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<br />813-780-0020 <br /> <br />t<; .,'f; <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Date Received <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />IlR'733 <br />I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />~a..U- ~cQr.' 2~,~' :sss~1 <br /> <br />I PARCEL ID# I 03 -~" -.::t-I- (fl:IO- () 6..2 fJ'D -- 2JO J- I:) <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />B ADD/ALT D SIGN D MOVE D <br />REPAIR <br />D COMM D <br />D FRAME D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br />SQ FOOTAGE I <br /> <br />BUILDING SIZE <br /> <br />111111111111111'111'11111111111'11"'1111111111111'1111111111111111111"11111111'1111111"1111111'11111111111111'111111"11'111111111"1111'111111 <br /> <br />1$ I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />D <br /> <br />LOT # <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />BUILDING <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />License # <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />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 />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 />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction, <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # I <br /> <br />4/ I ~ '" l!,)r, ( <br />Y/ N FEE CURRENT I Y/N I <br />License # I EC 00 0 17 )0 <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />11.......11.....11.......11111....11111......1111..11................111..111....11.......11.........11.11...111.................................. <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 />