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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit ApplicatiOn <br />Building Department <br /> <br />,C1l\-O I,.:>,-(OU-UU'; \ <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner phone Number I <br /> <br />I <br /> <br />E3 <br />D <br />D <br />YYlObi k hom e., <br />ISQ FOOTAGE I J Lf ?? g <br /> <br />liJ <br /> <br />PROPOSED USE D <br />TYPE OF CO~STRUCTION D <br /> <br />DESCRIPTION OF WORK I hl:.to..\ I <br /> <br />BUILDING SIZE I 3 / X 4 3 <br /> <br />11...,..11.,....""11.."111.....'.....,......11"'11....11'.........,.......11'1111...11.....'....'...11"1111...'11111111111111111'11..11...111 <br /> <br />D BUILDING I$L/~ooo.() b I <br /> <br />D ELECTRICAL 1$ 2 r;o. 0 () 1 <br /> <br />D PLUMBING 1$ 2 5D. 0 lJ I <br /> <br />D MECHANICAL 1$ loW.CO I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11'111"1111111"1""1111"'1111""'1111'1111111'1"'1"1'1111111"111111111"11"111"111"11111""11111"'111"111"'111"1111"11111'1'11"1 <br /> <br />Fee Simple Titleholder Address I <br /> <br />19120 I <br />I G{Qnd l10Yt20Y1 <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISIO~ <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADDIALl <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />OTHER I YYloolle h(\Vhe~ <br />STEEL D OTHER I <br /> <br />HEIGHT I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />D <br />NeG ../ <br /> <br />W.RE.C. <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br /> <br />~:c:'~I~~':~!~ <br /> <br />Address <br /> <br />I ~(~{r,{J~~~:1~ I ~N I <br /> <br /> <br />License # I <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br /> License # <br /> COMPANY <br /> REGISTERED <br /> License # <br />OTHER COMPANY <br />SIGNATURE REGISTERED YIN FEE CURRENT YIN <br />Address License # <br /> <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br /> <br />11111111' 1111' IIIIIIIIIII!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111111111111111111111111111111111111111111111I1I111111111111111111 <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 wi 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 onslte, 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 />II.llll!1111111111111111111111111111111111111111111111111111111I1111111111111111111111I11111111111111111111111IIIIIIIIIIIIIIillllllllllllllllllllll <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 Ale Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />