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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />WORK PROPOSED <br /> <br />Owner's Name <br /> <br />OwnefsAdd",os I >/~ ~p >~ <br />Fee Simple Titleholder Name P&A./A/4 PW? U3 <br />Fee Simple Titleholder Address I c;--; YJ 2: A/p >/ <br />:. >/>'1 ZA/p ~ <br /> <br />. PARCEL ID#I <br /> <br />E3 NEW CONSTR D ADD/ALT D <br />INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D OTHER 1//lIl/o4-17t1,;r.,1 ./f..I'e?e/(cr LI..(..I-FIS" <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I I <br /> <br />DESCRIPTION OF WORK I (.,v5t./L(. (/2((>, ~t?/-az, JhtIJ> ~f"e 6i/5 II~~U I <br /> <br />I sa FOOTAGE I I HEIGHT I <br /> <br />Z 2~ / <br />Owner Phone Number I <if i'? 71 9' 26 J r- <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />LOT# 17-/~ <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />I <br /> <br />III . I . , , 11 II 11111111111111111111 , 1111 , . I r II , 11111 , 1II1IIIII . n I " 1II1IIII , , III , III1I , , , . , II I r , r , , I . . . , , . 11111111 filII III , .. I . II n . 111111111111 . , , . <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br /> <br />1$ I <br />1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111 " 11111111111111111111111 " 11111111111111I111111111111111111111111111111 " " 11111111 " I " " 111111111 " 1111 " 1111 <br /> <br />BUILDER I <br />SIGNATURE <br />I <br /> <br />BUILDING SIZE <br /> <br />D <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 />~ <br /> <br />PLUMBING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />License # <br /> <br />>r ? Iy; t:t.J <br /> <br /> <br />COMMERCIAL <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br />11111111 " 1111111111111111111111 " 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 wI Slit Fence installed. <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 />....PROPERTY SURVEY required for all NEW construction, <br /> <br />I~;rf~~~, <br /> <br /> <br />License # I <br /> <br />Y/N <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />1111.1111.........................................................................................................................1............... <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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />