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<br />813-780-0020 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br />Owner Phone Number <br /> <br />2 Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />lDflA. Ave:- z.. \", \\.3 FL -S5~L/2 LOT # <br /> <br />I PARCELlD#lll~2~ Z'''''~O-O~bco-('')\~\ <br />~ (OBTAINED FROM PROPERTY TAX NOTICE) <br />D NEW CONSTR ADD/ALT D SIGN D MOVE D DEMOLISH <br />D INSTALL REPAIR <br />, <br />PROPOSED USE D SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I I <br /> <br /> <br />;;~~;,;;; ~I~", ,I" ~~:~f? ,~~~~~~r.:", ~~, ":~r.I..;~~~r~~~,~:~,, :r,:~ ,~:: ,I <br /> <br /> <br />D BUilDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY <br /> <br /> <br />~UMBING 1$ If 7f/g;:-- I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111111111111111 111111111111111111111111111111111111111 i 11111111111111111111111111111111111111111111111111 <br /> <br />:~~~RE I I ~= I Y I N FEE ctmR<NT Y I N <br />I <br /> <br />Fee Simple Titleholder Address I <br /> <br />I -3[y'5D~ <br />I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Address; <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />License # <br /> <br />AddreS!1 <br /> <br /> <br /> <br />COMPANY <br />REGISTERED Y/N FEE CURRENT Y/N <br /> License # <br /> ~ ~ I'v\' T-tt:f vv\ <br /> I FEE CURRENT Y/N <br /> License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address License # <br />111111111111 "I 1111111111111111111111111111111111111111111111111111111111. 11111111111111111111111111111111111111111111111111111111111111111111111 <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/ Slit Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivislonsflarge 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 />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />,..............................................,...............................................................................................,.. <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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />