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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br /> <br />Date Received <br /> <br />Owner's Address 600 N. Westshore Blvd., Suite 400 Tam a, Florida 33609 <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 />B <br />D <br />D <br /> <br />I <br />B <br />D <br />D <br /> <br />ADD/AL T <br />REPAIR <br /> <br />COMM <br />FRAME <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS 16260 Maisie Rd. <br /> <br />SUBDIVISION I Eiland Park <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />PARCEL 10#103 26 210230 OC100 0000 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />BLOCK <br /> <br />12 inch irrigation meter <br /> <br />SQ FOOTAGE I <br /> <br />D <br />D <br />D <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />SIGN <br /> <br />I <br />D <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />D BUILDING <br /> <br />o ELECTRICAL <br /> <br />~LUMBING <br /> <br />o MECHANICAL <br /> <br />D GAS <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br />D <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATI <br /> <br />D <br /> <br />PROGRESS ENERGY _-.1-- l--.--Wj3..E.C <br />~. <br />~~ <br /> <br /> <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />RESIDENTIAL <br /> <br />YI N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y I N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />~ ~~ Sll~~l~ <br />Y I ~ FEE CURRENT I Y I N <br /> <br />I ~::t:~-~ <br /> <br />:]:NC <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br />License # <br /> <br />Y I N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y I N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <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 <br /> <br />(Front of Application Only) <br />