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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />'1fG/f ~5 <br /> <br />Date Received <br /> <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />/g1'J1 ST <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />OWner's Name <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />5/3;;'/3 <br /> <br />IG7~ Sf <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br /> <br />PARCELlD#1 N - L(r 1-1- DO (0- 2,03do -- 0 170 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SUBDIVISION <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />D <br />D <br />I <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER I 'R ~O -T- <br />STEEL D OTHER I <br /> <br />I I <br /> <br />"'111111111"..1111111111111111"'1'1111111111'1111'.1'1111"'1'1111""'."1'1111"111111"'1'1111111111"1111111111111'1111111111'1'11111"1111 <br /> <br />SQ FOOTAGE I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />D <br /> <br />1$ 560. ~ I <br />1$ I <br />1$ I <br />1$ I <br /> <br />D GAS CKl ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I ,. S-o 0, ~ I FLOOD ZONE AREA DYES DNO <br /> <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <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 />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D <br />D <br />D <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <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 />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />license # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />license # <br /> <br />OTHER <br />SIGNATURE <br /> <br />Q <br /> <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />g--./ . <br />Address . license # <br />I1111I1111111I1111111111111111111111I1111111111111111111111111111111111111II1111I1111I111111111111I111111111I11111111111I1111111111111111111111111 <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 onslte, 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 />SIGN PERMIT <br /> <br />DI~~~ii~~~I: I . I . I . . . I . I I . I . . . . . . . . . . . . . . . . . . . . . . . . . I I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I <br /> <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 />