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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-78u-uu:.n <br /> <br />. <br />Date Received <br /> <br /> <br />Owner Phone Number <br /> <br />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 />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I Jg 55"0 <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL F1~r <br />SFR . lb (.... <br />BLOCK <br /> <br />c:. ~r~~' k 1(( <br /> <br />PARCELID#I \\-Z<o~ 21-bO\O-ito900 - DOCoO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />LOT# I <br /> <br />D <br /> <br />P,J;A A Vi- , <br /> <br />I <br /> <br />u. ADD/ALT 0 <br />~ REPAIR <br />c==J COMM c=J OTHER I <br />c==J FRAME c=J STEEL D <br /> <br />DESCRIPTION OF WORK I -r \'\5 6JU J I A JJ'Y1 . f..-/4) 'po ) e k> b '^ \ (J ~ 1\ t <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I <br /> <br />IIIIIII , I I1I1III1IIII111111 " II t II1I t 1111111111 , 11 r IIIII , IIIII , , IIII , , T T , III1I1I1IIIII , IIIII . I , III t . 1111111111111111 r 11111111111111111111111111111 <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />lil <br />c=J <br />c=J <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />1$ '--=:bcJY"\aJ-.ec9 <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />c=J GAS c=J <br />FINISHED FLOOR ELEVATIONS 1 <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <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 />c=J <br />c=J <br />c=J <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />'t\- <br />',. ~~b1~ <br />d I (S1 U1'" <br /> <br />PLUMBING <br /> <br />ROOFING <br /> <br />SPECIALTY c=J <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />~ <br /> <br />3-- "--> <br />- p <br />J'" <br />COMPANY <br />REGISTERED <br /> <br />lEx e.c.uf\\J e..bf~(toR <br />--.orl' YI N I FEECURRENT-' I Y/N <br /> <br />License # I <br /> <br /> <br />License # <br />1I1I111I111I111I111111I111111I111111I111111111II11111111I1I1II1111111I1I111111I1111I11I1II1I1III111111111111II1IIIII1111I11111I111 <br />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 />SanitalY Facilities & 1 dumpster; Site Work Permit for subdivlsionsllarge 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 wI Slit Fence Installed, <br />SanitalY 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 />DI~~~ii~~~~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . , . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , , . , , . . . . . . . . . . . . <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 />Address <br />111111111111111 <br />RESIDENTIAL <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 <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <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 />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />