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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Date Received <br /> <br /> <br />~/2 2-60/( <br />~, <br />.ph ?"112.t~ Z~,J.,; I), ~+ OWn., Phone Numbe, I <br /> <br />OWner Phone Number I <br /> <br /> <br /> <br />Fax-813-780-0021 <br /> <br />.*~stff <br /> <br />,... Owner's Name <br /> <br />L <br /> <br />- OWn." Add,... 1?7 C' E <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address I <br /> <br />SUBDIVISION <br /> <br />~tJt ~ ~ktof Z~~h~J)~F/3-3.s-qZ <br />I I PARCELlD#1 <br />B <br />D <br />D <br /> <br />LOT # <br /> <br />- JOB ADDRESS <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />D <br />D <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />00 <br />111 <br />D <br /> <br />MOVE <br /> <br />D <br /> <br />DEMOLISH <br /> <br />.h WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />SIGN <br /> <br />D <br /> <br />I Uup~ <br />D OTHER I <br /> <br />1trnr6 <br /> <br />OTHER <br />STEEL <br /> <br />.. BUILDING SIZE HEIGHT I / "I / <br />1IIIIIIIIIIIIIIIIIIIIIIP'IIIIIIIIIIIIIIII'lllllllll"1'1111111111111111"1""111111111"1'11111111111111111'11111111111111111111111111'1'11111111 <br /> <br /> <br />-iD <br /> <br />1$ 12-0(; t?:!2 I <br />1$ I <br />1$ I <br />1$ I <br /> <br />D GAS [XJ ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO <br /> <br />IIIIIIIIIII(IIIIIIIIIIIII(IIIIIII(IIIIIIIIII! 111111111111111(11111111111111111(1111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />--:~~~~R~">~ ;.~~:-."':.:~ L#m'ic'~~:;:'~ YIN <br /> <br /> <br />Address _ _ License # I <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 />o <br /> <br />W.R.E.C, <br /> <br />D <br /> <br />D <br /> <br />D <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N FEE CURRENT <br /> License # <br />Y/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 />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />License # <br />111111111(11111111(111111111111111111111111111111111111111111111111111111111111(111111111111(11(11111111111111111111111111(1111(11 <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 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 />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />1111.11111.11...........111.111.111,...........1111111.111111...11111......1111.....11111.11........11...111..1111111111.1........................ <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 AJC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />