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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application A'f ol.q -> ('.iL <br />Building Department . t' OV <br /> <br />rf t2.1Q <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fax-813-780-0021 <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />,M:--1377YO, L{~/lf4/{{Pf qg/ 5b <br />. I <br /> <br />I OC4fvtE f3.l 1>...$';0 "" I <br /> <br />El <br />D <br />D <br /> <br />JOB ADDRESS <br /> <br />El <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D BLOCK <br /> <br />DESCRIPTION OF WORK I f-d..ot.>f <br /> <br />I I SQ FOOTAGE I P GOO HEIGHT I g I-t' <br /> <br />.11..1111..111....111......'...1111........'11...11111..'11...11........11111........1111.11.11.....111.......11111111.1111......1111.111111111111 <br /> <br />17; ~ 7t? .!!Q. <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />A /I.>51t t)/(. eel h .fl, 53~ <br />PARCEL ID#I ff~~(p-';"I-Ol7D~O~){)-DDA-D <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />ADD/ALl <br />REPAIR <br />COMM <br />FRAME <br /> <br />LOT # <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I d..e~o/>f <br />STEEL D OTHER I <br /> <br />BUILDING SIZE <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />c=J GAS ~ <br />FINISHED FLOOR ELEVATIONS I <br /> <br />c=J <br />c=J <br />c=J <br />c=J <br /> <br />BUILDING <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />ROOFING <br /> <br />11,111..11111111'1...111""",.1,1.1,111.1'.."111,,.""'111111'1111"111111111","....1111'.'11111111111""111'....11111111111111111111111111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />llD CJ <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />I'c..>.s ~IC <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />YI N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />License # I <br /> <br />I/O v-z(!J 46ft is & <br />~ - Y I N I FEE CURRENT ., I Y I N I <br />License # Ice::: <.D ~79 5;). <br />. <br /> <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 />1111I11111111111111111111111111111111111111111111111111I1111II1111I1111111111111111111111111111111I111111I1111111111111111111111111111111111111111 <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 <br /> <br />Oriveways-Not over Counter if on public roadways..needs ROW <br /> <br />Fences (PloUSurvey/Footage) <br />