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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />I U"~,I.'" . _:-:, "":'-_. <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address I <br /> <br />Fee Simple Titleholder Namel <br /> <br />~ <br /> <br />\~C <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />B <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I ~"-S~ :s-c & <br /> <br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I <br /> <br />111111111..",111....1111.1.11111..,...,111...111.1.1...,............111.....'.111.11.11.11......11.....11..'...111'............11,.1111......'111 <br /> <br />JOB ADDRESS <br /> <br />I <br />\o~ \C3 <br /> <br />C.....cJ\J...... <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I <br /> <br />I <br />B <br />D <br />D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />D BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />D GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />'7 -> .:5D .'::;'-'V <br />----- <br /> <br />ROOFING <br /> <br />,'11111"111"'111""'111"1'1"'11""1111111111'.1.111"..",.11,.....1111"1111'."'1111'.".'.'111111",,'11,.,.."..'1'.1111"'11"1.1"'1.1 <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGf'lA TURE <br /> <br />Address <br /> <br />~~()~ I LOT# I <br />PARCEL ID#I (J 1- 2h -7-/- {)bID'" DR I {}(J60 000 U <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o SIGN ~ MOVE 0 <br />o <br />o <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <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 />SPECIALTY ~ <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br /> <br />I~~ ~~ ~\A~~ <br />I Y / N I FEE CURRENT I Y / N <br /> <br />LIcense # I <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 />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />111I11111111111 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 onslle, 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/ Slit 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 />111I11 J J II1I J I J 111I11111111111 J II J 1I111111 J 11I1 J II J J I111111111111I1 J I111111I11111111111I J 111111111111111111111111111111 i 11111111111111111111111111 <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. (A1C 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 />