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<br />81:3-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Date Received <br /> <br /> <br />EO<rt... <br />I 7 - Sr. <br /> <br /> <br />Fax-813-780-0021 <br /> <br />4 ~v*~ <br /> <br />Owner's Address <br /> <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 />Fee Simple Titleholder Address <br /> <br />SUBDIVISION <br /> <br />I ~ 0 { 3 17 ~ .fr. <br />I j?AIf..A IfJU- Jug <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PARCEL ID#I ();t - ..l.' ..,,)/ _ oj Yo - 00000 - o6J-o <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />I <br /> <br />D ADD/ALT D <br />D REPAIR <br />c==J COMM c=J OTHER <br />D FRAME D STEEL D <br /> <br />D pF .. It E.fUJ(JF WI 77-f- IS" .rd.} 30 ~.!Jt 41 S/fr.( 6.tL f <br /> <br />BUILDING SIZE I ISQ FOOTAGE I I HEIGHT I I MoO'?, 'Iff <br /> <br />~ .....(.,....""""..""",....",..."",..",..,.,.....,......,.............................................,.......,.....,..., ....,...... <br /> <br />~ BUILDING 1$" I <I;). s-: 00 I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D <br /> <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />WORK PROPOSED <br /> <br />E1 <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER <br /> <br /> <br />DESCRIPTION OF WORK <br /> <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 />SPECIAL TV D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />111"'11'111111"""1.1.1""...111"""1'1.111..111.."".111.'1'..11.......".111..11'.1111.."".......","111'111'1.1'11'111"'."111"'111 <br /> <br />=:::~~~RE~ cS~~ <br /> <br /> <br />Address _ <br /> <br />J 'C/C. VIe EJ <br />I Y IN I <br /> <br />COMPANY <br />REGISTERED <br /> <br />1/h,/1tc ~/~oy. <br />Y', Y I N I FEE CURRENT <br />License # I <br /> <br />ELECTRICIAN <br />SIGNATURE <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 />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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 onsile, Construction Plans, Stormwater Plans wI 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 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 />1111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111 <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 ~ewers ~ervice Upgrades AlC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysuneeds ROW <br />