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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-78U-UU~1 <br /> <br />Owner"s Name <br /> <br /> <br />I r ;}- ')- rc.~ 7 <br /> <br />c'Acz ~,/~ <br />J3);2<-;2 <br /> <br /> <br />9/ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner.s Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />~r t.:' N UL-- .;''t) c,f <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />LOT# I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br /> <br />PARCELlD#1 .-)2. - ~~- ZI- 0 ~/f1. - 60 G'co -cxfl.o <br />(OBTAINED FROM PROPERTY TAX NOnCE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />E1 <br />D <br />D <br />I <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />D <br />D <br />D <br />;Z 7Irv A7c~ c A C~ "'~ <br /> <br />BUILDING SIZE I I sa FOOTAGE I I HEIGHT I <br />IIIIIII , III1III1I1III11111111111111111111111111111111111 , II , II , 111111111111111111111111 . I , III r "111111111111111111111 . IIII J II t IIIII r IIIIII r 11111111 <br /> <br />DESCRIPTION OF WORK <br /> <br />OTHER I <br />STEEL D <br /> <br />o-z:~d--- <br /> <br />OTHER I <br /> <br />D BUILDING 1$ I <br /> <br /> <br />o ELECTRICAL 1$ I <br /> <br />o PLUMBING 1$ I <br /> <br /> <br />o MECHANICAL 1$ 55(;.0 ~-c) I <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111 " III " 1111111111111 " 11111I " III " 1111111111111111 " 1111 " III " 1I111 " 11111I " 1111111111111111111 " 11111111111 " " " 1111" 111111 <br /> <br />COMPANY I I <br />REGISTERED <br />I <br />I <br />I <br />I <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <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 />BUILDER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />License # <br /> <br />MECHANICAL COMPANY <br />SIGNATURE REGISTERED <br />Address License # /BA <br />OTHER COMPANY <br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N <br /> <br /> <br />Address License # <br /> <br />1111111111" III/III " 1111111/1111 " 111111111111111111111111 " II " 1111111111111111111111I " 11111111 " I " 11111 " " 1111I11111111111 " I " " 11111111111 <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 subdivlslons/large 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 /> <br />.......11111...'"1'.11..11111...11......1111.11..............11.........................11........................11111111111111111111111111111111 <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. (Ale 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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />