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<br />813-780-0020 <br /> <br />. <br /> <br />Date Received <br />111111111111 <br /> <br />Owner's Name <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br /> <br />Fax-813-780-0021 <br /> <br />.~ ~~.If13 <br /> <br />!:1Kr"~1 <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />c? -5 Rei <br /> <br />B <br />D <br />D <br />I C/;,f-/V( <br />I <br /> <br />93 (VJ <br />I <br />t=j. <br />D <br />D <br />~cw c~ <br /> <br />SQ FOOTAGE I <br /> <br />~f:e( <br /> <br />PARCELlD#1 /1- U-2J-003o -OlJ(POO -0/5lJ <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />ADD/ALl <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />Fee Simple Titleholder Address I <br /> <br />1-57/3 <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />J I?d (p <br /> <br />HEIGHT I <br /> <br />11..........11..1111...........111....11.........1111....................11..........11.........................111111.....11...1111...11.11.11111 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ 50 d. c;?C/ <br /> <br />1$ <br /> <br />D GAS D ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIAL TV D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />1""""'111111111"'11'11"""1111"1111111111111111'11"'1""1111""'111"11"""1111111'1111111"'"""'111"""""1'1"111111111""" <br /> <br />BUILDER <br />SIGNATURI: <br /> <br />COMPANY <br />REGISTERED <br /> <br />. FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNA TURI: . <br /> <br />Address I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Y I N FEE CURRENT <br /> <br />License # <br /> <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br />;/ /Z? <br />f.. ~/ C:-1'< <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Address I <br /> <br /> <br />~I~HN~~URE: I <br />Address I <br /> <br />~e <br />I Y I N I <br /> <br />Cc.e-"'~ <br />FEE CURRENT I Y I N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />I11111I11111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111I11I111111111 <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 />Drivew:lys-Not over Counter if on public roadways..needs ROW <br />