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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 />Date Received <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number L <br /> <br />Owner's Name hJ 'L T ~ a-~ <br />Owner's Address Is /.AJ7 9TH, r7 <br />Fee Simple Titleholder Namel.s~ f' <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />JOB ADDRESS <br /> <br />15/0(7 <br />I <br /> <br />r 7/1 J7 <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />E3 <br />D <br />D <br /> <br />LOT # I 9 <br /> <br />PARCEL ID#III-~t.-.2)- t!JOJO - /9300 -OCl9LJ <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />I <br /> <br />SUBDIVISION <br /> <br />90 1$ <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />DGAS 0" <br />FINISHED FLOOR ELEVATIONS I <br /> <br />E3 <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK f?.t: - <br /> <br />I/YOOS&r7 I <br /> <br />.11.'..,..11.1111.....11.11...11......11.......11..11...............11.............11..........11....................11111.........11....111111... <br /> <br />BUILDING 1-- 3cz> ' I VALUATION OF TOTAL CONSTRUCTION ~:< 3 O/J, V{;J <br /> <br />I <br />I <br />I <br />D <br />I <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER <br /> <br /> <br /> <br />BUILDING SIZE <br /> <br />SQ FOOTAGE I <br /> <br />HEIGHT I /j 7~~ <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 />ROOFING <br /> <br />SPECIAL TV 0 <br /> <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />COMPANY 1ft;1A'J"~ /!>vltAe.t.S ~ I-A.I~ <br />REGISTERED L Y / N I FEE CURRENT <br /> <br />License # I <br /> <br />Y/N <br /> <br />Address <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 /> <br />111111111111111 111I1111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 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 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 />1I111II111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111fllllllllllllllllllllllfllllllllllllll <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 />