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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Date Received <br /> <br /> <br />tZ- iLl J <br />If~ S'I'. <br /> <br /> <br />Fax-813-780-0021 <br /> <br />-k1 ~ ~l\5 <br /> <br />c ~ <br />Owner's Address I J-;;;2. YO <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />I <br />I <br /> <br />~ J&3 / p'L. JI.] <br />I I /7/.[) . .off <br />BUILDING SIZE I ISQ FOOTAGE HEIGHT . <br /> <br />0~<::""""""'" .............................................."..................................,..................................... <br /> <br />BUILDING 1$ /~, y~ (!) o..f I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 5'';< YO 1'l-:Y-51 <br /> <br /> <br />ION! e r- Z tI'll- 'j/llh'LV I <br />T 1~78' <br /> <br />E3 NEW CONSTR D ADD/ALT <br />INSTALL D REPAIR <br /> <br />PROPOSED USE D SFR D COMM <br /> <br />TYPE OF CONSTRUCTION D BLOCK D FRAME <br /> <br />T~ oq: -1(~IlOO;:; td/17-f <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCELlD#1 II - ~ -.}-/ - 00/0 --17000 - 100dO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />OTHER I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />~ <br /> <br /> <br /> <br />M E..J/"1 / /UJ V. <br />Y I N FEE CURRENT <br /> <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGt.!ATURE <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <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 />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />111111111111111 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 subdivisionsllarge 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 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />