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<br />Date Received <br /> <br /> <br /> <br />Fax-813-780-0021 '\ <br />~ ~&LP <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Owner's Address <<;;'"~D3 (J/lfl.\<..er <br /> <br />Fee Simple Titleholder Namel <br /> <br />Sr- <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />5) <br /> <br />s--;- ~ >I <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS S"('JO C" I Rive-< 7 ~,,dJ..rJ.,l/s fL. LOT # <br />SUBDIVISION I PARCEL ID#III - 2- f? - 2l-()(J ( 0 - OS-7 00 - b 2- ~ 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED NEW CONSTR ~ ADD/ALT D SIGN D MOVE D DEMOLISH <br /> INSTALL REPAIR <br />PROPOSED USE SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION BLOCK D FRAME D STEEL D OTHER I <br /> <br /> <br />BUILDING SIZE <br /> <br />11....11..................111........11......111..1111..'.....111................1111.11........111...11......'11.......1,..1.........11111..11111 <br /> <br />0 BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C, <br />D PLUMBING 1$ }/ ).00 I <br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />0 GAS D ROOFING D SPECIAL TV D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11'111..'11'...1'1"'."1'11..."'111"1'1"11....1'".'111111..."'11111111111.."'111"11111"111."""1''1'1'..."1.1'11'...'111".'1"1"'111 <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <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 FEE CURRENT I Y / N I <br /> <br />License # I q= c. J in. (; 7 1ft <br /> <br />f{('j'to - ~ \X)'t-t r <br />I Y / N I . FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />52,$'0 <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <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 />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 onsite, Construction Plans, Stormwater Plans w/ 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 onsile, Construction Plans, Stormwater Plans w/ 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 />1I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />