <br />Ol-2-~ ~~/-62--IO- ooooo-i2-<f1 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />I <br />E3 <br />o <br />CJ <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />OTHER I <br />STEEL D <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />OTHER I <br /> <br />BUILDING SIZE I ISQ FOOTAGE 11 )00 I HEIGHT I <br />. . . . , , . . . ~ I . . . . I I . . . ". . . , , . . I I . . . I I , I I . t I . . I . I I I . I . . . . . I I I . . . . . . I . . I . . , I I I . . . . . I I I . . . I . I . . . . I . . I I . I I I . . . . I . . . I . , . I . . . . . I . . I . . , I . . I , I . . . . I I . I , I . I I I . <br /> <br />PLUMBING <br /> <br />1$ Lj 1~-V, UO <br />1$ <br />1$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />BUILDING <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />CJ <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <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 />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />OTHER <br />SIGNATURE <br /> <br />~_.- I <br /> <br />IJ~olo Snfft:- ~j S-L 1l<.J(J6X I(x:~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />L~o ft6~WtCW\ ~I h~ T0 <br />I Y I N I FEE CURRENT Y I N I <br />License # I Oc c 0(7 7 .') 7 <br /> <br />Address <br /> <br />Address <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Pennlt for new construction, <br />Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Stonnwater Plans wI Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Pennit for subdivislonsllarge projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Fonns, R-O-W Penn It for new construction. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans wI Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster. Site Work Pennit 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 i 11111111111111111111111111111111111111111111111111111 <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 />