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<br />813-180-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />sf- <br /> <br /> <br />n <br />Owner Phone Number 3 <br />Owner Phone Number I <br /> <br />Owner Phone Number [ <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I Still <br />I <br /> <br />10 ft. Sf <br /> <br />I <br /> <br />LOT # <br /> <br />I <br /> <br />D NEW CONSTR r-v ADD/ALT D <br />D INSTALL [S;2j REPAIR <br />~ SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK D FRAME CJ <br /> <br />DESCRlPTlON OF WORK I ~)<- ~cj / ,,~J+ &1.;'1(0# '\ \ (\ <br /> <br />BUILDING SIZE I .SQ FOOTAGE I I HEIGHT <br /> <br />'111'1'1' pip II,. 1'1'1'11'1'1 "1 11.1.11.1" III""" III" III" '1.111111"" I., 1111 I".. , I' I'" I" 111'1111... III. II, I, 1'1" 1'.11111 H 1111" I",'"'' <br /> <br />1$ ~'t<p. "'7~tr.6D VALUATIONOFTOTALCONSTRUCTION <br /> <br />1$ I <br />1$ 1 <br />1$ I <br />D GAS ~ ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />PARCEL 10#1 <br /> <br />SUBDIVISION <br /> <br />/1-1& - '^ 1- CK)/O- l-Ik:O.' ~~O <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />D <br />D <br />D <br />D <br /> <br />BUILDING <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />[:JNO <br /> <br />II . . I" I III 1111" I' , I , III , I , III 11111111111 , 11111" · · I" II , , 1111111 .. .. 11111111111111 .. " " .. II , II" 11111111111 .. .. 1"11111111111111111111111 , I 111111 <br /> <br />BUILDER I <br />SIGNATURE <br /> <br />Address L <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> LIcense # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> LIcense # <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 /> <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-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 subdivisions/large projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-Q-W Permit for new construction. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wi 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 />111111111111111111111111111111111111111 , 111111111111111 , 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />- ijJ- ~I ()~ <br />uk to fLJvV'<X-1 <br />-- 11 A J l{urLCK 13,L'0;' <br />/ C,00'- U V <br />